The Institute of Medicine reports that the average patient experiences at least one error every day he is hospitalized. The annual death toll from medical errors is estimated at 44,000 to 98,000 Americans. How can you protect yourself or a loved one from a dangerous mistake? Learn how one woman discovered that her doctors had covered up a serious surgical error they made when she was a teenager.

Guests: Janet Lynn Mitchell, a patient’s right’s advocate and author of Taking A Stand. Her Web site is http://www.janetlynnmitchell.com/

 Pierce Scranton, MD, an orthopedic surgeon in private practice in Seattle, Washington. He has been team physician for the Seattle Seahawks and president of the American Orthopedic Foot and Ankle Society. He is author of a novel, Death on the Learning Curve. His Web site is: http://www.piercescranton.com/

Here are Dr. Scranton's questions:

Top 10 Questions to Ask Your Doctor Before Accepting Medical Treatment

How long have you been in practice?

What is your experience in treating this condition?

What are the treatment options, and what other options are available that you or the health plan are not offering? If you don’t understand the doctor’s basic explanation of your condition and treatment, then by all means ask him or her for more information.

What are the possible complications of the proposed medical treatments or surgeries?

If there are any complications, how will you correct the problem?

Aside from your own partners, who would you go to for medical treatment if you had this condition?

Are you personally going to perform the surgery?

Will others assist and participate, in a major way, in this medical treatment?

Can I ask your bookkeeper what my financial responsibility will be? You need to know in advance…and don’t be afraid to negotiate!

For a printable, pdf version of the top ten questions designed by Larry Miller, go to What Ails You.

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  1. DH
    Reply

    About ten years ago I experienced severe enough pain in my knee to ask a work colleague for a referral. She recommended a local sport medicine orthopedic doctor her high school daughter had seen for a sports injury.
    After reviewing an MRI of my knee, the doctor had me standing in a busy corridor, looking at the MRI, with people all around, while he explained that (1) I might need my leg amputated, due to necrosis (dead tissue), or, (2) at the very least, I would need surgery (though he did not say what kind of surgery). He then recommended I take Fosamax.
    I went home and listened to my instincts, which said this doctor was incompetent and, at the very least, had treated me with disrespect.
    I talked with nurses from local hospital ER department and quickly learned the name of the expert “knee” doctor whom all agreed was excellent. I waited a month to see him. He looked at my MRI and examined me and then told me: (1) my knee had hurt because I had increased my exercise, (2) there was no necrosis (dead tissue) in my knee, and (3) I would never need surgery on my knee.
    Meanwhile, I could find no information on labeling for Fosamax that seemed in any way related to my knee pain. Finally, I called the pharmaceutical company and talked with a medical expert who worked with the drug, which is usually prescribed for bone loss from osteroporosis. I asked if there were any trials or new clinical information about using Fosamax for anything not listed on drug info insert, or about my condition of knee pain. He said no, he had never heard of anyone prescribing this medicine for what I described.
    I have two more pieces of this story. First, when I went to my regular doctor for a yearly checkup and told her which doctor I had originally seen, she exclaimed “oh you should have asked me, I would have told you not to see that man!”.
    And, finally, I happened to be talking with a staff person from the original doctor’s clinic, someone who had no idea I had ever heard of this man much less seen him as a patient. This staff person revealed that he had left his employment because he knew that the physicians intentionally lied to patients about false conditions in order to get more business. I was deeply sad to hear this.
    Be careful, beware, never assume anything, and trust no one, at least not initially, is my advice to you. About any physician regarding any condition or problem.
    And, by the way, this man is still practicing medicine. I imagine his patients are new or naive or have never learned about his unethical conduct or mis-diagnosing.

  2. SL
    Reply

    I developed serious dry eye following blepharoplasty. Before the surgery I asked the surgeon about possible bad outcomes and he said infection and scarring of which he had neither in his practice. I read the American Academy of Ophthalmology pamphlet he provided which said the eyes may feel dry at first after surgery but this generally disappears as the eyelids heal.
    Nothing I ran across on the internet alerted me to the seriousness of dry eye or the fact that I was a poor candidate. Apparently dry eye is not an uncommon outcome. Had I known to research dry eye,I would have learned that post-menopausal women (I was 68) who have an under active thyroid (I have taken Synthroid since 1997) should be especially cautious about this surgery.
    A careful surgeon will first perform tests to evaluate the patient’s tear production and quality of tears. My surgeon did neither. I continue to see articles about the advantages of this surgery but they mention only the positive aspects. The surgery occasionally causes blindness and I have never seen that reported. I have written The New York Times and the Washington Post medical writers to ask them to let the public, especially older women who have thyroid disease, know that dry eye may develop following eye lid surgery and that it is important to be evaluated for dry eye before surgery.
    I did not receive responses so I hope your site may help someone avoid this truly miserable (and expensive: Restasis, drops, special glasses, lid cleansers, humidifiers etc.) outcome. My doctor keeps telling me to “hang in there” as there is “lots in the pipe line” but so far, nothing truly beneficial is available.

