10 most expensive errors in healthcare settings

Medical errors have been in the news lately. An Ontario provincial review probing unnecessary surgeries at a Windsor hospital found significant concerns with the work of a pathologist involved in a mistaken mastectomy case.

In the US, avoidable medical errors added $19.5 billion to the nation’s healthcare bill in 2008, according to a claims-based study conducted for the Society of Actuaries (SOA). The report lists the 10 most expensive errors in healthcare settings.

Here are the 10 most expensive types of medical errors:

1. Pressure ulcers–374,964 errors, $10,288 per error and $3.858 billion total.

2. Postoperative infections–252,695 errors, $14,548 per error, $3.676 billion total.

3. Mechanical complication of a device, implant or graft–60,380 errors, $18,771 per error, $1.133 billion total.

4. Postlaminectomy syndrome–113,823 errors, $9,863 per error, $1.123 billion total.

5. Hemorrhage complicating a procedure–78,216 errors, $12,272 per error, $960 million total.

6. Infection following infusion, injection, transfusion, vaccination–8,855 errors, $78,083 per error, $691 million total.

7. Pneumothorax–25,559 errors, $24,132 per error, $617 million total.

8. Infection due to central venous catheter–7,062 errors, $83,365 per error, $589 million total.

9. Other complicaitons of internal (biological) (synthetic) prosthetic device, implant and graft–26,783 errors, $17,233 per error and $462 million total.

10. Ventral hernia without mention of obstruction or gangrene–53,810 errors, $8,178 per error and $440 million total.

They most expensive errors on a per-error basis are:

1. Postoperative shock–$93,682.

2. Infection due to central venous catheter–$83,365.

3. Infection following infusion, injection, transfusion or vaccination–$78,083.

4. Gastrostomy complications, infection–$66,765.

5. Complications of transplanted organ–$66,658.

6. Infection and inflammatory reaction due to internal prosthetic device, implant and graft–$62,265.

7. Tracheostomy complications–$56,479.

8. Gastrostomy complications, mechanical–$55,219.

9. Infusion or transfusion reaction–$51,686.

10. Gastrostomy complications–$49,115.

The report highlights the need for hospitals to reduce errors. It also serves as a wake-up call to patients and family members. Now that you know where the errors occur, you know a bit more what questions to ask when you or a loved one is hospitalized.

Adapted from a blog post that appeared on White Coat, Black Art.

Brian Goldman is an emergency physician and author of The Night Shift: Real Life In The Heart of The E.R., published by HarperCollins.

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