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This is not my first rodeo when it comes to writing about medical negligence, malpractice, doctor errors and physician mistakes. I don’t always have the support of the Wall Street Journal. Over 4,000 mistakes per year are too many.

We are all human, even surgeons, but we put our lives in their hands. They were taught in school, trained by more experienced doctors, and then fly solo with their staff of trained assistants and colleagues. I realize stuff happens, bad results occur, and some surgeries have unavoidable consequences, but not “never events.” They should never occur. They do happen and much too often. I talk to victims and survivors weekly if not daily from Mid-Michigan.

Mistakes like wrong side, wrong site surgery, leaving a sponge or other instrument in, taking out the wrong organ, or severing the wrong duct, artery, or nerve should never happen with proper planning and technique. Many of the calls result in relatively minor impact but some result in serious permanent injury or necessitate a loved one’s call on a dead patient’s behalf. Medicare has taken the position that it won’t pay for the consequences of these “never events” and why should the taxpayer cover these costs? Frankly, why should the victim’s health insurance company pay if it was someone else’s fault and they have malpractice insurance that has already been paid for? I can’t tell you how many times I have had this argument with doctors, hospitals, and their lawyers during settlement negotiations. Certainly the victim/survivor should be covered.

How can this unacceptable number of “never events” be eliminated?

Here are some questions you can ask:

  • What surgery are you recommending?
  • What experience do you have in doing the procedure?
  • What are the risks and benefits?
  • Where will the surgery be done?
  • What type of anesthesia will be used?
  • What alternatives are there?
  • Should I get a second opinion?
  • How long will the recovery be?

No question is a bad question, so be your own advocate or bring an advocate to speak up for you.

Here are some things your doctor should do:

  • Doctors should confirm/double check ID
  • Verify the procedure
  • Take a time out
  • Check I D and procedure again
  • Communicate so everyone in the room is on the same page
  • Obtain a proper history
  • Properly document the entire encounter

Failure to follow these protocols can get a surgeon in trouble. This redundant, deliberative process is similar to the old adage “Measure twice, cut once.”

Patient safety should be the highest priority in operating rooms, hospitals, and doctors’ offices. Patient Safety First!


  1. Gravatar for John McKiggan
    John McKiggan


    Great information. I think it's important to provide the public with tools to educate themselves and to encourage them to advocate for themselves.

    Your checklist is a perfect example. I wrote about a study in the New England Journal of Medicine that found using surgical checklists reduced fatalities by more than 40%!



  2. Gravatar for Chad Engelhardt
    Chad Engelhardt

    As usual, an excellent and insightful article Mr. Mittleman.

    What is amazing is that these are just the sentinel events which resulted in payment. These catastrophic medical errors are significantly underreported and go uninvestigated or even covered up by hospitals. Preaching to the choir, it is only the civil justice system that bring these never events under scrutiny and only a civil justice system free of tort deform will has the real teeth to make our medical system safer.

  3. Gravatar for Minna

    Good information and toooooo bad about doctor responsibility.

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