Medical Error Caused by Prevalent and Pervasive Surgeon Fatigue

In a study conducted by the Massachusetts Hospital and reported in the Archives of Surgery researchers found that surgery residents were often suffering from fatigue. In fact the findings suggest that fatigue plays a significant role in medical error.

Fatigue Level can be on par with Alcohol Impairment

The researchers found that orthopedic surgical residents were fatigued during almost half of their time awake. They were critically impaired during more than one-quarter of their time awake. This impairment was as severe as that expected from a blood alcohol level of 0.08%. These data indicate that orthopedic surgical residents participating in the study were at high risk of making medical errors due to fatigue that could injure their patients or themselves. Overall, residents’ fatigue levels were predicted to increase their risk of medical error by 22% (individual range, 7%-49%) compared with well-rested historical control subjects.

The Night Shift can be Dangerous

The study found that compared with day-shift rotations, night-float rotations induced more critical impairment and greater predicted risk of medical error. This risk is likely exacerbated by working independently and cross-covering many patients, which frequently occurs on night-float rotations.

Medical Error is linked to Fatigue

The research findings are supported by other studies that suggest that fatigue increases the risk of medical error. Other recent studies of residents in surgical and acute care settings found that extended shifts and circadian rhythm disruptions increase medical error and cognitive decline. Interns working extended shifts are at increased risk of making medical errors injuring patients. Another study found an association between resident fatigue and perceived medical error. A large-scale retrospective comparison of surgical outcomes before and after implementation of resident work-hour restrictions found a decrease in complication rates associated with reduced surgical service workload. Finally, yet another study found that surgeons and obstetricians obtaining less than a 6-hour opportunity to sleep when on call experienced a near tripling in complication rates when performing elective procedures the following day.

Fatigue can be Avoided

The study authors contrast the organization of hospitals to high reliability organizations. High-reliability organizations share several characteristics: they have a well-developed safety culture, they perform system-based error analyses, and they maintain a preoccupation with failure. Most important, these organizations have generated significant safety gains by addressing workplace fatigue. According to the WHO when these practices have been adopted by health care institutions they have shown to be effective.

Medical Error caused by Fatigue is Actionable at Law

In the eyes of the law the fact that a medical error is caused by fatigue does not excuse the health care provider from legal liability. Regardless of the cause of the medical error, whether it be tiredness, carelessness, inattention, or lack of knowledge, a claim for damages may be brought by reason of the error or mistake. If you or a loved one have been harmed as a result of malpractice or medical negligence then contact us for a free case consultation by completing our case evaluation form or calling us at 416 862 0997 to speak to one of our lawyers.

This entry was posted in health care, hospitals, medical malpractice, standard of care. Bookmark the permalink. Comments are closed, but you can leave a trackback: Trackback URL.