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Study Suggests Medical Errors Now Third Leading Cause of Death in U.S. (2016)

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Re: Study Suggests Medical Errors Now Third Leading Cause of Death in U.S. (2016)

#161

Post by spaetzleesser »

temp0826 wrote: post #137
marcus0x62 wrote: post #101

Earlier quoted context omitted.

My anecdotal data (which is primarily second-hand from friends who work closely with doctors in a hospital setting) agrees with your anecdotal data, for whatever that is worth. There are some spectacularly bad doctors out there which the medical system provides cover for, mainly, as far as I can tell, because they generate revenue. It is important to understand that in the American private healthcare system, the doct…

I believe this is a big part of it. Anecdotal as well, but my grandmother had a new leadless pacemaker installed for dubious reasons by a doctor that specialized in this particular type of leadless pacemaker. The pacemaker migrated at one point and it resulted in her chest filling with fluid, the removal procedure was very tough on her (leading to other complications on an already frail body) and marked the beginning…

"installed for dubious reasons by a doctor that specialized in this particular type of leadless pacemaker"

That's the problem with a fragmented health system. A lot of doctors are specialists in a certain procedure and want to repeat their pet procedure on every patient they see. I saw this with my ex who had chronic leg pain. Most of the doctors we met just wanted to repeat what they do every day (and makes them good money). There are only a few doctors who have a wide knowledge of the area and can recommend a treatment that actually fits.

Re: Study Suggests Medical Errors Now Third Leading Cause of Death in U.S. (2016)

#162

Post by spaetzleesser »

reader_x wrote: post #111
rscho wrote: post #99

Earlier quoted context omitted.

I gather you are not a healthcare professional, hence the artificial dichotomy stemming from your perception as an outsider. Medical competency is very difficult to assess objectively. You're good/bad because people say so. There isn't any form of performance feedback.

Anecdote here, but my friend who is an anesthesiologist (MD) says:(1) anesthesiologists know exactly who the good and bad surgeons are (they see the outcomes and also must manage fluid loss), and (2) bedside manner by surgeons has no correlation to good surgical technique so patients have no idea.

I work at a medical device company and I also had reps warn me of certain surgeons when I looked for one for a friend.

Re: Study Suggests Medical Errors Now Third Leading Cause of Death in U.S. (2016)

#163

Post by deltaonefour »

Nevermark wrote: post #48
danpalmer wrote: post #18

The US incentivises blaming healthcare providers in order to recoup costs. I'm sure there are issues with substandard care, but I'm not sure the data can be fully trusted given that putting the blame on a healthcare provider in any way possible is often in the best interests of the patient.

I would think that the healthcare industry is very good at avoiding blame and sweeping blameworthy incidents under the rug. I expect the data can't be completely trusted in either direction.

Customer satisfaction is more trust-able.

The incentive for retaliation is simply customer unhappiness. Patients don't just sue doctors because doctors are sitting on a pile of money, people don't behave this way. Most People sue because they are pissed.

However if you caused someones death and don't want to go to jail... well that can be swept under the rug, people actually do behave this way.

Re: Study Suggests Medical Errors Now Third Leading Cause of Death in U.S. (2016)

#164

Post by spaetzleesser »

seren wrote: post #85
sschueller wrote: post #46

Earlier quoted context omitted.

This is insane. These device UIs should be standardized and any manufacturer making a significant UI change to their product should not be permitted to sell it under the same name and number. The FDA should be looking at this before approving such devices for use. Don't aircraft have more or less standardized controls and displays?

As far as I am aware, for every significant UI change we do at the medical device company I am working for, we bring a panel of final users (doctors and techs) to our facility and we have to do some validation tests, and finally show these validation results to the FDA before releasing the product.

"As far as I am aware, for every significant UI change we do at the medical device company I am working for, we bring a panel of final users (doctors and techs) to our facility and we have to do some validation tests, and finally show these validation results to the FDA before releasing the product."

I also work for a device company and a lot of these panel members aren't really competent at giving good feedback because they lack the technical knowledge. And the FDA mostly just checks for completeness of paperwork. They look at the actual product only once there is a problem in the field.

Re: Study Suggests Medical Errors Now Third Leading Cause of Death in U.S. (2016)

#165

Post by giantg2 »

chiefalchemist wrote: post #133
giantg2 wrote: post #127

Earlier quoted context omitted.

There are too many variables. You could have two people with the same diagnosis but one has a complication. Even if you do everything 'right' the success isn't 100% because there are slight variations in people and diseases.

Agreed. All the more reason to look for patterns of what works or what might not. The human body is complex. Why not look for as much help as possible?

Collecting the data to explore is massively different than using it to evaluate individual performance.

Re: Study Suggests Medical Errors Now Third Leading Cause of Death in U.S. (2016)

#166

Post by spaetzleesser »

nradov wrote: post #145
freeone3000 wrote: post #14

Earlier quoted context omitted.

Medical insurer's profits are limited to a percentage of their gross income, so, more expensive medications and procedures are preferred to less expensive ones in order to preserve overall income.

