Many Iowans have suffered medical errors, and most weren't told, poll finds

Nearly one in five Iowans say they’ve had personal experience with medical errors, such as surgical mistakes, wrong diagnoses or incorrect medications, a new poll shows. In more than half of those cases, medical staff members did not inform the patients.

The poll, organized by the Heartland Health Research Institute, found that 19 percent of Iowa adults have experienced a medical error in their own care or in the care of someone close to them in the past five years. Among those who said they’d experienced such an error, 60 percent said they were not informed about it by medical staff members.

“This is something we need to open our eyes about,” said David Lind, who runs the Clive-based research company. “If we want to reduce medical errors, we have to know how many medical errors we have.”

Lind, who has spent years analyzing the rising cost of health insurance provided by Iowa employers, decided to study medical errors because he sees them as an expensive, tragic and avoidable problem. He notes national studies estimating 98,000 to 440,000 patients die per year due to medical errors. In Iowa, that would translate to between 959 and 4,300 deaths, many of which could be prevented, he said.

Lind spent $47,000 to hire a professional polling firm to seek the views of 1,010 randomly selected Iowa adults. Many of the Iowa survey’s questions were developed by Harvard University researchers for a poll done of Massachusetts residents. The margin of error for the Iowa survey is 3.1 percentage points. The results are published in a 55-page report released Monday.

“It’s not to frighten people — it’s more to enlighten people about what’s going on,” Lind said of the report.

Here are some of the key findings:

Of those who experienced medical errors, 59 percent said the mistakes happened in hospitals, 29 percent said the mistakes happened in clinics, 4 percent said the mistakes happened in nursing homes and 8 percent said the mistakes happened somewhere else or they were unsure.

Sixty percent of those who experienced medical errors said the mistakes caused serious health consequences. Ninety percent believed the errors were preventable.

Ninety-five percent of Iowa adults think hospitals should be required to report all medical errors to a state agency. Ninety-eight percent think all health care providers should tell patients when errors occur. Fifty-seven percent believe their personal doctors would do so.

A leading Iowa health care quality expert said most doctors and hospital leaders agree with Lind that medical errors should be curbed and patients should be notified if they happen. “The providers really want to communicate with the patients if an unintended consequence happens,” said Tom Evans, a Des Moines physician who leads the Iowa Healthcare Collaborative.

The state’s main hospital and physician associations helped found Evans' group in 2004, as a way to improve the quality of health care. Evans said attitudes have come a long way, including among his fellow physicians. “It’s based on the premise that one error is too many,” he said. “…I think the days of people sticking their head in the sand and saying, ‘It didn’t happen,’ are a long time ago.”

An Iowan whose baby daughter was permanently injured by a medical error said she was surprised to hear just 19 percent of Iowans have experienced such mistakes in their own cases or those of loved ones. “I think people don’t always realize it happened or they don’t want to think it happened — they’re kind of in denial,” said Ingrid Gerling of Burlington.

Gerling’s daughter, Nyasia, had nerves in her right arm torn away from her spine as medical professionals tried to pry her out of the birth canal 10 years ago. Her right arm and hand are virtually unusable. The family sued, alleging the doctor ignored clear signs that the birth should have been done by cesarean section. A jury awarded the family $5.5 million.

Gerling spoke at the Iowa Statehouse last spring against limits on such awards. Legislators approved some of the limits, even though the number of medical malpractice lawsuits filed here has been dropping for years. The number fell from 335 in 2002 to 182 in 2016, state court administrators say.

Evans said doctors and hospital leaders have learned that malpractice lawsuits are less likely if patients are informed immediately when there is a problem. Lisa McGiffert, a national advocate for patients’ rights, agreed.

McGiffert is a health policy expert for Consumers Union, which publishes Consumer Reports magazine. She said numerous studies show patients tend to sue if they feel they were misled about their care. Patients generally understand that mistakes can happen, she said. “What really ticks people off is when the hospitals and doctors clam up about it.”

McGiffert’s group pushes for more openness in health care, and it notes there has been progress.

One of the primary patient-safety focuses in Iowa — and nationally — has been on reducing the spread of deadly bacteria in hospitals. Years ago, many hospitals resisted public reporting of how often their patients were becoming infected, especially with bacteria that had become resistant to antibiotics. But hospitals are now required to report such rates, and hospital-acquired infections have fallen significantly.

“When I first started in 2003, people just didn’t believe infections were preventable — and now they know most of them are,” she said.

McGiffert said Lind’s Iowa survey offers insight into medical safety issues. “It’s important to tap into patients’ experiences. We rely too much on what hospitals report,” she said. “I think this is really exciting. I wish every state could do it.”

Preventing medical errors

Here is a list of tips for patients hoping to prevent a medical error by one of their care providers, assembled by the Heartland Health Research Institute and the Agency for Healthcare Research and Quality: