Botched anesthesia for routine knee surgery at Baylor University Center led to Tx man in vegetative state. Involved one Anesthesiologist overseeing 4 Nurse Anesthetists - too many? Ask who will tend to you or your loved one before anesthesia.

2021 sentinel events (result in death, permanent harm, severe temporary harm or intervention required to sustain life): Falls— 485 events Delay in treatment— 97 Unintended retention of a foreign object— 97 Wrong surgical site— 85 Medication error— 35 Alarm response— 22 Be alert!

Errors involving medicine harm 1.5 million people in the U.S. with 218,000 deaths annually. A survey of 2,000 parents found nearly 1/2 keep no longer needed meds - a danger to all, especially children. Some medical degrade or get contaminated over time.

The Joint Commission reports that communication problems contribute to more than 70% of medical errors. Pay critical attention to communication when next in a hospital.

A surgeon at Bristol Hospital operated on the wrong knee of a patient after failing to follow protocol and independently verify the correct knee. Getting surgery? Ask the surgeon how he knows the right area to cut on.

Institute for Safe Medication Practices reports that between 6/2020 and 12/2021, 70% of all vaccine errors were with COVID shots. Other vaccines ( flu, hepatitus,tetnus): wrong vaccine 24%, expired dose 14%, wrong dose for age 13%. Last category has not improved over last decade!

Keep a critical eye open whenever in a hospital, as a patient or visiting others. I once observed hospital activities for two hours and identified 18 inappropriate practices that could harm a patient. (I conveyed these to a hospital Director in a letter - without effect.)

A late 2019 study of cell phone use by caregivers in the Operating Room found adherence to hygiene requirements before and after phone use at about 20%.

Know someone in a Vet's Home? Pay attention to safety on your next visit. Many shortfalls found in a N.J. home include: Nurse cut the tube of a catheter rather than removing it properly. Pt. had to be taken to ER for proper removal; and gross lack of COVID infection controls.

Recent U.S. hospital safety grades indicate a number of hospitals need work. Is yours one of them? One state had 58 with a grade of C or lower; 4 in another state got Ds; one hospital was told to have the staff "wash their hands before seeing patients". Hard to believe!

Want to find out how safe you or your loved ones will be if they need to go to the hospital? On the web, go to hospitalsafetygrades.org, enter the name of your hospital and if they participate in Leapfrog as many do, you will get a feel for how safe they are.

Live in New York state? Better read The War on Error and ask caregivers a lot of questions. In recent Leapfrog grading, 19 hospitals statewide got an A but 33 got a D.

Live in the Washington DC area? Be careful. Recent Leapfrog patient safety assessment gave University of Maryland Capital Region Medical Center in Upper Marlboro and Fauquier Hospital in Warrenton, Virginia, both Ds, & Howard University Hospital an F.

You are your own best patient safety guard. Most common safety error: medication problems. Recently had to tell medical staff all meds I take. Wrote them down; handed to staff; checked records later; found they made an error in transcribing, showing one dose as half the actual.

A 39 year old man from Berlin in the hospital for surgery on his left ankle - torn ligament. When he awoke after surgery, found they had operated on his RIGHT ankle! The left ankle had been shaved and marked for surgery. How do these things happen? Ask a lot of questions!

W T Subalusky ZHH Does this find it? youtube.com/watch?v=zsRSgX…

A "new study" by the medical community just concluded that structured turnovers of info by caregivers resulted in a 47 % reduction in adverse events. Duh! In nuclear submarines we found this out more than 50 years ago! Nuke principles like this are reflected in The War on Error.

A 2014 study published in BMJ Quality & Safety showed 12 million victims of misdiagnosis every year. Research your doctor. Get a 2nd opinion if in doubt. Make your provider explain EVERYTHING.

250,000 die each year from medical errors. When other causes of death, such as outpatient fatal drug reactions (198,000), deaths due to misdiagnosis (132,000), hospital-acquired infections (100,000), and pulmonary embolism (119,000) are included, that number goes to 800,000.

New Zealand: 3 yr old had worsening cough & wheezing. Over 1 1/2 hr, Caregivers: failed to give oxygen (forgot it was turned off for a leak); doctor directed wrong resuscitation procedure for a child; tech issues prevented getting ICU help; Pt. given overdose of adrenalin; died.