Navigation Links
Famed neurosurgeon's century-old notes reveal 'modern' style admission of medical error
Date:2/21/2011

The current focus on medical errors isn't quite as new as it seems. A Johns Hopkins review of groundbreaking neurosurgeon Harvey Cushing's notes, made at the turn of the last century, has turned up copious documentation of his own surgical mishaps as well as his suggestions for preventing those mistakes in the future.

Authors of the article, published in the Feb. Archives of Surgery, suggest that such open documentation may have played an important role in spurring groundbreaking medical treatment advances in Cushing's era and could have the same effect today.

"Acknowledging medical errors is evidently something that doctors identified early on as critical to advancement a very long time ago," says principal author Katherine Latimer, B.S., a medical student at the Johns Hopkins University School of Medicine.

Latimer and her colleagues scoured Johns Hopkins' archives to locate operative notes covering 878 of Cushing's patients. The notes, transferred decades ago to microfilm, covered the early years of Cushing's career, from 1896 to 1912, at The Johns Hopkins Hospital. After deciphering the notesa monumental task, the authors say, owing to Cushing's poor handwriting, abbreviations, and pages crowded with notes of other physicians, toothe researchers selected 30 cases in which errors were clearly delineated.

The cases fell into categories of errors similar to those that plague doctors today, the authors said, classifying 11 of the cases as errors of judgment in which Cushing made the wrong choice during a surgery. One example: operating on the wrong side of a patient's brain. Seventeen cases were identified as "human error," mistakes in which Cushing revealed clumsy or careless behavior, such as dropping an instrument into a surgical wound. Three of the errors were considered equipment or tool oversights, such as the case in which a woman's heavy bleeding left Cushing and his colleagues without enough wax, a substance used at the time to seal blood vessels.

Latimer and her colleagues say they were surprised by Cushing's frank and copious documentation of his own shortcomings. His notes acknowledged mistakes that may have resulted in patients' deaths, as well as those that didn't seem to harm patients' outcomes. They said the documentation took place in an era in which malpractice litigation was becoming a growing concern for doctors. Though malpractice penalties were substantially smaller in Cushing's day, lawsuits presented a serious risk for physicians' reputations, the authors noted.

The authors also emphasized that Cushing practiced in a time of enormous surgical innovation. For example, patient mortality from surgical treatment of brain tumors fell from 50 percent to 13 percent during his career. While some of this jump ahead was due to improving technology, the authors propose that part of the reason was open documentation of errors, which helped Cushing and other surgeons develop fixes to avoid them.

"People are human and will make medical mistakes," says Latimer, "but being vigilant about your own shortcomings is critical to improving. To keep medical innovation flowing, we need to strive to maintain this same vigilance today."

Alfredo Quinones, M.D., associate professor of neurosurgery at the Johns Hopkins University School of Medicine and senior author of the study, adds that today's medical errors continue to have a tremendous impact on patients and their families. "Recognizing errors and reporting them can help us greatly improve medicine," he says. "After all, we are all working towards the same goal: better patient care."


'/>"/>

Contact: Christen Brownlee
cbrownlee@jhmi.edu
410-955-7832
Johns Hopkins Medical Institutions
Source:Eurekalert

Related medicine news :

1. International Pinot Noir Celebration Guest Chef Jason Stoller Smith to Cook Famed Northwest Salmon Bake at White House Picnic
2. International group of neurosurgeons to assemble in Buffalo
3. Pittsburgh Neurosurgeons Explore Use of Drug that Illuminates Brain Tumor Cells To Guide Surgery
4. A century-old puzzle comes together: Scientists ID potential protein trigger in lung disease sarcoidosis
5. Sully Sullenberger keynotes HFES 54th Annual Meeting
6. NOSCAR announces first NOTES transoral and transvaginal gallbladder removals performed as part of US multicenter human trial
7. First US surgery to compare NOTES vs. laparoscopy
8. Labiaplasty May Be Covered by Insurance, Notes Chicago-area Plastic Surgeon Allan Parungao, MD
9. NOSCAR announces 2010 NOTES research award winners
10. Employers Sceptical of Government's Fit Notes Initiative
11. HCA Announces Offering of $1.0 Billion Senior Secured First Lien Notes
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:12/9/2016)... ... 2016 , ... Mediaplanet today announces distribution of the latest edition of “Transplants,” ... up as an organ donor for the 123,000 people in the United States who ... save up to 8 saves through organ donation and enhance many others through tissue ...
(Date:12/8/2016)... ... December 08, 2016 , ... The ... beginning January 1, 2017. The name change aligns the entire company with ... improving health care quality. , “We are very proud of the achievements associated ...
(Date:12/8/2016)... N.Y., and JENNERSVILLE, Pa. (PRWEB) , ... December ... ... announce that Penn Medicine Southern Chester County, a Property owned by an affiliate ... $23 million, 72,000 square foot Penn Medicine Southern Chester County ambulatory care center ...
(Date:12/8/2016)... ... ... Premier Fitness Camp (PFC) and The Chopra Center for Wellbeing announced today the ... their world headquarters of Omni La Costa Resort & Spa in San Diego. , ... loss, personal development, a healthy lifestyle, or mental and physical healing. The week-long wellness ...
(Date:12/8/2016)... ... 2016 , ... STAT courier is pleased to announce that due to customer ... are expanding their presence in Dallas. One of the most exciting parts for STAT ... to the Dallas and Forth Worth market. STAT takes pride in treating their employees ...
Breaking Medicine News(10 mins):
(Date:12/8/2016)... -- KEY FINDINGS North America ... in 2016 and is expected to continue in the ... large number of surgical procedures that are taking place ... the patient temperature management market.) Patient warming and cooling ... blood during surgeries, lowering the risks of neurological disorders ...
(Date:12/8/2016)... -- Allergy Diagnostics Market: Scope and Methodology ... used to determine the presence of allergens such ... in the samples by determining the presence of ... on global allergy diagnostics market, analyzes the current ... consists of an executive summary that provides information ...
(Date:12/8/2016)... 8, 2016 Research and Markets has announced the addition ... their offering. ... This report analyzes the worldwide markets for Endodontic Supplies in US$ ... , Japan , Europe , ... World. Annual estimates and forecasts are provided for the period 2015 ...
Breaking Medicine Technology: