CLINICAL CROSSROADS CLINICIAN’S CORNER CONFERENCES WITH PATIENTS AND DOCTORS A 62-Year-Old Woman With Skin Cancer Who Experienced Wrong-Site Surgery Review of Medical Error Thomas H. Gallagher, MD, Discussant After a life-threatening complication of an injection for neck pain several years ago, Ms W experienced a wrong-site sur- DRDELBANCO:MsWisa62-year-oldwomanwhoexperienced wrong-site surgery when a lesion was removed from her face. gery to remove a squamous cell lesion from her nose, fol- Several months ago, a pink, scaly plaque on her face was bi- lowed by pain, distress, and shaken trust in clinicians. Her opsied and diagnosed as a 0.5-cm squamous cell carcinoma. experiencehighlightsthechallengesofcommunicatingwith Threemonthslater,MsWenteredanoperatingroominaBoston, patients after errors. Harmful medical errors occur relatively Massachusetts, hospital for surgery to remove the skin cancer. frequently. Gaps exist between patients’ expectations for The morning after her surgery, Ms W removed her ban- disclosureandapologyandphysicians’abilitytodeliverdis- dages and discovered that the surgery had been performed closureswell.Thisdiscrepancyreflectsclinicians’fearofliti- on an area to the right of the lesion. Ms W feels that the sur- gery team marked an area of skin incorrectly before the sur- gation,concernthatdisclosuremightharmpatients,andlack gery was performed and believes she would have identified of confidence in disclosure skills. Many institutions are de- the mistake if she had been given
JAMA – American Medical Association
Published: Aug 12, 2009
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