July: a time of sweltering heat, fireworks-related injuries, and newbie doctors roaming the halls of teaching hospitals, ready to learn medicine by practicing on you. The “July Effect”—the idea that medical mistakes spike in that month because new, inexperienced residents are on the scene— has become the subject of repeated studies trying to sort out whether it’s real or just conventional “wisdom.” Those studies have reached differing results. So, should we believe the newest one, which attributes a 10 percent July spike in fatal medical errors to those freshmen docs?
The study by David Phillips and Gwendolyn Barker, to be published in the Journal of General Internal Medicine, has a large sample size going for it. Phillips says that many prior “July effect” studies have examined just a single hospital’s population. But:
He and Barker, by contrast, probed a national database of more than 62 million death certificates that spanned from 1979 (when hospital status was first recorded in those records) through 2006 (the most recent year for which data were available). They turned up almost a quarter-million deaths that were coded as having not only occurred in a hospital setting, but also been due to medication errors. Both in-patient and out-patient cases were included [U.S. News & Report].
Under a new law, California hospitals are supposed to report all serious medical errors to the state, and the first batch includes stories that will scare anyone with a looming hospital admission date. [D]uring a 10-month period ending in May, doctors performed the wrong surgical procedure, operated on the wrong body part or on the wrong patient 41 times, records show. During the same period, hospitals reported that foreign objects were left in surgical patients 145 times [AP].
Officially called “adverse events,” those accidents are also known as “never events” because they are considered preventable, and many safety experts say they should never happen [Los Angeles Times]. The new disclosures listed 1,002 cases that caused serious medical harm; under the new law, the public health department must begin to post all these cautionary tales on the Internet by 2015.