  3. Philip G.W.
    Reply

    Dozens of heartbreaking events like these happen everyday and yet the states are passing “tort reform” which limits the recovery from hospitals and doctors for malpractice cases. In Texas the limit is now $100,000.

  4. anne
    Reply

    Love your shows, thank you. Please do a show on torte reform to balance this show. I am training to be a PA, and I believe that it will be harder and harder to find good medical care as the cost of defending well intentioned– and not so well intentioned –litigation grows exponentially, and good practitioners leave this field due to malpractice suits.

  5. Lynn
    Reply

    Much of the information on the show was excellent. My issue is affordability. Many in your audience are un or under insured and have limited incomes. There was no discussion of the economic realities of seeking second or third opinions and the additional diagnostic testing this may incur. Most employer provided insurance plans will cover one second opinion but not three or four. Travel to another city for an appointment is also expensive.
    A patient’s financial resources affects his ability to pursue alternatives. It also reinforces the power imbalance between patient and physician. Your shows should at least acknowledge that approximately 20% of us have economics as a major barrier.
    PEOPLE’S PHARMACY RESPONSE: THAT IS CERTAINLY A DIFFICULTY THAT MAY BE TOUGH OR IMPOSSIBLE TO OVERCOME.

  6. CMB
    Reply

    My 78 year old husband recently went into the hospital for a planned gall bladder operation that failed. During the two and a half days that he was there, he did not receive his heart medications despite the fact that we repeatedly asked about them and were assured that the doctor had everything under control. He was receiving IV, and we asked if meds were being delivered through the IV.
    Again we were assured all was well. As we were preparing to leave the hospital, my husband’s defibrillator fired twice, almost knocking him to his feet and signaling a problem with his heart. When the nurse found his blood pressure and heart rate to be normal, she said we could leave. I told her he had suffered two heart attacks previously with perfect BP and insisted on seeing the charge nurse and the attending physician.
    The physician was in surgery; his assistant checked with him and confirmed that he had not received the heart meds during our stay. The doctor told me to give my husband the heart med when we got home (3 1/2 hours away). Even though I told them I did not feel we should be leaving and insisted on the heart medication before we would leave, the doctor gave us one dose of heart medication and discharged us.
    Three hours later, on arrival home, my husband’s defibrillator fired again – and then 11 more times before he was stabilized. We wound up going by ambulance to a small local hospital where they checked the blood work and discovered he had suffered a heart attack. From there we went to another hospital where he spent the next six days. The first hospital had sent him home while he was having a heart attack – even though I kept telling them something was terribly wrong! We were just fortunate that the defibrillator worked all 14 times.

  7. mld
    Reply

    Unfortunately, two missed diagnoses in the last year in our family.
    The first was non-lethal. Primary Care doctor told me a growth on my neck (which I couldn’t see) was harmless and would go away on its own. A year later, it was bleeding constantly. I now have a 3-inch scar on my neck from removal of a large, infiltrated basal cell carcinoma.
    The second was lethal and has been reported to our state’s health department: Our adult daughter spent a month in a local ICU with H1N1, then MRSA, and other hospital-acquired infections. She complained of excruciating pain in her back. On the 16th hospital day, she became paralyzed from the chest down. Eventually, she indicated she was no longer in pain, became stuporous, and died. The autopsy (which she had requested) revealed osteomyelitis at T8, discitis, deteriorated rib ends near T8, blood clots and damaged spinal cord near T8 — all from MRSA.
    The physician who interpreted these results to us (who is outside of the system that cared for our daughter) informed us that the antibiotic management was poor — she was given antibiotics no more than half the time she was in the hospital and then, not on a consistent basis. He also said that there was no reason why the focal point (in her spinal column) of MRSA should have been missed.

