Day on Torts

The November 2007 Annals of Surgery  has an interesting article on surgical errors.  The abstract of the article says that  the authors "analyzed 444 randomly sampled surgical malpractice claims from four liability insurers. Among 258 claims in which injuries due to error were detected, 52% (n = 133) involved technical errors."

They found that "[f]orty-nine percent of the technical errors caused permanent disability; an additional 16% resulted in death. Two-thirds (65%) of the technical errors were linked to manual error, 9% to errors in judgment, and 26% to both manual and judgment error. A minority of technical errors involved advanced procedures requiring special training ("index operations"; 16%), surgeons inexperienced with the task (14%), or poorly supervised residents (9%). The majority involved experienced surgeons (73%), and occurred in routine, rather than index, operations (84%). Patient-related complexities-including emergencies, difficult or unexpected anatomy, and previous surgery-contributed to 61% of technical errors, and technology or systems failures contributed to 21%."

So, what do they conclude?  "Most technical errors occur in routine operations with experienced surgeons, under conditions of increased patient complexity or systems failure. Commonly recommended interventions, including restricting high-complexity operations to experienced surgeons, additional training for inexperienced surgeons, and stricter supervision of trainees, are likely to address only a minority of technical errors. Surgical safety research should instead focus on improving decision-making and performance in routine operations for complex patients and circumstances."

Yesterday I wrote about tort statistics revealed by the 2006-07 "Annual Report of the Tennessee Judiciary."  Among the statistics I cited was that there were 584 medical malpractices cases filed in the state of Tennessee and a total of 15 medical malpractice trials.

To put that in perspective, remember that according to the National Institute of Health 98,000 people a year die in the United States from malpractice in hospitals alone.  Assuming that Tennessee is neither worse nor better than average, that means that 1986 Tennesseans die each year as a result of malpractice in a hospital setting (because we have about 2% of the nation’s population).

And yet only 584 malpractice cases were filed in the entire state for the fiscal year ending June 30, 2007.  Those cases presumably involved not only deaths in hospitals but also injuries in hospitals and deaths and injuries in outpatient settings, nursing homes and surgery centers.  They also include cases against pharmacies and home health agencies and outpatient physical therapy centers.