Note: Unfortunately the links below are now dead.

 

Your Life In Their Hands

From the Radio Times article 30 September - 6 October 2000

Medical errors have always made headlines but few people realise the sheer scale of the problem - accurate figures are difficult to come by but both British and American studies suggest that around 1 in 25 patients in hospital is harmed as a direct result of medical error. Most of these, thankfully, will be minor, but around a third of mishaps result in some form of long term disability or death. Translate these fractions into hard figures and the scale of the problem quickly becomes apparent. There are approximately 10 million hospital admissions in the UK every year which means, assuming a universal 4% risk of medical mishap, that as many as 400,000 people could be injured in some way by their doctors or nurses - 56,000 of whom will be killed.

A risk that compares poorly with other activities perceived as dangerous - .... Hospitals, on the other hand, don't scare most people but maybe they should! Data from the States suggest that patients admitted to a typical acute care hospital have a 1 in 200 chance of being killed as the result of a medical or nursing cock up - and there is nothing to suggest that things are any better here, indeed they may well be worse......

From:

From:

http://www.surgerydoor.co.uk/level2/Radio%20times%20archives/docmistake.shtml

 

BMJ VOLUME 329 14 AUGUST 2004

 

BMJ 2004;329;369-

doi:10.1136/bmj.329.7462.369

Paul Aylin, Shivani Tanna, Alex Bottle and Brian Jarman

 

Dr Foster’s case notes

How often are adverse events reported in English hospital statistics?

 

It has been suggested that an estimated 850 000 medical errors occur in NHS hospitals every year resulting in 40 000 deaths.

 

We will have missed some conditions arising as a complication of treatment not specifically coded as an adverse event (for example, pulmonary embolus following surgery or stroke following carotid endarterectomy). Hospital acquired infections are also poorly represented within ICD-10 (there is no specific code for methicillin resistant Staphylococcus aureus, MRSA).We have not included obstetric complications, and there may be additional codes that might be used.

 

http://www.bmj.com/cgi/reprint/329/7462/369.pdf

 

 

BMJ VOLUME 322 3 MARCH 2001 bmj.com

 

BMJ 2001;322;517-519

doi:10.1136/bmj.322.7285.517

 

Adverse events in British hospitals:

preliminary retrospective record review

Charles Vincent, Graham Neale, Maria Woloshynowych

 

Abstract

Objectives To examine the feasibility of detecting adverse events through record review in British hospitals and to make preliminary estimates of the incidence and costs of adverse events.

Design Retrospective review of 1014 medical and nursing records.

Setting Two acute hospitals in Greater London area.

Main outcome measure Number of adverse events.

Results 110 (10.8%) patients experienced an adverse event, with an overall rate of adverse events of 11.7% when multiple adverse events were included. About half of these events were judged preventable with ordinary standards of care. A third of adverse events led to moderate or greater disability or death.

 

 

In this pilot study about 10% of patients admitted to acute hospitals experienced an adverse event

 

About half of the adverse events were preventable with current standards of care

 

A third of these events led to moderate or greater impairment [including death]

 

6% led permanent impairment

 

8% contributed to death

 

http://www.bmj.com/cgi/reprint/322/7285/517

 

Reporting during the study:

 

By Lois Rogers

 

Medical error is the third most frequent cause of death in Britain after cancer and heart disease, killing up to 40,000 people a year - about four times more than die from all other types of accident. Provisional research figures on hospital mistakes show that a further 280,000 people suffer from non-fatal drug-prescribing errors, overdoses and infections. The victims spend an average of six extra days recovering in hospital, at an annual cost of £730m in England alone.

 

A pilot study investigating the issue - the first attempt to measure the problem in Britain - shows that one in 14 patients suffers some kind of adverse event such as diagnostic error, operation mistake or drug reaction. Charles Vincent, head of the clinical risk unit at University College London, who is leading the study, has pioneered efforts to examine the extent of clinical errors in Britain. His team has so far concentrated on two London hospitals. The first data from one hospital showed that 32 out of 480 patients in four different departments were victims of hospital mistakes.

 

Vincent's estimate of 40,000 deaths comes from studies showing that 3-4% of patients in the developed world suffer some kind of harm in hospital. For 70% of them the resulting disability is short-lived, but 14% subsequently die. "It is a substantial problem," Vincent said. "There is a need to find out the true extent of error, what kind of things are going wrong and the cost." He believes the death rate may be even higher than indicated by the preliminary figures.