  8. barb s
    Reply

    Recently experienced close call in fainting at 2am after taking Cymbalta 30mg for fibromyalgia & depression on the previous afternoon followed by Ciprofloxacin 250 mg 6pm (for UTI) after dinner. I’m hypoglycemic & woke up feeling a little hungry (unusual for me) and somewhat faint. I hurried to swallow some honey on a spoon and progressed to getting down on the floor before my face hit it.
    After the cold sweats and horrible feeling passed, I ate some cereal and went back to bed. Dr. took me off Cymbalta, but kept me on Cipro anyway. My wrists were weakening after only 4 days of it, so I stopped. I read the side effects & will use cranberry juice & tablets instead. To top it off, the lab results came back negative for UTI. I’m “normal”….whatever that means. Moral of the story is: “Wait a week using natural options and if you don’t die, you’ll live to get advice from the Graedons.” A much better solution, in this case!

  9. CAR
    Reply

    Hi! Your show is very informative & been a help to me. Recently I have had implant work done on my mouth-the upper left. Had bone putty put in last year & 6mos later had the implants done. Then had the abuttments installed & the beginning of Jan. went to the regular dentist for the permanent abbutment to be installed & the teeth put on them.
    The first one went fine, but on the 2nd the dentist decided to torque the abuttment a little more & guess what-he loosened the whole thing, but went ahead and put on the tooth anyway. I waited 3 wks. before calling the special dentist & he said get in her ASAP. He took an x-ray & told me the whole thing would have to come out & start over again & he has done that & is not charging me for the new procedure, but no compensation for the pain & discomfort & long wait to get this done again.
    What would you recommend I do? Also, I had a knee-joint replacement in ’07-the Dr. bragged about using a woman’s knee joint replacement. I was going to therapy & was having problems & after the therapist begged me to get a 2nd & 3rd opinion, which I did & was told a joint-replacement was needed because the femur did not properly fit into the joint replacement & I could easily break the leg. I was not a happy camper & did not go back to the 1st surgeon, but had another one of the 2nd opinions do the surgery.
    Ended up with a spike down my lower leg, a spike in the femur & a pin in the middle of the knee to stabilize it. Did the therapy thing again & have decent use of the leg, but not quite the bend I wish I had. Can’t ride a bike any more, for one thing, but do go swimming & can walk without too much difficulty. Should we have taken that surgeon to task because the surgery obviously was a failure? Would appreciate your input on these issues. Thanks, Joe & Terry!! C. A. Ruga

  10. EHR
    Reply

    RE questioning the surgeon regarding who will be actually doing the surgery. MBK’s comment is much to be preferred to the semi-honest, rather cringing approach that your guest suggested. If one speaks openly, honestly and courteously to the surgeon why should it be necessary to assure her/him that no one’s professional integrity is being questioned but that you want full disclosure regarding a procedure that you are financing. It should not be necessary to blame a spouse for wanting a second opinion or to reassure a surgeon (or physician) that asking about what is going to happen is not an accusation of unethical behavior.
    There is a degree called M.Div., but even the recipients do not claim that the divinity in question belongs to them. Your guest was talking about M.D.s. It just means that they know about medicine (and/or surgery). When it’s your surgery in question it should be considered outrageous that egos need to be fed before it may be asked about.

  11. Bunker Hill
    Reply

    Top Ten Questions? Where’s #10?

  12. MBK
    Reply

    I heard your program this morning – February 27, 2010 – It came to our home at a very stressful moment, we just attended a meeting with a surgeon, my husband is going to have open heart surgery in two weeks, a very delicate operation at a teaching hospital. Fortunately we had questions already prepared for the surgeon, but some of the questions we heard in your program were very appropiate and we never thought, for example: is the surgeon is going to be from start to finish during the operation? Also we had a very bad experience in another teaching hospital, wonderful reputation, a very difficult surgery and then having some problems after the surgery that the surgeon referred to his assistant, he was not the appropiate person to handle the situation at that moment, and actually made a very big mistake. During the first visit to the surgeon’s office after the surgery, we were able to express our concerns and he acknowledged the mistake, not only apologized but also wrote us a letter.
    We learned that we need to be prepare at all times, know your rights as a patient and not be afraid to express your feelings in a very professional manner.
    We always carry a notebook, write every information we get from the doctors and actually repeat what we have written to the doctor, to be sure we are all on the same page.
    Thank you for your wonderful program that we hear every Saturday since we retired in NC three years ago.

