#209 ‒ Medical mistakes, patient safety, and the RaDonda Vaught case | Marty Makary, M.D., M.P.H.

<a href="https://peterattiamd.com/martymakary2/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=220606-pod-martymakary&utm_content=220523-220606-pod-martymakary-podfeed"> View the Show Notes Page for This Episode</a> <a href="https://peterattiamd.com/subscribe/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=220606-pod-martymakary&utm_content=220606-pod-martymakary-podfeed"> Become a Member to Receive Exclusive Content</a> <a href="https://peterattiamd.com/newsletter/?utm_source=podcast-feed&utm_medium=referral&utm_campaign=220606-pod-martymakary&utm_content=220606-pod-martymakary-podfeed"> Sign Up to Receive Peter's Weekly Newsletter</a> Marty Makary is a surgeon, public policy researcher, and author of the New York times best-sellers Unaccountable and The Price We Pay. In this episode, Marty dives deep into the topic of patient safety. He describes the risk of medical errors that patients face when they walk into the hospital and how those errors take place, and he highlights what amounts to an epidemic of medical mistakes. He explains how the culture of patient safety has advanced in recent decades, the specific improvements driven by a patient safety movement, and what's holding back further progress. The second half of this episode discusses the high-profile case of RaDonda Vaught, a nurse at Vanderbilt Hospital convicted of negligent homicide after she mistakenly gave a patient the wrong medication in 2017. He discusses the fallout from this case and how it has in some ways unraveled decades of progress in patient safety. Furthermore, Marty provides insights in how to advocate for a loved one in the hospital, details the changes needed to meaningfully reduce the death rate from medical errors, and provides a hopeful vision for future improvements to patient safety. We discuss: <ul class="ul1"> <li class="li2">Brief history of patient safety, preventable medical mistakes, and catalysts for major changes to patient safety protocols [0:12];</li> <li class="li2">Advancements in patient safety and the dramatic reduction in central line infections [14:55];</li> <li class="li2">A surgical safety checklist—a major milestone in patient safety [23:03];</li> <li class="li2">A tragic case stimulates a culture of speaking up about concerns among surgical teams [25:19];</li> <li class="li2">Studies showing the ubiquitous nature of medical mistakes leading to patient death [29:42];</li> <li class="li2">The medical mistake of over-prescribing of opioids [33:48];</li> <li class="li2">Other types of errors—electronic medical records, nosocomial infections, and more [35:43];</li> <li class="li2">Importance of honesty from physicians and what really drives malpractice claims [40:26];</li> <li class="li2">A high-profile medical mistake case involving nurse RaDonda Vaught [47:31];</li> <li class="li2">Investigations leading to the arrest of RaDonda Vaught [59:48];</li> <li class="li2">Vaught's trial—a charge of "negligent homicide" [1:05:16];</li> <li class="li2">A guilty charge and an outpouring of support for Vaught [1:12:09];</li> <li class="li2">Concerns from the nursing profession over the RaDonda Vaught conviction [1:18:09];</li> <li class="li2">How to advocate for a friend or family member in the hospital [1:20:22];</li> <li class="li2">Changes needed for meaningful reduction in the death rate from medical errors [1:26:42];</li> <li class="li2">Blind spots in our current national funding mechanism and the need for more research into patient safety [1:31:42];</li> <li class="li2">Parting thoughts—where do we go from here? [1:35:48];</li> <li class="li2">More.</li> </ul> Connect With Peter on <a href="https://twitter.com/PeterAttiaMD">Twitter</a>, <a href="https://www.instagram.com/peterattiamd/">Instagram</a>, <a href="https://www.facebook.com/peterattiamd/">Facebook</a> and <a href="https://www.youtube.com/channel/UC8kGsMa0LygSX9nkBcBH1Sg">YouTube</a>

Actionable Insights

1. Bring a Hospital Advocate

Ensure a family member or friend is present as an advocate during hospital stays. Their presence helps ensure care is more comprehensive and coordinated, as they can take notes, ask questions, and communicate with the care team.

2. Actively Communicate with Care Team

As a patient or advocate, proactively ask to speak with the doctor in charge of care daily and inquire about alternatives to proposed treatments. Asking questions about reasons for procedures and available options can lead to better care.

3. Foster a ‘Speak Up’ Culture

In any team or professional setting, encourage colleagues to voice concerns about safety without fear of ridicule. Creating an atmosphere of collegiality and psychological safety prevents catastrophic errors by ensuring all potential issues are raised and addressed.

4. Be Honest About Mistakes

If you are a medical professional, be honest with patients when a mistake occurs, as ‘sorry works’ and honesty often drives trust and forgiveness. This approach can build stronger bonds with patients and may even prevent malpractice claims.

5. Question Medication & Hand Hygiene

Patients and advocates should ask nurses to explain every medication being administered and its purpose. Additionally, always ask doctors and nurses if they have washed their hands before any interaction to promote a partnership in care and reduce infection risk.

6. Contact Patient Relations for Concerns

If care does not seem right, communication is ineffective, or an error is suspected, contact the hospital’s patient relations department. They have staff on call 24/7 to address concerns and ensure issues are formally reviewed.

7. Value Non-Technical Skills

Medical professionals should prioritize and develop non-technical skills like effective communication, teamwork, and organizational abilities, not just technical procedural skills. This holistic approach contributes to safer systems and better patient outcomes.