Doctors are human too and sometimes they make mistakes. The mistakes sometimes mean the difference between life and death. Luckily for the rest of us, most doctors really take it personally when they
Tough Mistake
“I’m a surgical resident and my focus is on pediatrics. I have done a fair amount of surgeries so far and death is not an uncommon thing for me. But the worst was a case with a then 8 year old kid. I was operating on his ulnar and accidentally caused damage on the nearby nerve. He lost about 20% of his sensory stimulus. He wanted to be a violinist.”
Very Tragic
“I had a 9 year old girl bought in one night with her parents complaining of fever and respiratory distress, presenting with coughing and wheezing. The kid was really out of it and the parents were very upset. I thought it was Bronchitis, but I admitted her and ordered treatment for her fever and cough as well as throat cultures.
I was with another patient when the kid started hallucinating, sobbing and spewing everywhere. I figured it had to do with the fever, so I packed her with ice, but she died maybe a half hour after that. This wasn’t my first death, but it was one of the worst. I couldn’t tell the stiff neck since the kid was out of it. She also couldn’t tell me anything else that would point to simple or complex seizures.
She died of neisseria meningitidis. Completely wrong diagnosis. To make matters worse, we called in all her school mates and anyone else we could wake up just in time to see three other kids go. The rest got antibiotics quickly enough.
Probably my worst day in medicine.”
Youthful Mistake
“As a very young doctor in training I misdiagnosed a woman with epilepsy. Some years prior she had sustained a gunshot wound to the frontal area, damaging the underside of one of her frontal lobes and severing an optic nerve to one of her eyes, as well as some of the muscles that rotated that eyeball. Surgery saved her life but the frontal lobe was scarred and the eye was blinded and always pointed down and at an angle away from her nose.
A few years after that she began having spells of a bizarre sensation, altered awareness, a pounding in the chest, and she had to sit down, stop what she was doing, and couldn’t speak. These were odd spells and I assumed she had developed frontal lobe epilepsy from the scar on her brain. Increasing doses of anti-seizure drugs seemed to work initially, but then the spells came back.
A couple years after my diagnosis her endocrinologist, who treated her for diabetes mellitus, checked a thyroid. It was super-high. The spells were manifestations of hyperthyroidism. She drank the radioactive iodine cocktail which ablated her thyroid, got on thyroid replacement therapy, and felt well thereafter. No permanent harm done and she was able to come off the anti epilepsy drugs.
She was obese – not the typical skinny hyperthyroid patient – and if she developed thyroid eye disease, I couldn’t tell because her one eye was already so messed up. I see how I screwed it up. but in retrospect I have never been sure what I could have done differently, except test her thyroid at the outset of treatment. Hence, a lot of patients – thousands – have had their thyroid checked by me since then. Every so often I pick up an abnormality and it gets treated.
The lady was an employee of the hospital where I trained and I ran into her one day;she gave me a hug and let me know how this had all gone down. She made a point of wanting me to know she didn’t blame me “because I always seemed to care about her and what happened to her.”
I think about her, and how I screwed up her diagnosis and set back her care, almost every day. I am a much better diagnostician now but I always remember this case and it reminds me not to get cocky or be too sure that my working diagnosis is correct.”
Paging Dr. House
“My first week of my intern year (year one outside of medical school, when you’re on call overnight and all that, AKA “Season One of Scrubs”), everyone “signs out” their team’s patients to the doctor on call overnight. So that doctor (intern, with an upper-level resident also present overnight to supervise) is covering many patients they hardly know, maybe 60 or more. The situation was that a patient with dementia, unable to really communicate with people and clearly ‘not there’ but conscious, arrived from a nursing home with I think some agitation as the original complaint.
Basic labs ordered in the ER show the kidney function is worse than usual, which could be due to many things, but what really MUST be distinguished is between ‘not enough blood pumped forward to the kidneys and rest of the body’ (e.g. heart is failing and it’s backing up into the lungs) VS ‘not enough liquid in the blood TO flow’ (e.g. due to vomiting a lot or something). This is critical to distinguish because for the first you give medicine to make them pee out the extra liquid, and in the second you give more fluid. Either treatment for the opposite problem is catastrophic. Fortunately it’s usually easy to distinguish ‘wet’ from ‘dry’, based on listening to heart and lungs, chest x-ray (is there ‘congestion’ evidence?), blood pressure and heart rate (tend to drop BP and raise heart rate upon going from laying down to standing positions if you’re too ‘dry’), looking at neck veins while sitting up at an angle (they bulge if too ‘wet’), and so on. This patient was unable to cooperate with exam, answer questions, and the X-ray was sort of borderline (unchanged from the last x-ray maybe several weeks ago). My resident instructed me to sign out the patient with instructions to continue a 500mL saline inflow, then re-assess to see whether the patient looked more ‘wet’ or less ‘dry’. I signed this out, and forgot to make the order to stop the saline after 500mL, so it ended up running slowly in all night. The intern on call (also first week as doctor) forgot to re-assess at all or shut off the saline if it had been noticed because so busy with new admissions. We’d also ordered 3 sets of ‘heart enzymes’ meant to diagnose a heart attack, one reason for a patient suddenly getting ‘wet’ (i.e. heart pump failure), since the EKG was not interpretable (had a pacemaker which makes it impossible to tell). Lab fucked up too, because hospital policy was that if the first set of ‘heart enzymes’ was negative, apparently the 2nd and 3rd sets, each traditionally spaced 6-8hrs later to catch a heart attack if it starts to evolve and become detectable by blood test, were both cancelled.