While the Affordable Care Act (Obamacare) did introduce a minimum medical loss ratio, insurers still have a strong incentive to hold down costs by encouraging use of cheaper generic medication so that they can offer lower prices to plan purchasers. Most medical insurance is purchased by employers and other group buyers, and they look closely at costs. In most cases, physicians have to obtain specific approval in orde…

My impression is that they mainly focus on pushing costs to the patient in the form of higher and higher deductibles.

Re: Study Suggests Medical Errors Now Third Leading Cause of Death in U.S. (2016)

#167

Post by ClumsyPilot »

TaupeRanger wrote: post #121
ncmncm wrote: post #71

Earlier quoted context omitted.

We don't know whether it is the case or not. It could just as easily be worse than it says. Probably is. If I had to tell you about all the medical mistakes experienced by just my immediate family, just the facts, I would be at it all day long.

Unless the mistakes led to death that wouldn't have otherwise occurred in a similar timeframe, the anecdotes wouldn't even be relevant.

Medical mistake literally killed my family member by giving her an IV with the wrong drug. She was dead withing 20 minutes.

Re: Study Suggests Medical Errors Now Third Leading Cause of Death in U.S. (2016)

#168

Post by KineticLensman »

jodrellblank wrote: post #125
KineticLensman wrote: post #100

Earlier quoted context omitted.

> Uhm, considering our technological advancement in the medical sector I'd argue "age" should be the only valid cause of death. For this to be true we would have to be able to predict and treat every possible disease and condition, wherever it occurred. When I had my Ventricular Fibrillation event I was lucky that it occurred just outside the door of a place that had a defibrillator. If it had occurred twenty minutes…

> " No amount of credible technological advancement would have saved me then. " Assuming there was a cause of your fibrillation; maybe advancement in imaging and detection could have spotted worsening rhythm or small damage developing in the heart, or growing chemical imbalance in time before it happened, and given you an Implantable defibrillator[1] in advance, or a hypothetical wearable one, or treatment to repair…

> maybe advancement in imaging and detection could have spotted

It's possible that I have hidden Long QT syndrome [0]. Mine can be detected following drug provocation using adrenaline but under normal conditions it doesn't show on my ECG. It is undetectable on MRI or angiograms because it is electrochemical rather than mechanical in nature. There are emerging genetic tests that can pick up some of the possible congenital causes.

> If you were unconscious and wearing a watch with ECG features

Current watches with ECG features don't detect my Right Bundle Branch Block [1], let alone the hidden Long QT.

[Edit]

> and given you an Implantable defibrillator

They are quite expensive to implant prophylactically, create a small risk of infection in the heart itself and require explanting every few years for a battery change. I had one implanted after the event.

[0] https://en.wikipedia.org/wiki/Long_QT_syndrome

[1] https://en.wikipedia.org/wiki/Right_bundle_branch_block

Re: Study Suggests Medical Errors Now Third Leading Cause of Death in U.S. (2016)

#169

Post by GuB-42 »

It may actually be good news. Depending on how the stats are made.

That a death qualifies as a medical mistake means that proper treatment existed. For example let's say that 50% of people die from "the plague". The plague is lethal and untreatable, no medical mistakes can be made because nothing can be done. One day, a cure is found, cheap and 100% effective, unfortunately, the procedure is tricky and as a result, 1 out of 5 times, it is done improperly and the patient dies.

In the end, 4/5 cases survive, which is great news, is used to be zero, but if we look at the share of deaths because of medical mistakes, it has increased a lot.

Of course, it needs to be fixed, but usually, it is something we know is fixable, better than a disease without treatment.

Re: Study Suggests Medical Errors Now Third Leading Cause of Death in U.S. (2016)

#170

Post by giantg2 »

ncmncm wrote: post #76
giantg2 wrote: post #61

Earlier quoted context omitted.

True, but we live in an age where we we trust our lives with computers so that we can do things we couldn't do otherwise. Flight control computers are necessary for most new commercial and military aircraft because they're fly by wire or can be uncontrollable by nature (Max, V22, etc). We're at the point that the FAA and people in general don't care about an inherent instability if the computer can fly it.

The computer was not flying it. The computer was actively fighting the pilot, who was desperately trying to keep it flying, while the computer was forcing it to crash instead. To be clear: with the computer entirely powered off, the plane would have flown just fine. Not exactly like other 737s, but more like them than anything else.

"The computer was not flying it. ... the computer was forcing it to crash instead."

Sounds to me like the computer was in fact in control of the plane if it causes it to crash. The "computer" is the MCAS system that sits between the pilot and the actual control surfaces. This is a fly by wire aircraft.

Yes they could have turned the MCAS off and had it fly ok... if they even knew it existed. Although they weren't trained on the different flight characteristics they would experience with it off either.

"with the computer entirely powered off, the plane would have flown just fine."

Just to be clear, if you had a total computer failure or power down, a fly by wire aircraft could not function. I assume you are only talking about the MCAS.

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