June 28, 2014, NY Times reported that military hospitals have “consistently had higher than expected rates of harm and complications in two central parts of its business — maternity care and surgery.”
Since punishing doctors for medical malpractice hadn’t affected these statistics, in 2001, the Pentagon instructed military hospitals to conduct an investigation, or “root-cause analysis,” within 45 days of a debilitating injury or death. These reports were to be forwarded to the Pentagon’s patient-safety office where analysts would review what happened and come up with a solution to prevent it from happening again.
“Unfortunately, R.C.A.s are used relatively infrequently,” a 2008 Pentagon audit stated. In fact, only 32 had been performed in 2003 despite 80 injuries and deaths; 25 were performed in 2011 despite 50 deaths; 44 were performed in 2012 despite 110 deaths; and 31 were performed in 2013 despite 79 deaths.
Even if hospitals submitted these reports, patient-safety offices are not authorized to force a hospital to change its procedures, said Dr. Mary Lopez, a former staff officer for health policy and services under the Army surgeon general.
Thus, the mistakes, injuries, and deaths continue. Between 2006 and 2010, the government paid at least $100 million per year for medical malpractice claims. If active-duty service members were able to sue, that number would have tripled, according to the Congressional Budget Office.
The Most Common Errors Military Hospitals Make
After reviewing “Pentagon studies, court records, … thousands of pages of data, and interviews with current and former military health officials and workers,” nytimes.com determined that most of the mistakes military hospitals make are the result of miscommunication among staff, failure to review a patient’s chart before sending him or her home with a misdiagnosis, surgical errors such as leaving tools and sponges inside the patient, and unsanitary operating rooms.
“For three years, [Womack Army Medical Center] has had a higher-than-average rate of surgical complications, and in March 2014 it suspended all elective surgery for two days after inspectors found problems with surgical infection controls,” nytimes.com said. “In addition to Womack, three other major hospitals … have had high rates of surgical complications for two or three years in a row. Five of the eight cited last year had also been flagged repeatedly for high rates of infection related to surgery.”
In 2010, the Pentagon’s patient-safety center reported that, for the first time since it began keeping track in 2001, “all surgeries and procedures were performed on the right person.” However, the following year, it reported that “surgeons were still performing the wrong procedure or operating on the wrong patient or part of the body at an ‘alarming’ rate,” per nytimes.com.
Likelihood of a Hemorrhage or Birth Injury
A woman who gives birth at a military hospital is 15 percent more likely to be injured during forcep-assisted delivery than a woman who delivers her baby at a civilian hospital. Women are also 40 percent more likely to suffer a hemorrhage afterward at a military hospital, according to nytimes.com. About 2,500 women suffered severe bleeding in 2012.
“One of the broadest measures of safe childbirth is the rate of injuries to babies, ranging from cerebral hemorrhages to small cuts on babies’ scalps,” said writers Sharon LaFraniere and Andrew W. Lehren. “From 2009 to 2011, … the rate at military hospitals was twice the national average.”
Military hospitals deliver more than 50,000 babies per year, and they’re twice as likely to be injured as a baby born elsewhere. About 5 in 1,000 were injured at the hands of military doctors and staff in 2011.
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