 

Britain's death rate is comparable to that in America............

 

http://www.sunday-times.co.uk/ news/ pages/ sti/ 1999/ 12/ 19/ stinwenws02011.html?1281951

 

Accessed from:

 

http://articles.mercola.com/sites/articles/archive/2008/01/02/doctor-error-mistake-kills-patients.aspx

 

 

 

 

Note that the UK and US experiences had different accident and death percentage figuress but resulted in comparable overall fatality rates.

 

 

 

From The Times

August 13, 2004

Blundering hospitals 'kill 40,000 a year'

·  One in ten treated by NHS falls victim to errors, officials admit

By Nicola Woolcock and Mark Henderson

 

ONE in ten patients admitted to NHS hospitals will fall victim to medical errors, which have now become Britain’s fourth-biggest killer.

Medical accidents and errors contribute to the deaths of 72,000 people a year, and they are directly blamed for 40,000. They also cost the NHS £2 billion in increased hospital stays alone.

However, fewer than a third of an estimated 900,000 annual mistakes are properly reported, an independent audit reveals today.

The report by the healthcare research group Dr Foster highlights both the scale of medical error in the NHS and the extent to which the system for reporting them is failing.

Roger Taylor, research director of Dr Foster, said: “Compared with the transport industry, the number of errors causing very high levels of death is extraordinary.”

Action Against Medical Accidents, a charity which helps victims of medical negligence, said: “The research confirms our experience of an alarming rate of errors occurring in our NHS. The figures do not even include errors occurring in primary care, such as in GPs’ surgeries, and are likely to be significantly less than the actual rate as they are only based on reported errors.........

The Dr Foster study, which is published today in the British Medical Journal, shows that the number of mistakes to which NHS hospitals openly admit is a small fraction of the total accepted by the Government’s patient safety watchdog.

It found that only 276,514 errors were recorded each year by English hospitals, even though the National Patient Safety Agency (NSPA) puts the true figure at closer to 900,000.

Approximately 25 per cent of errors occur during surgery, and another 25 per cent in diagnosis or pre-care. The other half of all mistakes are made during treatment on the ward. They can range from providing patients with inadequate nutrition to prescribing the wrong dose of medication.

The figures do not include any hospital-acquired infections or complications of childbirth, and almost 10 per cent of the trusts surveyed claimed an unlikely error rate of zero.......

“We need to increase pressure and encourage organisations to make this a top priority. People would be concerned about flying with an airline which had two crashes. That’s an infinitessimal risk when compared with a problem of this magnitude. It’s an absurd situation.”

Research around the world has indicated that most hospitals have an error rate of about 10 per cent, and that about half these incidents could have been prevented.

Dr Foster analysed more than 50 million “episodes” of patient care, defined as a period spent under the supervision of one doctor, and found 276,514 were recorded as involving an adverse event. This rate of 2.2 per cent clearly underplays the true extent of the problem, the researchers said.

The NPSA estimates that medical errors contribute to around 72,000 deaths each year, making them the fourth leading cause of death after cardiovascular disease, cancer and respiratory conditions......

NHS trusts are now required to have a “no-blame” reporting system for adverse events involving error, but doctors and experts said this is not yet working smoothly.........

Edwin Borman, deputy chairman of the British Medical Association consultants’ committee, said: “These findings are not a surprise. We have to crack this issue of reliable reporting........

A spokesman for the Patients’ Association said: “We must have confidence that any harm to patients is avoided but with such poor recording, including not having specific records for MRSA or other hospital-aquired infections, the figures suggest the tip of a much bigger iceberg.”

http://www.timesonline.co.uk/tol/news/uk/article468980.ece

Sick people die in hospital. Shocking.

Next they'll be telling us that dead people are found in cemetaries.

Better lock yourself into your car Mr B. They'll never get you there.

EO

> Take care
> Sick people die in hospital. Shocking.
> Next they'll be telling us that dead people are found in cemetaries.
> Better lock yourself into your car Mr B. They'll never get you there.
> EO

You've totally missed the point. People go into hospital with minor ailments, and are carried out in a shroud after dying from C. difficile or some other super bug. The number of people dying from super bugs vastly outnumbers the number dying on the roads. So why aren't council do-gooders putting effort into that? Oh yes, they can't use cameras to milk patients for money.

