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World Today

Doctors Look for New Ways to Safeguard Against Medical Mistakes

Aired May 18, 2000 - 8:48 p.m. ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

WOLF BLITZER, CNN ANCHOR: Our focus tonight is your health and the realities of modern medicine. Simply put, trips to the doctor aren't what they used to be. Family physicians these days are often part of a large practice, making personal relationships difficult. A fact made more apparent when a treatment goes horribly wrong.

The first of our two reports is on medical mistakes: how they happen, how they can be prevented, and what doctors are doing to take responsibility for their actions.

Here's CNN medical correspondent Elizabeth Cohen.

(BEGIN VIDEOTAPE)

ELIZABETH COHEN, CNN MEDICAL CORRESPONDENT (voice-over): When 7- year-old Ben Kolb (ph) went in for ear surgery, it was supposed to be a quick, simple operation. But during the surgery he went into cardiac arrest and died the next day.

When the staff at Martin Memorial Hospital in Florida did an investigation, they realized they'd made a horrible mistake. They'd injected Ben with the wrong drug, a powerful, highly concentrated form of epinephrine.

(on camera): It's not supposed to be injected.

HAAS: Not supposed to be injected, no.

COHEN: Never.

HAAS: Never.

COHEN (voice-over): Ben was supposed to be injected with epinephrine, but with this kind, a solution 1,000 times weaker than what he was given. When poured into sterile containers used in the operating room, the two drugs look exactly alike.

(on camera): After a tragedy like this, it's human nature to look for someone to blame, an individual doctor or nurse. But here at Martin Memorial, they looked for what was to blame, what had gone wrong with the system.

(voice-over): They made two important changes. Two staff members must now be present when medicines are transferred from labeled bottles to the syringe or container the surgeon will use. And they've instituted a better labeling system in the operating room.

Martin Memorial settled out of court with Ben Kolb's family. Donni Haas is head of risk management at the hospital.

HAAS: We had a procedure that was flawed, and that procedure placed Ben in jeopardy, and it placed our practitioners in a situation where error occurred that they will carry with them for the rest of their life. They will never forget that.

COHEN: This week, the American Hospital Association is sending out a guidebook to help all hospitals identify procedures that might be prone to errors. And the association has sent out a video, where medical professionals talk openly about mistakes.

Dr. John McLain, Ben Kolb's anesthesiologist, appears in the video.

JOHN MCLAIN, ANESTHESIOLOGIST: We were very forthright with the family. And we said, look, your son got the wrong drug. We're responsible. What can we do to help you?

COHEN: Now Martin Memorial serves as a model for hospitals across the country, teaching the lesson that to learn from mistakes you have to own up to them first.

Elizabeth Cohen, Stuart, Florida.

(END VIDEOTAPE)

BLITZER: Anyone who has tried to read a prescription will understand one new idea designed to improve medicine: better handwriting. Cedars-Sinai Medical Center in Los Angeles recently held a penmanship class for some of its doctors to help nurses and pharmacists decipher the sometimes cryptic scribbles on charts and prescriptions and to avoid the chance a patient might be given the wrong medication.

When mistakes happen, medical errors, or what a patient might perceive as an error, often become lawsuits. Malpractice suits against doctors come with the job, but an increasing number of physicians are deciding the job may not be worth the trouble.

Here's CNN's Bill Delaney.

(BEGIN VIDEOTAPE)

BILL DELANEY, CNN CORRESPONDENT (voice-over): The shadow on the brightly lit hallways of every hospital in the country is lawsuits.

DR. GARY KRAUS, OBSTETRICIAN/GYNECOLOGIST: The average obstetrician in Massachusetts will be sued five times in her career. And since most suits evolve over a six- to eight-year period, one would assume that at all points of the career the doctor is in the midst of some phase of a lawsuit. DELANEY: Why about a year ago now Massachusetts gynecologist Dr. Gary Kraus decided to fight back. Himself sued unsuccessfully three times in his 30 years as a doctor, Kraus enlisted his insurer, a company called Pro-Mutual, to perform an evaluation for him to determine how he could break out of his large, lucrative but impersonal group practice to partner with just one other doctor. The idea: to discourage lawsuits simply by spending more time with patients -- the way it used to be.

KRAUS: In the past, it was much better than what we have now. The patients loved their doctors. And because of this and the dedication and devotion that the doctors would spend with the patient, to sue such a person would be like suing a parent.

DELANEY: One doctor's idealistic vision in what for many, though, can seem a cynical age.

Last year, 19,039 patients sued their doctors, amounting to $3.7 billion in claims.

(on camera): One result of which is that many of us apparently now routinely face doctors who may not want to be there at all. In a recent survey, 31 percent of doctors said they'd choose another profession if they could start over.

(voice-over): A figure unsurprising to the special breed of psychiatrists who specialize in counseling doctors, like Dr. Miguel Leibovich of Cambridge, Massachusetts. He says what particularly demoralizes his patients is that three-quarters of all lawsuits against them never find any negligence.

DR. MIGUEL LEIBOVICH, PSYCHIATRIST: It's something like a knife in their hearts. So their surprise is why people are doing this? There are a lot of reasons, I think, but sometimes it's greed. And we know that. People wish to make some money.

DELANEY: Besides trying to shrink and personalize their practices, some doctors are also trying to fight back by learning mediation skills at workshops like this one outside Boston, trying to head-off problems before they get to the lawyers.

LEONARD MARCUS, HARVARD SCHOOL OF PUBLIC HEALTH: Physicians haven't been trained in models and methods of conflict resolution. And what we're hoping to do is give people tools of resolution, so that it really doesn't get to the level of effecting the quality of patient care.

DELANEY: How doctors' stress effects patients, how many mistakes are caused by it, hard to say, but perhaps the most chilling questions of all.

Bill Delaney, CNN, Boston.

(END VIDEOTAPE)

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