Medical Technology That Can Be Bad for Your Health

Medical technology can and often does save lives — but sometimes the unthinkable happens and the device that was supposed to help a patient actually causes harm, perhaps even death. With patient safety rising to the top of the list of hospital priorities, each and every aspect of care is being scrutinized for improvement opportunities, including medical technology. I recently took a look at a report entitled Top 10 Health Technology Hazards, released by the ECRI Institute, an organization dedicated to improving the quality of health care. Dan Alt, manager of ECRI’s problem reporting system, told me that while some problems on the list are related to equipment design, others are caused by human error — and most are avoidable if hospitals take specific precautions. Alt said the goal is to prevent, not spread, panic.

What Are The Dangers?

What are the dangers on ECRI’s list? Here are the top 10:

1. Alarms that fail to adequately convey when a patient is in danger. For example, desensitization, improper settings or disabling of alarms put patients at risk if an emergency is not recognized.

2. Needlesticks and other sharp objects. These may expose clinicians (and even patients, though this is highly unusual) to life-threatening pathogens, including HIV.

3. Air embolism from contrast media injectors used in angioplasty. These high-tech power injectors can introduce air bubbles into the blood vessel, which may cause a dangerous, sometimes even fatal, air embolism.

4. Foreign matter left in patients after surgery.

5. Surgical fires. Fortunately these are quite rare (about 650 a year). Like all fires, surgical fires are caused by an ignition source (for instance, an electrocautery device or a laser) in the presence of supplemental oxygen (for anesthesia) and a fuel source. The complicating factor in surgical fires is that two clinicians are effectively “in control” of two of the factors — the surgeon of the lasers and electrocautery devices, the anesthesiologist of the oxygen. They must work together to reduce the risk.

6. Anesthesia equipment that hasn’t been properly checked prior to each use. This carries the risk of problems like misconnected breathing circuits, ventilator leaks or empty gas cylinders.

7. Misleading patient information displays, which convey ambiguous or confusing data, such as vital signs and airway pressure.

8. CT radiation dose. Exposure to the high radiation levels from CT scans is thought to account for about 6,000 additional cancers each year for patients.

9. Magnetic resonance imaging (MRI) burns. Causes include crossed cables, improperly placed sensors or patient contact with the coils.

10. Fiber-optic light-source burns, typically caused by inappropriate placement of cables on the patient.

HEALTH CARE IS HIGH RISK

This report was created from information taken from a number of medical reports and resources. (You can see the report at ecri.org.) James Conway, MS, senior vice president of the Institute for Healthcare Improvement (IHI.org), called the findings “sobering” but noted that it is important to remember that “health care is a high-risk industry.”

On the positive side, Conway pointed out that the fact that the report even exists is evidence of the new focus on patient safety, which only became a priority in the last decade. He said that hospitals are getting serious about safety issues, setting up groups and committees to deal with issues raised by reports like the one from the ECRI Institute. However, he said his observation is anecdotal and doesn’t necessarily represent the majority of hospitals. The idea that patient safety isn’t always paramount in the medical field is disconcerting. While patients generally can’t do a great deal to eliminate or avoid these high-tech hazards, Conway said forward-looking organizations should welcome input from patients and family members about matters of concern.

WHAT CAN YOU DO?

Conway offered five suggestions to patients to help improve the effectiveness and safety of their medical treatment…

  1. Educate yourself and compare options. I’ve written often on the importance of evaluating hospital quality data before you decide where to be treated.
  2. Ask questions. If you don’t understand something, ask. Bring a list of questions to each visit with your doctor and get precisely detailed answers about the procedures, medications, etc., so you understand exactly what is supposed to happen.
  3. If you see something, say something. As a patient or a visitor, if you notice that something doesn’t look right — a medication that doesn’t look like what you’ve been getting, or a monitor that seems to be acting funny — speak up.
  4. Never go alone. Bring someone with you for each doctor’s visit. They’re sure to see or hear things you’ll overlook or that you’ll forget.
  5. Give — and demand — respect. If you aren’t satisfied with an answer, respectfully ask to speak to someone else. Or ask the nurse or physician to double-check. You deserve a thorough answer. And getting the answer you deserve can go a long way to making your stay safer.