> You've totally missed the point.

Actually, that would be you.

People go to hospitals because if they didn't they would die. As such, they are willing to accept the risk that comes with emergency medicine, like surrounding themselves with very sick people, or putting themselves in the care of a very overworked junior doctor who prescribes potentially-deadly medication.

People do not go to the shops or to work out of such life-and-death need. As such, they are not willing to accept the risk of death on the roads that the anti-safety brigade seem so keen to preserve.

>> You've totally missed the point.

> Actually, that would be you.

Actually, that would be you.

Yes, people go to hospitals because if they didn't they would die. As such, they are willing to accept the risk that comes with emergency medicine, like surrounding themselves with very sick people, or putting themselves in the care of a very overworked junior doctor who prescribes potentially-deadly medication.

 

BUT WE AREN'T TALKING ABOUT THEM!

We aren't talking about people having high risk, low survival chance, bleeding edge, potentially life saving emergency operations or treatment

People do not go to the out-patients clinic or to hospital for a minor operation or routine treatment out of such life-and-death need. As such, they are not willing to accept the risk of death on the operating table, from something like the oxygen being turned off in error, or from routine treatment, such as a treatment needs to be safely injected into a vein, being lethally injected into the spine, that YOUR anti-safety brigade seem so keen to preserve.

As for people do not go to the shops or to work out of such life-and-death need, actually, if they had to do it on cycle, horseback or shanks pony, vast numbers would die as a result.

People out there in the real world are full aware of the fact that it is only the motor car that enables modern society to survive.

London was congested to gridlock when when it was a fraction of its current size and people travelled a fraction of the distance they do now.

By horse traffic!

And thousands died from the esnuing disease.

At the turn of the last century massive radial, grid and orbital road systems were proposed to alleviate this gridlock.

Put on the back burner due to the First World War, Depression, and then World War two, they were eventually ressurected as a FIVE ring motorway orbital system.

 

Now, with London having grown massively, along with the country, and commuting, travel and transport vastly more, all that is left of those proposals, put forward to deal with Victorian and Edwardian horse traffic, a merging of rings three and four, the, M25, might struggle to cope, but, thanks to the motor car, it does cope.

Without the car, even if we walked, we's be walking across the roofs of gridlocked Hansom Cabs!

As such, they ARE so keen to preserve modern society to the extent of tolerating the relatively tiny death toll on the roads!

 

The facts speak for themselves:

The vast majority of adults not only drive, but feel that limits on main roads are too low.

Whatever they say to pollsters.

 

> The vast majority of adults not only drive, but feel that limits on main
> roads are too low.
>
> Whatever they say to pollsters.

Ah, yes, those professional pollsters. What do they know about gauging public opinion?

Whereas you, Mr Mann of the People, have your finger on the pulse of society. Despite apparently never having actually got off your backside to do anything. And despite the fact that you can empty a bar by the very dread that your appearance would instill, so it is very unlikely that you would ever actually hear what people really think about anything. Nonetheless, you just intuitively know what everyone is thinking about everything. And if they aren't thinking it, you know that they should be thinking it.

Errrrrrrrrrrrrrrrmmmmmmmmmmmmmmmmmmm

 

Two well known facts, clearly not know by you:

 

Most people lie to pollsters and tell them what they think is the PC "correct" answer.

 

Most people break the limit where it is safe to do so.

 

 

>> You've totally missed the point.

>Actually, that would be you.

No.

>People go to hospitals because if they didn't they would die. As such, they are willing to accept the risk that comes with emergency medicine, >like surrounding themselves with very sick people, or putting themselves in the care of a very overworked junior doctor who prescribes >potentially-deadly medication.

>People do not go to the shops or to work out of such life-and-death need. As such, they are not willing to accept the risk of death on the roads >that the anti-safety brigade seem so keen to preserve.

Do you have a clue what you are talking about?

Do some reading and you will find out that the UK has a serious problem with hospital acquired infections, and no I don't think it is acceptable to go into hospital for a minor ailment and die from a bug caught in a dirty ward. It is nothing to do with being surrounded by sick people, and everything to do with poor infection control. One cause is a slavish adherence to government targets which distort the nature of service delivery. (According to doctors and senior medical practitioners who know far more than you.) And check up and you will find that the problem is MASSIVELY worse than 10 years ago.

