4 ms·

Complexity probably has something to do with it. Every surgery is slightly different. So a reasonable size checklist would be missing enough items to kill the

Complexity probably has something to do with it. Every surgery is slightly different. So a reasonable size checklist would be missing enough items to kill the patient, and a complete one, the patient dies before you are 1% through it.

heymijo 7y ago
You, Bluegill, and pmiller make good points about the complexity of humans and surgery.
lonelappde 7y ago
This is silly. Every surgery in the world requires "confirm which body part you are removing" and "make sure the scalpel is outside the patient before sewing up".
- hestipod 7y ago
  Yet people still cut off the wrong bits, leave things inside. Read this is you want to get mad: https://www.nj.com/hobokennow/2008/06/humc_suspends_doc_who_removed.html https://www.nj.com/hobokennow/2008/06/humc_suspends_doc_who_... The doctor who did this is still practicing last I checked, as are the staff involved in covering it up, and the hospital he worked for was not informing patients of his history. Another shockingly similar case: https://www.deseretnews.com/article/412903/HOSPITAL-SETTLES-SUIT-OVER-REMOVAL-OF-WRONG-LUNG.html https://www.deseretnews.com/article/412903/HOSPITAL-SETTLES-... Just two cases I remember reading about. Over a quarter million or more per year according to most sources. Medical mistakes are the THIRD leading cause of death in the USA. Actually, conscientiously using a checklist to reduce that isn't too much to ask.
  - userbinator 7y ago
    Yet people still cut off the wrong bits, leave things inside. The checklist is basically the physical equivalent of asking "are you sure you want to remove this limb?" every single time, and people will just "click OK" before long.
    - hestipod 7y ago
      Aviation proves that untrue. Mostly people follow them. That some will not doesn't invalidate their worth. I am always confounded by people who argue everything isn't good enough, and then nothing ever changes as a result.
  - DanBC 7y ago
    Medical mistakes happen and are very common, and I wouldn't be surprised if there were 250,000 per year. But "wrong site surgery" is a tiny subset of medical error, and I'd be amazed if that was more than 1000 per year. Most medical error is in the form of medication error. Medication error is very common, and I'd be surprised if it was as low as 250,000 per year. I'd guess that number was the number of people harmed by a medication error. These errors are serious and we need to work to stop them, but we also need to put them into context. There are over 800 million physician office visits in the US per year. There are over 140 million ED visits per year.
- Engineering-MD 7y ago
  And these bits are put into checklist. In theory (and in my experience) they are performed at the beginning and towards the end of every operations. It’s the large decision space in between that struggles to be covered.
- JudgeWapner 7y ago
  They have that last part. It's called the count.

heymijo 7y ago

You, Bluegill, and pmiller make good points about the complexity of humans and surgery.

lonelappde 7y ago

This is silly. Every surgery in the world requires "confirm which body part you are removing" and "make sure the scalpel is outside the patient before sewing up".

hestipod 7y ago
Yet people still cut off the wrong bits, leave things inside. Read this is you want to get mad: https://www.nj.com/hobokennow/2008/06/humc_suspends_doc_who_removed.html https://www.nj.com/hobokennow/2008/06/humc_suspends_doc_who_... The doctor who did this is still practicing last I checked, as are the staff involved in covering it up, and the hospital he worked for was not informing patients of his history. Another shockingly similar case: https://www.deseretnews.com/article/412903/HOSPITAL-SETTLES-SUIT-OVER-REMOVAL-OF-WRONG-LUNG.html https://www.deseretnews.com/article/412903/HOSPITAL-SETTLES-... Just two cases I remember reading about. Over a quarter million or more per year according to most sources. Medical mistakes are the THIRD leading cause of death in the USA. Actually, conscientiously using a checklist to reduce that isn't too much to ask.
- userbinator 7y ago
  Yet people still cut off the wrong bits, leave things inside. The checklist is basically the physical equivalent of asking "are you sure you want to remove this limb?" every single time, and people will just "click OK" before long.
  - hestipod 7y ago
    Aviation proves that untrue. Mostly people follow them. That some will not doesn't invalidate their worth. I am always confounded by people who argue everything isn't good enough, and then nothing ever changes as a result.
- DanBC 7y ago
  Medical mistakes happen and are very common, and I wouldn't be surprised if there were 250,000 per year. But "wrong site surgery" is a tiny subset of medical error, and I'd be amazed if that was more than 1000 per year. Most medical error is in the form of medication error. Medication error is very common, and I'd be surprised if it was as low as 250,000 per year. I'd guess that number was the number of people harmed by a medication error. These errors are serious and we need to work to stop them, but we also need to put them into context. There are over 800 million physician office visits in the US per year. There are over 140 million ED visits per year.
Engineering-MD 7y ago
And these bits are put into checklist. In theory (and in my experience) they are performed at the beginning and towards the end of every operations. It’s the large decision space in between that struggles to be covered.
JudgeWapner 7y ago
They have that last part. It's called the count.