I have written often on the need for an elder to have a patient advocate to get the best care. But, what should the advocate do besides be in good communication with the doctor? I read an interesting article by Dr. George G. Ellis, Jr. In it he identifies the most common causes of medical mistakes that lead to legal claims by patients. While it is always good to avoid mistakes, take note that when a mistake arises to a legal claim a patient has had a bad outcome. You can read Doctor Ellis’s article here.
According to Dr. Ellis, here are the two most common medical mistakes and how you can prevent them.
When the doctor prescribes, or administers, a medication the side effects and interaction with the medications the patient is already taking must be considered. According to one study 100,000 people die each year due to adverse drug interactions, making it the fourth leading cause of death. The study found 350,000 cases of serious adverse drug reactions in nursing homes each year. Read more here
The failure to recognize adverse side effects and interactions was fatal for Michigan attorney Jean Hannah’s mother. She wrote how her mother who was an active 83 year old woman died in 63 days in a nursing home from this problem. She wrote about it in her book “Taking Charge: Good Medical Care for the Elderly and How to Get It.”
Seasoned social worker Diane Sasson, of Sasson Senior Services who has helped many seniors with problems of aging, reports that online.epocrates.com is an excellent, free resource for checking medication side effects and interactions. To check on the effects of alternate medications, such as herbal remedies, one will need an annual subscription.
Moral: The patient advocate must know all the medications the patient is taking and their side effects and interactions with the patient’s other medications.
This mistake is made of two parts: one, the tests do not happen either because the order was not executed so no tests were scheduled or the patient did not show up for the tests. The second part occurs when the test reports an abnormality and the physician does not follow up. Sometimes the lab performs the wrong test and the physician does not notice. Then the untreated medical condition becomes much more serious.
One study found that perhaps 25% of all medical malpractice claims involve the failure to follow up on tests. See “No News Is Not Always Good News.”
One can easily find many malpractice case reports based in this error. Malpractice attorney Jules Olsman reported an $850,000 settlement for a 64-year-old man who died as a result of a medication error when the patient was discharged from a rehabilitation center without anticoagulants that were specifically ordered by his physician’s assistant, causing him to suffer a blood clot and die.
To read a full case report involving this error see “Failure to follow up . . . leads to $150,000 award”
For some practical advice to the patient advocate, listen to the podcast interview of Dr. John Hickner, professor of family medicine at the University of Chicago in the New York Times Wellness blog
The moral for the patient advocate is no news is not always good news.” Monitor the medical practice at every step. Be sure tests ordered are completed. Be sure the lab performs the right test. Get a copy of the lab report. And finally, check with the doctor to learn the results of the test.
With simple vigilance the patient advocate can help an aging parent avoid the majority of serious medical errors.