Basically if you create a target, which you need to achieve to get funding, then you will always achieve that target, but by cheating. Here is an example. My late mother was given an appointment for a cataract operation. She had to cancel due to illness. So they gave here a new appointment. According to statistics she waited 2 months for her appointment, which was the time from the cancellation to the operation. Actually the time she waited from first consultation to operation was over 5 years. That is how faceless bureaucracies twist the truth to achieve targets.

"death on the roads that the anti-safety brigade seem so keen to preserve"

Yes, you mean local councillors who are obsessed by revenue generation at the expense of road safety then. Well, let's hope that they improve soon.

You really are an uneducated fool. And since I never argue with a fool, I will not respond further.

> Most people lie to pollsters and tell them what they think is the
> PC "correct" answer.

Amazing that, isn't it? For at least two reasons.

First because you would have thought that pollsters -- you know, the people who actually work in this area rather than pontificating from the depths of their ignorant armchairs -- might have figured that out and been able to compensate for it if it were a significant effect.

And second because I am sure I have heard you claim that the liberal left are actually a small minority of the population, and "real people" have no time for their trendy nonsense. Strange that these real salt-of-the-earth types who stand no nonsense from anyone would completely lose their nerves when confronted with an opinion poll, an opportunity finally to let the World know what real people think, and opt for the PC correct answer.

Or maybe you are just talking through your backside. Again.

> > Most people lie to pollsters and tell them what they think is the PC "correct" answer.

> Amazing that, isn't it? For at least two reasons.

> First because you would have thought that pollsters -- you know, the people who actually work in this area rather than pontificating from the depths of their ignorant armchairs -- might have figured that out and been able to compensate for it if it were a significant effect.

 

Firstly, the job of the poollsters isn't to establish the truth.

Firstly, the job of pollsters is to get the results their clients pay them for.

 

Secondly, how do you know I'm pontificating from the depths of my armchair, ignorant, or otherwise?

In fact, secondly, how do you know that I'm not a person who actually works in this area!

Anyone would think youi were pre-judging me.

Do you know what that makwes you?

 

And thirdly how do you know that they haven't figured that out.

Thirdly, how do you know that they haven't been able to compensate for it if it were a significant effect.

 

But what do you expect them to do?

Publish a poll that says we interviewed a thousand people and two thirds of them actually thought that no, actually, we aren't that bothered about "poor defenseless lobsters being cruelly tortured to death, squealing in agony, and pain, by nasty evil, people who are prepared to boil living creatures alive for their selfish pleasures"!

Or publish a poll that says we interviewed a thousand people and two thirds of them said, that they were really bothered about "poor defenseless lobsters being cruelly tortured to death, squealing in agony, and pain, by nasty evil, people who are prepared to boil living creatures alive for their selfish pleasures".

But we know that half of them will be lying and that actually of the thousand people we interviewed two thirds of them said or actually thought, that no, actually, we aren't that bothered about "poor defenseless lobsters being cruelly tortured to death, squealing in agony, and pain, by nasty evil, people who are prepared to boil living creatures alive for their selfish pleasures"!?!?!?

 

Oh, and we haven't even got to your second point!

> And second because I am sure I have heard you claim that the liberal left are actually a small minority of the population, and "real people" have no time for their trendy nonsense. Strange that these real salt-of-the-earth types who stand no nonsense from anyone would completely lose their nerves when confronted with an opinion poll, an opportunity finally to let the World know what real people think, and opt for the PC correct answer.

Errrrrrrrrmmmmmmmmmmmmmmmmm

Firstly, most people make an excuse (lie) to avoid the pollster, or just quickly give them what they think they want to hear to get rid of them (lie again).

Very few, regardless of how "down to earth they are" will tell them where they can go, or put their poll.

Secondly, how many people, regardless of how "down to earth they are",  will want to upset other people, or look bad in their eyes, even if they disagree, or don't liike, them.

Think about how many people allow salesmen to visit, and even sign up for stuff they don't want.

If, for instance, you had the faintest idea of how such people work, you would know that they, or their telephone teams, triple, or even quadruple, book their appointments, because most people don't like to say no to another person, even over the phone. But so many will ring or write to cancel that they will be lucky to be left with one appointment per slot, and if they ever get two they will have plenty of empty slots to reschedule them into.

