Why fatal medical errors are highest in July

I am not TV person but I make an exception when it comes to Grey’s Anatomy and I follow closely the travails and tribulations of the medical students. Which is why this research is very interesting for me.

The school year in the US is ending soon and commencement ceremonies are being organized in all learning institution. (By the way, I always wondered about using the term “commencement” at the end of the school year. Is it the case of “I open at the close” ala Harry Potter snitch)?

Anyway, what do all these have to do with health care? Well, in July many medical students leave their classroom to become interns and interns move up to become residents. The interns finally get to do real-life medicine while the residents get more responsibilities in patient care.

However, this shift in the working structure of teaching hospitals may have some consequences – increase in fatal medical errors. Researchers at University of California San Diego report that deaths due to iatrogenic events – aka medical errors – spike in July. Is this simply coincidence or is this linked to the influx of new residents getting more responsibilities?

The researchers looked at 244,388 U.S. death certificates issued between 1979 and 2006 and identified those cases of death due to medical errors. Their analysis showed:

• The month of July has the highest number of deaths due to medical errors than any other month of the year.
• This July spike is especially evident in counties with teaching hospitals where the death rate is 10% higher in July than expected.

What are kind of medical errors usually occur?

Medication mistakes. These are errors involving drug mix ups, giving the wring drug, or the wring dose resulting in overdose. The case of the Quaid twins and the heparin overdose is a well-known example. A study shows that a lot of medication errors involve babies and little children

Surgical mistakes. These mistakes usually involve surgery on the wrong site. A well-known case was that of the comedian Dana Carvey in 1997. He was underwent open heart surgery to treat a blocked artery but the surgeons operated on the wrong one. This resulted in a $7.5million malpractice lawsuit in favor of Carvey.
A friend of mine In New Zealand was supposed to undergo a simple laparoscopy to remove a gall stone. Instead, a wrong duct was cut and she ended up losing 60% of her liver.
Surgical mistakes, however, can seldom be attributed to newbie surgical residents who may assist but usually do not perform solo surgery this early in the school year. However, the fact remains that new residents may are more likely to make mistakes than their more experienced colleagues.

The USC San Diego researchers believe their results call for a re-evaluation of the policies of teaching hospitals. They wrote:

“Our findings provide fresh evidence for 1) re-evaluating responsibilities assigned to new residents; 2) increasing supervision of new residents; 3) increasing education concerned with medication safety. Incorporating these changes might reduce both fatal and non-fatal medication errors and thereby reduce the substantial costs associated with these errors.”