This ‘Never’-Land Is No Place for Peter Pan

I’m sure glad Peter Pan never had to go to the hospital. If he had, the story in his enchanted Neverland might have had a not-so-happy ending, one that could have taken more than Tinkerbell to fix.

Last month, CMS added several so-called “never events” to the list for which it won’t pay hospitals for continuing care. As “serious and costly errors in the provision of health care services that should never happen,” the agency described, these mistakes are preventable medical errors that can cause dire consequences for the patient — like if Peter Pan were admitted and his magical powers of flight were mistakenly removed.

In the real world, such mistakes — leaving items inside surgery patients or transfusion of the wrong blood type — can cause serious injury or death. They also result in increased treatment costs for Medicare.

Adding to its list of such events, the three new hospital-acquired conditions for which CMS said it will not pay include surgical site infections following some elective procedures, including certain orthopedic surgeries and bariatric surgery; complications related to poor control of blood sugar levels; and blood clots in the leg following knee or hip replacement.

In addition, Acting Administrator Kerry Weems said CMS is developing three national coverage determinations on Medicare’s coverage of certain surgical procedures in the never-event category, including surgery on the wrong body part, surgery on the wrong patient and the wrong surgery performed on a patient.

The wrong body part? The wrong patient? The wrong surgery? At the risk of mixing my fictional flying characters, “Holy Hospital, Batman!”

We have all heard of these unfortunate cases on occasion. Widely reported earlier this year, actor Dennis Quaid’s infant twins were mistakenly given an adult dose of a blood thinner. In 2003, the nation followed daily reports of a teenage girl who received a heart of the wrong blood type in a transplant operation and died after two long weeks.

A landmark 1999 report from the Institute of Medicine (which advises the federal government on health care issues) found that medical errors including hospital-acquired conditions may be responsible for as many as 98,000 deaths annually, at costs of up to $29 billion. That report brought the issue to public attention, but the situation has not improved.

According to a recent Los Angeles Times article based on data from the California Department of Public Health, between July 2007 and May 2008, hospitals in the state reported 1,002 cases of serious medical errors involving patients. While the percentage is small — California hospitals admitted 4 million patients in 2007 — the human toll is immense: Records showed 466 patients developed severe bedsores, foreign objects were left inside 145 surgical patients and physicians performed the wrong procedure or operated on the wrong body part or patient 41 times. That’s just in California in less than one year.

Sadly, many of us, in particular the patient populations served by HME providers, end up at the hospital doors seeking medical attention. I find it nightmarish to think we might need more help once we get inside.

When there is a choice of setting for continuing care, just send me home, please.