  13. G.C.
    Reply

    My mother was treated for years for increased swelling of her legs and constant exhaustion. Then one day she suddenly became so confused and disoriented that we thought she had suffered a stroke. In the hospital her doctors informed us that her liver was severely damaged and they expected her to live only about 18 months. “How could that be?” I asked as she had seen her doctors religiously for 20 years. “No one ever did any blood work” we were told.
    Despite all their tests and discussions the hospital could not determine the cause of the liver damage. However, they did conclude she was anemic and prescribed daily iron supplements. She made many more trips to the ER due to her sudden episodes of confusion and memory lapses, while being closely followed by a new primary care physician. After about a year her gastroenterologist performed more lab work. As he read it he looked at me in shock and asked, “How can this reading be so high now when it was so low a year ago in the hospital? Her iron is at toxic levels”.
    Further tests by a hematologist revealed she had HEMACHROMATOSIS. Not one, but many, many doctors failed my mother.

  14. Chuck
    Reply

    My mother died unexpectedly in hospital when someone gave her oxygen, but failed to read her chart. Interstitial fibrosis had reduced her lung capacity to something like 10% of normal, so her required oxygen tank supply rate had been increased to compensate. The nurse or tech that changed out her tank set the supply rate to “normal” without checking. Mom slowly went hypoxic, which triggered a medical crisis in which the hospital dumped a huge amount of oxygen into her rapidly. That triggered a cold-induced respiratory event (they failed to pre-warm the oxygen) which stopped her breathing, and then, her heart. We only got this much info after a nurse broke ranks to let us in on what happened; later others confirmed this story. Mom was still dead, though.

  15. PAK
    Reply

    Have you heard about the problem with excess radiation given patients at Cox Hospital in Springfield, MO? It has been on the local television stations and in the local newspaper, Springfield News-Leader this week.

  16. toni a.
    Reply

    I went to a prominent teaching hospital for one surgery and was given the wrong one. The doctor told my spouse when I pressed them about it that they ran out of time in the operating room so they just did this one instead.
    I contacted several attorneys and had paper work for every single step of the journey… the attorneys would take a deposition and then pass me on to someone else. It finally became apparent that the attorneys were backing the medical school physician. I have all this documentation and no one cares. What is this world coming to?
    My spouse would not let me tell Blue Cross about it as he was afraid they wouldn’t cover the bad surgery. SO I never got the surgery I signed up for and which Blue Cross had approved. It is a scary place out there and now I need a major hernia repair (same doctor’s work) and they want to do it as an outpatient even though it will require a major incision and opening me up.
    What am I supposed to do when I get home and who will be able to care for me? I asked for a copy of my medical records from this school and they sent me some stuff that had nothing to do with me and completely contradicts my papers and my consent for surgery form… oh well sorry to burden you all with this. I guess I just needed to tell someone. Thanks for listening.

  17. T2*
    Reply

    Dr. Scranton’s book sounds great, I am looking forward to reading it.
    The subject of the sometimes contradictory goals of excellent medical education and excellent clinical care in teaching hospitals has been studied in detail. For people interested in learning more about this subject, two of the best books (in my opinion) are:
    Forgive and Remember by Charles Bosk
    Complications by Atul Gawande

  18. kmc
    Reply

    My 85 year old mum was mis diagnosed with a urinary tract infection in the ER. I thought they might have taken a dirty sample but no one listened. So they gave her a urinary tract specific antibiotic. (We later found out she had pulmonary edema related to a virus.) But the meds, 3 days later, depleted her sodium and she took a very bad fall that put her in the hospital. By then, the urinary tract culture came back negative and we could verify it had been the wrong med for her. She recovered in the hospital but it was an arduous journey for her. That’s where we spent Christmas this past year.

  19. KSM
    Reply

    The surgeon removed the wrong fibroid tumor from my breast – then tried to charge me for it, along with the hospital. It took a lawyer to get those charges removed from my records. And then I had to trust the guy to go in again and get it right. Thank heavens it was benign.

  20. PGC
    Reply

    What do you do if you have experienced unexpected results from a surgery? My wife had her veins stripped and thinks the doctor may have cut on the wrong side of her leg. Would a doctor say in medical records that he made an error?

  21. MK
    Reply

    Our son was born 7 weeks premature and given gentamycin intravenously possibly in a PIC line. None of the doctors whom we usually use were involved in the on-site hospital care. We were particularly concerned about the large number of health care professionals rotating through his care at the hospital. He has permanent sensorineural hearing loss now. To date all tests have shown no genetic causes. One would think that there was a responsible unit at the hospital that would review situations to insure that this does not happen again.

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