Denials, deflections, and cover-ups: Why some hospitals and doctors repeat the same mistakes and endanger their patients
Study: 77% of doctors will not admit to medical mistakes
The Washington Post recently published an article about whether hospitals and doctors should apologize for medical mistakes.
I find the article interesting because it really begs a different question—do hospitals and doctors typically even acknowledge that they make mistakes? Sadly, I have to say “no.” Looking back on all the years that I have spent as a Texas medical malpractice attorney, I cannot think of a single instance where a doctor or hospital admitted to a mistake, let alone apologize for it.
From an early age, parents and teachers teach us to say “I’m sorry” when we make a mistake. If someone bumps into you, he will apologize. If a waiter gets your order wrong, she will say she is sorry. If your CPA makes a mistake on your tax return, she will apologize and fix it.
Not owning up to mistakes breeds a culture of danger in health care
When it comes to medical mistakes and malpractice, there is a culture of not admitting to a mistake, not apologizing, and just generally having sealed lips.
This has a profound impact on patient safety and delivering quality health care. If doctors, hospitals, and nurses will not even acknowledge that a medical mistake occurred, then how can they take steps be to prevent the same mistake in the future?
Years ago, I represented the family of a teenager who had been a patient at Children’s Memorial Hermann Hospital, in Houston’s Texas Medical Center. She had an infection that had spread up into her brain and formed an abscess. The surgical team drained the abscess and sent her to a room on the neurosurgical floor.
At first, she was doing fine. Then, after a day or two, her family noticed that she was acting strangely, and they told the healthcare providers about it. We hired medical experts to review the case and they had the opinion that the doctors and hospital did not pay attention to her electrolyte levels—and, in particular, her serum sodium level—and did not give her the proper IV fluids. As a result, her brain swelled up and herniated. This teenager was left with a severe permanent brain injury.
That case was thoroughly studied by both sides, with lots of medical experts who reviewed what happened. We never heard an acknowledgement of any mistake and certainly no apology. I certainly felt that they had made some serious mistakes and hoped that they had learned from them.
And then something happened about six months later that shocked me.
A friend of mine was involved in a bad car wreck. In a chat with his father, I learned that the son had suffered from brain hemorrhaging or bleeding from the wreck. At that time, he was recovering after brain surgery at Memorial Hermann Hospital, in the Texas Medical Center. That got my attention.
I told the dad, “This probably won’t happen with you son, but just in case . . .” and shared with him what had happened in the other case, where the cheap, simple sodium monitoring was not properly done and caused a permanent brain injury. I suggested that he keep an eye on son and to let the doctors and nurses know immediately if he started acting funny, and to ask about his sodium level.
A few weeks later, I received a call and thank you card from the dad. His son had started acting out of character, and the dad spoke up and asked the nurses about it. He asked about his son’s sodium level and insisted on getting it tested again. It wasn’t long until doctors and nurses rushed into the room and started emergently treating the son for low sodium—hyponatremia. It saved his son’s life.
I spoke with a hyponatremia medical expert about that case and he asked, “Did the young man die that day?” He was pleasantly surprised to hear that he survived and was doing well. We can thank his dad for that.
I spoke with a Memorial Hermann Hospital risk manager and told her about this near-disaster, and asked her to get some training for those neurosurgical floors. In short, I asked them to learn from their mistakes—even though they would not own up to them!
Hospitals, doctors, and nurses won’t typically apologize, but often deflect blame
I am not suggesting that the lack of an apology for a medical mistake from a doctor, nurse, or hospital means that they are bad people. It also does not mean that they intentionally made the medical error, or that they are generally incompetent.
In the medical profession, many feel like they will be punished if they say, “I made a mistake and I am sorry.” In fact, a recent study found that 77% of doctors would not disclose certain mistakes. Instead, they will:
Gloss over and evade. They avoid the subject matter, such as a delay in diagnosis, by giving vague answers to questions. Often, a patient will not ask pointed questions for fear of embarrassing the doctor or appearing aggressive.
Clam up. They stop coming in your room. Or they may decline to answer questions in a straightforward way, opting for complicated medical explanations that no one can understand.
Deflect to the procedure. They may say things like, “this was a really complicated procedure and we expected this result.” You might also hear about how things will get better over time or with additional procedures.
Deflect to the patient. Sometimes they try to, in effect, blame the patient. “You really had a lot of problems coming into this surgery that affected the outcome.” Or something along the lines of, “We started the surgery, but then when we got in there, you had a lot of other problems that caused the harm.”
This type of conversation erodes trust and causes frustration.
Painter Law Firm is here to help
Have you or someone you care for suffered from an unexpected injury in the hospital or after treatment by your doctor? Are you getting the runaround when trying to get basic answers from your healthcare providers about what happened? Medical malpractice may be involved.
Call 281-580-8800 for a free consultation with our experienced Houston medical malpractice attorneys about your potential case.
Robert Painter is a medical malpractice lawyer at Painter Law Firm PLLC.
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A physician has to supervise the care and prescriptions of nurse practitioners and physician assistants under written, signed agreements
On 4/1/2018, the new law will end the current practice where doctors can secretly enter a DNR order against patient and family wishes
This article was originally published in the September/October 2017 edition of "The Houston Lawyer" magazine
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