Cancer: Guarding Against Medical Mistakes

If you have cancer, you probably worry about someone making a mistake in your care. It’s hard to ignore newspaper headlines about surgeons removing the wrong leg or breast by mistake, or stories about cancer patients dying after receiving the wrong chemotherapy drug.

Unfortunately, you are right to worry. Hospitals can be dangerous places (for the germs that live there alone), and mistakes like these happen all too frequently.

A few years ago, assertive patients starting writing messages such as “not this one, dummy” on their bodies before surgeries like mastectomies. Now, some hospitals provide the pen and ask surgery patients to label the body part that is to be cut—or the one that should NOT be.

I am especially concerned about a recent study that shows that doctors, nurses, and other staff at hospitals often do not report mistakes they see their coworkers make. The study, released in January 2005, was co-sponsored by the American Association of Critical-Care Nurses and VitalSmarts, a California consulting firm.

The mistakes the researchers documented were not trivial: They included a nurse who watched a colon surgery patient die after the nurse failed to convince a doctor who intimidated her that the patient was in trouble.

Not only were the mistakes documented in the report serious, they were also shockingly common: Eighty-four percent of doctors and 62 percent of nurses and other care providers said they had seen coworkers take short cuts that could endanger patients. And 88 percent of doctors and 48 percent of nurses and other providers said they worked with people who showed poor clinical judgment.

The fact is, if you have a chronic medical condition—which would include many if not most cancer patients—the odds are high, perhaps as high as 50 percent, that you will be the victim of a medical mistake, large or small. This includes patients, like me, who have chosen their doctors and hospitals carefully and are being treated at reputable, leading cancer centers. Mistakes happen. Doctors, nurses, and other medical personnel are human (and often over-worked or sleep-deprived), and they sometimes make errors.

Certainly some “bad apples” are allowed to continue to practice medicine after repeated or serious mistakes. Gag orders prevent people who win medical malpractice suits from talking about their cases, and hospital policies are often designed to keep mistakes by their doctors quiet. In your spare time, if you have the energy, consider lobbying for changes in the law that will make it easier for cancer patients (and others) to get the information they need about dangerous hospitals and doctors with histories of malpractice suits and drug or alcohol abuse problems.

But for now, back to you and what you can do to protect yourself here and now.

This is my position on protecting myself from medical errors: I double-check everything. I keep notes and lists. And I ask questions. This is not paranoia. Nor does it imply a lack of trust or confidence in the people who are treating me.

Rather, it is a pragmatic attitude that acknowledges that medical mistakes do happen, and that I want to do what I can to make sure they don’t happen to me.

Read on for suggestions on how to prevent mistakes during various types of cancer treatment.

@ Jeanne Sather 2006