How many people, for example, vote for the BNP? But how many people will admit that in public company?

Or think about how many people, and how often, feel obliged, if they do dare to say anything that "liberals" might not agree with 100%, feel obliged to excuse it, and defend themselves, with a comment along the lines of I'm nopt racist and have a lot of whatever friends, but.......

So clearly, it is you who:

Are just talking through your backside. Again.

Can't be bothered with most of that, but here are a couple of lowlights.

> Secondly, how do you know I'm pontificating from the depths of my armchair,
> ignorant, or otherwise?
>
> In fact, secondly, how do you know that I'm not a person who actually works
> in this area!
>
> Anyone would think youi were pre-judging me.
> Do you know what that makwes you?
>
Well, maybe you do work in that area. And all the times you droned on about being a civil engineer, you were lying. Who knows. In fact, given how little of substance you know about even the things in which you claim to be an expert, who cares.

> How many people, for example, vote for the BNP? But how many people will
> admit that in public company?

Ah, you do have a point there. Some fraction of the people who display ludicrous nasty right-wing behaviour do actually have sufficient intelligence and conscience to be embarrassed by their own actions. You are just not one of them, probably because you lack both of those personal attributes.

And if you think I'm lying:

http://www.theregister.co.uk/2007/11/06/radiohead_comcast_stats/

 

What makes a bad poll?

Political polling is badly served by people unwilling to tell the truth (ironically given what the public say about politicians fibbing). This became acute in the late Thatcher/John Major era when fewer people were prepared to admit to pollsters that they were Conservatives. This helped to give the Tories artificially low poll ratings that then made it even more embarrassing for people to say they were going to vote Conservative (on top of the perceived stigma of being associated with the "nasty party").

This "spiral of silence" meant that "shy Tories" went underreported and helped to mess up the opinion polls (not least because they were more likely to vote). Perhaps New Labour may become similarly socially unpopular. A bad poll also asks loaded questions. Thus asking the public of they're willing to join the euro would probably get a different response to one where they were asked if they were willing to give up the UK's independence to join the euro. Similarly, human beings are naturally more inclined to say "yes" than "no" so, again, questions have to be framed carefully.

http://www.independent.co.uk/news/uk/politics/the-big-question-how-much-faith-should-we-have-in-political-opinion-polls-421377.html

 

More on why Hillary won when the polls said that she wouldn't.

My two leading theories were the Bradley Effect (people say they are going to support a black candidate then don't) and the Spiral of Silence (people are embarrassed to tell a pollster they really supported Hillary not Obama).

http://timesonline.typepad.com/comment/2008/01/more-on-why-hil.html

 

When yes means no

By Mori's own admission - its latest poll findings - the public remains unconvinced.

But that may not be entirely its own fault. After all, one of the hardest-learned lessons from 1992 was that of the so-called built-in Labour bias. Many of those polled said they would vote Labour when, in fact, they had no intention of doing so.

This type of denial was still apparent long after Mr Major's victory. Several post election surveys found more people claiming they voted Labour than could possibly have done. It's a similar phenomenon to when a ropey pop song occupies the number one slot for weeks on end and yet no-one you know will admit to buying it.

In other words, it's not just pollsters, cabinet ministers and journalists who lie. Ordinary people do too.

http://news.bbc.co.uk/1/hi/uk/263494.stm

 

http://www.cimt.plymouth.ac.uk/resources/topics/art001.pdf

 

In order to counter the predictable, and reasonable, charge that people often lie to pollsters, giving them answers that they think are more socially or politically respectable than what they truly believe, the Brookings researchers........

http://www.49thparallel.bham.ac.uk/back/issue7/brooks.htm

 

 

And even if people didn't lie to pollsters, because people who are of the right, or even of the centre, are so afraid of receiving the kind abuse I get from frothing at the mouth "anti" nazi leaguers, and the like, they are much more likely to simply decline to answer the poll than those who are neutral or positive toward the "liberal" options, therefore you get an instant sampling bias!

 

 

And I thought it would be hard to find some both more ignorant.

And more arrogant.

Than my old mate FW!

 

I know you don't read what I write.

But do you ever read anything?!