Patient Safety Blog

Lasik is a popular laser surgery done on the eyes to correct vision. However, last week Lasik patients went to Washington D.C. to speak to the Food and Drug Administration on harmful side-effects that they experienced as a result of the surgery, including the following:

(1) Severe eye pain

(2) Dry eye

(3) Blurred vision

The effects of intense chronic pain can have a devastating effect on people's lives. One case was particularly extreme. From the article:

Colin Dorrian was in law school when dry eye made his contact lenses so intolerable that he sought Lasik, even though a doctor noted his pupils were pretty large. Both the dry eye and pupil size should have disqualified Dorrian, but he received Lasik anyway -- and his father described six years of eye pain and fuzzy vision before the suburban Philadelphia man killed himself last year.

"As soon as my eyes went bad, I fell into a deeper depression than I'd ever experienced, and I couldn't get out," Gerard Dorrian read from his son's suicide note.

One quoted patient said he was considered a "success" by doctors despite experiencing terrible after-effects:

Matt Kotsovolos, who worked for the Duke Eye Center when he had a more sophisticated Lasik procedure in 2006, said doctors classify him as a success because he now has 20-20 vision. But he said, "For the last two years I have suffered debilitating and unremitting eye pain."

These patients are demanding clearer standards for who can qualify for Lasik, as well as better information from the FDA on how many patients suffer these various side-effects.

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Posted In: Surgery

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A new study shows that heart surgery patients are more likely to die or suffer other problems if they get blood that has been sitting on the shelf for more than two weeks. The study, entitled Duration of Red-Cell Storage and Complications After Cardiac Surgery, was published in this week's New England Journal of Medicine.

From the linked Washington Post article:

A number of hospitals have re-evaluated long-standing practices and taken steps to minimize transfusions. One example: Duke University Medical Center in North Carolina has reduced its use of transfused blood products by 17 percent in the past 3 1/2 years.

Concern about the safety of older blood for cardiac patients is one reason for the change at Duke, said Dr. Sunil Rao, a Duke assistant professor of medicine who runs the cardiac catheterization labs at the Durham VA Medical Center.

If you will require a transfusion in the near future, this would be a good thing to ask your doctor and hospital about to find out their policy.

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Posted In: Surgery

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Out of nineteen industrialized nations, the U.S. has the most deaths that could have been prevented by access to timely, effective medical care.

Ellen Nolte and Martin McKee of the London School of Hygiene and Tropical Medicine performed the study, looking at deaths before the age of seventy-five caused by numerous diseases and complications. They found that France performed the best by this measure--though France, and other countries that ranked higher than the U.S., spends less money on health care than the U.S. does.

Not only was the U.S. the worst in these rankings, but we Americans are also ranked four places lower than we were in the last study (which covered 1997 and 1998). We are getting worse and spending more money.

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Posted In: General , Medical Error , Medications , Standard of Care--Hospitals , Surgery

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Rhode Island Hospital has, for the third time this year, done a brain surgery on the wrong side of the patient's head.

The hospital has been fined $50,000 and has received a reprimand from the state Department of Health. In this most recent instance, the patient was 82 years old. Fortunately, the patient was unhurt by the mistake. However, in one of the previous instances of this mistake at this hospital, the patient died as a result.

Rhode Island Hospital has said that it will be conducting a review of its procedures and implementing reforms. One such reform would be to allow nurses greater power in ensuring that procedures are followed correctly. Another would be to mandate better verification of surgery plans, which would require better communication between surgeons and other doctors. These reforms highlight a major factor in averting medical errors: teamwork. The multiple healthcare professionals involved in taking care of a patient need to be empowered to speak up if they see something going wrong. They also need to know what the others are doing, and to make sure that they are not acting contrary to the recommendations and instructions of other healthcare providers. Performing a surgery on the wrong side of the head is only one possible thing that could go wrong in the absence of communication. Another example would be giving a patient medications that, combined with medicine the patient is already taking, could cause problems. Such errors can be minimized through proper communication between healthcare professionals.

For more information: When Surgeons Cut the Wrong Body Part

Posted by Patrick A. Malone | Permalink | Email This Post

Posted In: Medical Error , Standard of Care--Hospitals , Surgery

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The risks of plastic surgery have been in the news lately thanks to the death of Donda West, mother of Kanye West. West died following a "tummy tuck," a common plastic surgery operation. At this time, the cause of her death is unclear.

In the wake of her death, the American Society of Plastic Surgeons issued a press release. They emphasize that plastic surgery is generally safe, but offer general suggestions as to what prospective patients should do to reduce their risk.

Research is the number one safety precaution: read studies about the risks and benefits of whatever procedure you are contemplating. Make sure you hear opinions from multiple sources: your primary care physician, your surgeon, medical journals and former patients who have undergone the procedure. Make sure you understand what will be happening to you every step of the way.

Furthermore, be sure to check the credentials of the experts who are giving you advice. The ASPS emphasizes making sure that your surgeon is board-certified and that your outpatient surgery center is accredited.

Most of these are common-sense procedures that ought to be applied to any surgery you may need to undergo. When it comes to plastic surgery, as it is often not part of an emergency procedure, you have the opportunity to take some time and research the risks before assuming them.

More resources:

FAQ from the ASPS on Outpatient Plastic Surgery

Ten Plastic Surgery Risks You Need to Know

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Posted In: Surgery

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