Too Many Patients Can Lead To Hospital Errors

Most of us like to think we are good at multitasking. However, research shows that multitasking is a myth. In reality, we are just switching our attention from one task to another quickly. Taking your attention away from one task can lead to mistakes. For many people, a multitasking mistake at work may lead to sending out an email to the wrong person. However, for doctors, cognitive overload can endanger patient safety.

According to neuroscientist Earl Miller, “People can’t multitask very well, and when people say they can, they’re deluding themselves. Switching from task to task, you think you’re actually paying attention to everything around you at the same time. But you’re actually not.”

In an emergency medical situation, patient overload often involves multiple interruptions, resulting in errors and compromising patient safety. A case study reviewed an overloaded intensivist’s treatment of a 72-year-old female patient. The patient was admitted to the intensive care unit (ICU) after going into acute respiratory distress related to acute pancreatitis. She was given a central line, and immediately administered IV fluids and vasopressors.

However, over the next 8 hours, the patient’s condition continued to deteriorate. The intensivist in charge was taking care of 9 other complicated ICU patients, talking to patients’ families, and dealing with nurses and respiratory therapists. The 72-year-old patient eventually went into cardiac arrest. After 25 minutes of resuscitation, led by the intensivist, the patient regained a pulse.

After a full set of lab tests, the intensivist was thinking about what to do next. However, another ICU nurse approached the doctor about a different patient. This type of cognitive overload can prevent the doctor from having adequate, uninterrupted time to interpret the patient’s symptoms. According to some studies, cognitive interruptions can compromise attention and memory.

Hours later, after a chest radiograph was performed, a radiologist informed the intensivist that the patient had a large pneumothorax, or collapsed lung. A thoracic surgeon placed a chest tube in the patient, who immediately began to respond with increased oxygenation and blood pressure. However, the patient’s blood pressure dropped again and she continued to suffer progressive acidosis.

When a central line is inserted, there is a small risk of puncturing the lung, causing a pneumothorax. The rate of pneumothorax after a central line insertion is less than 1%. While the chest radiograph usually shows evidence of a collapsed lung, some pneumothoraces may not be visible on the film. According to the authors of the case study, “multiple interruptions, stress, and patient complexity led a critical care physician to experience cognitive overload and an inability to maintain situational awareness to recover from interruptions.”

Eventually, the family decided to withdraw support, and the patient died. According to the case study, the intensivist “didn’t have the time to think more broadly about why the patient was worsening despite treatment, and that she had felt overwhelmed by numerous required tasks and multiple interruptions.

If you or a loved one was injured by a medical mistake, you may have a claim against your healthcare provider for the damages suffered. A medical malpractice claim may allow you to recover monetary damages for your medical bills, pain, and suffering. At Gilman & Bedigian we have been fighting for medical malpractice victims for decades, with a focus on getting you the compensation you deserve, so you can get better and move forward with your life.