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Medical mistakes: A legal and ethical dilemma for doctors and patients

John Hawley had surgery in late January of 1998  

Ask John Hawley about medical mistakes, and he'll tell you how he lost half a lung to a misdiagnosis of cancer. Ask his wife, and she'll tell you about the fear that she felt through the ordeal. They'll both tell you they were stunned that his doctors never told them about the mistake.

Experts say medical mistakes occur all the time, and doctors often fail to tell patients about them. A recent report estimates that up to 98,000 patients a year die from medical errors.

Hawley, a retiree from the U.S. Navy, went into surgery in late January 1998 at Lawnwood Regional Medical Center in Fort Pierce, Florida. Half of one lung was cut out, and tissue was sent to the pathology lab for a follow-up analysis.

For the year following the surgery, the Hawleys say they lived in fear, worrying that John's cancer might reoccur. The Hawleys say they were astonished to find out that allegedly the doctors had known, but had not told them, that the post-surgery pathology lab analysis had revealed that Hawley apparently had been misdiagnosed with cancer.

"I was tickled to death for about 30 seconds," says Hawley, "then I got really mad, figured that I went through all of this pain and been drug through everything, and back for appointments to see the people who done it, and they never mentioned a word to me. And I was pretty mad."

Hawley is suing Lawnwood hospital and some of its doctors. All the defendants declined to comment, citing the lawsuit.


"We know that even when doctors are aware of errors causing injury -- and usually they're not aware -- only about one time in four in some studies were patients actually told that an injury has occurred. And I actually suspect the number's lower than that," says Dr. Don Berwick of Harvard's Institute for Health Care Improvement.

Dr. Nancy Dickey of the American Medical Association says most injuries are not caused by negligence, but by competent doctors working in complex, sometimes flawed systems. She does acknowledge that doctors are reluctant to confess to mistakes -- for fear of lawsuits.

"I believe the education process tries hard to identify errors and use them as learning experiences," says Dickey. She adds, "Unfortunately I think there is . . . a liability message that says don't tell anybody anything, lock the file down and pray that nobody sues you before the statute of limitations is over."

President Clinton has proposed nationwide mandatory reporting of medical errors as a way to hold hospitals and doctors accountable. Tune in to CNN & TIME Sunday at 9 p.m. ET to see why this may not be the answer to breaking doctors' code of silence.

Medical errors kill tens of thousands annually, panel says
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Study: Drug reactions kill an estimated 100,000 a year
April 14, 1998
Report: Deaths from medication errors on increase
February 28, 1998

National Patient Safety Foundation
National Academy of Sciences Institute of Medicine
AMA - American Medical Association Home Page

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