Thursday, July 12, 2012

Right and wrong

On Monday, I underwent the 1st step of having a tooth crowned. Right before the dentist began, his assistant read from my chart, "Today, we are preparing a crown for #31 on the lower left - I mean lower right..." My immediate response: "Don't take off the wrong leg!" We all laughed, but it's not a joke for those to whom it's actually happened:

Tampa, Florida, U.S. / March 1995
Willie King, a 51-year-old diabetic, was told in the recovery room at University Community Hospital that instead of removing his gangrenous right foot, surgeons had mistakenly amputated his left leg below the knee. King's brother commented, "Now he'll be without any legs at all. He's very depressed about it."

Callao, Peru / January 2010
Doctors at the Alberto Sabogal Hospital amputated the healthy leg of an 86-year-old man before realizing their mistake. "I was shocked when I lifted the sheets and saw they had taken his left leg. The ulcer was on his right leg and they had to amputate that one too to keep the infection from spreading," said his daughter.

Sankt Johann, Austria / June 2010
Surgeons removed the wrong leg of a 91-year-old woman. She was suffering from vascular disease, so they were forced to amputate the correct leg below the hip as planned a few days later.

These are a few examples of a much larger issue. According  to estimates, wrong-site surgery occurs 40 times a week in U.S. hospitals and clinics. In the U.K., lungs were transplanted into a patient of the wrong blood type, healthy kidneys were removed, an unnecessary hysterectomy was performed, the wrong leg was amputated, and holes were drilled on the wrong side of a neurosurgery patient's head. Mistakes have multiple causes, including mixing up left and right, operating on a patient who was accidentally given someone else's test results, marking the incorrect site, or failing to mark the site at all. In addition, surgeons may not be open to a pre-surgery checklist and members of the surgical team may be reluctant to speak up if they think something might be wrong. John Clarke, surgeon and clinical director of the Pennsylvania Patient Safety Authority, asks, “If you can’t solve the wrong-site-surgery problem, what can you solve?

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