I came in and first thing in the morning checked on this patient, who was screaming things nobody could understand and the nurses had chalked up to dementia and agitation. I checked the labs and saw the second and third heart enzymes hadn’t been done. I went to the bedside and saw the IV fluids still running. I immediately ran to the overnight intern, who said things had been so busy and nobody had called to notify that things were wrong. We stopped the fluids, immediately got a heart enzyme test, learned this patient was by now having a massive heart attack made much worse by the addition of IV fluids all night to this frail failing pump. I can’t get the screams out of my head, and cried a lot and was pretty depressed for a few weeks at least after this. The patient died because the status ended up being decided as not to resuscitate based on what the nursing home had on file, although no family members were known at all. This patient was totally alone, and spent the last night of their life in physician-induced agony. But I acknowledge the failure of two interns, the nurses, and the lab. Ultimately the blame fell on the lab and I think someone was fired, but I made clear to everyone that I felt to blame and wanted quality improvements made to prevent future errors, or at least catch them early if they happen. That’s I think the best you can do when you make a mistake.
There’s a Scrubs episode where as I recall at the end there’s a brief scene where the ghosts of dead patients representing medical errors follow around the physicians like little trains. It’s very poignant, but I can’t find the clip. That’s what it’s like though.”
How Do You Miss A Gunshot?
“I missed a gunshot wound once. A guy was dumped off at the ER covered in blood after a rap concert. We were all focused on a gunshot wound with an arterial bleed that was distracting. The nurse placed the blood pressure cuff over the gun shot wound on the arm. We all missed it because the blood pressure cuff slowed the bleeding.
I was doing the secondary assessment when we rolled the patient, and I still missed it.
We didn’t find it till the chest x-ray. The bullet came of rest in the posterior portion of the thoracic wall without significant trauma to major organs.
The patient lived. But I still feel like I fucked up big time.”
The Baby Is Fine, The Scalpel Is A Goner
“Not me, but my mom. She just retired as an ob/gyn and she told me about a time early on in her career when, while not a real medical mistake, she still almost ruined the operation. She was performing a c-section I think, and she dropped her scalpel on the floor. Before she could think, she blurted out “oh s—!” as a reaction. The mother, thinking something was wrong with the baby, started panicking. It took a team of nurses, the husband, and the mother of the patient to calm her down.”
Close Call
“Pathologist here. Biggest mistake I ever made was cutting myself during an autopsy on an HIV patient. Lucky for me, I did not acquire the virus, so everything had a happy ending. (For me, anyway. That guy was still dead.)”
Stop Shocking The Patient
“Fun story, while my wife was having her c section for our daughter she over heard one of the nurses say “there’s only nine”, and my wife thought they were talking about my daughters fingers or toes. So she’s freaking out that our daughter is missing a finger or toe, and I keep assuring her that our daughter was perfect, which she was. We found out about 10 minutes later that the nurse was talking about the surgical tools that were supposed to be accounted for, and one of them was missing. So my wife got to spend the next 2 hours in x-ray because they thought they had left a tool inside my wife, and stitched her up. They found the missing tool, not inside my wife, a couple hours later, so that was a relief.”
More Than A Flesh Wound
“I’m a nurse, but I was working in the ER when a guy came in for a scratch on his neck and “feeling drowsy”. We start the usual workups and this dude’s blood pressure TANKED. We scrambled, but he was dead within 10 minutes of walking through the door. Turns out the “scratch” was an exit wound of a .22 caliber rifle round. The guy didn’t even know he’d been shot. When the coroner’s report came back, we found that he’d been shot in the leg and the bullet tracked through his torso shredding everything in between. There was really nothing we could’ve done, but that was a serious “what the fuck just happened” moment.”
Glad I’m Not Sick
“PharmD here. Couple different quick stories.
Heard of a pharmacist who filled a fentanyl patch incorrectly and the dose was so high that the patient went into severe respiratory depression and died. They’re still practicing.
Worked with another pharmacist back in the mid 2000’s when I was still a tech who filled a script for Prozac solution (concentrated it is 20mg per mL. Average adult dose is 20 mg.) instead of 1 mL once daily he filled it for one teaspoonful (5 mL). The child got serotonin syndrome and almost died. He is no longer working to my knowledge.”
Cough Free
“My grandmother has had diabetes for about 20 years, and takes a handful of meds to help control it. About 10 years ago, she developed a persistent cough. It wasn’t bad, she said it felt like a constant tickle in the back of her throat.
She went to her doctor to find out what was going on, and he ordered a battery of tests concerned that she was developing pneumonia, lung cancer, etc. All the tests came back negative, so he prescribed a cocktail of pills to help combat it. Over the span of 5 years, she had tried about 35 different meds and none helped.
One day when she went it for a routine check-up, her normal doc was out and she saw one of the on-call residents. He looked at the barrage of pills she was on and asked why. When she explained, he replied, “Oh, the cough is a side effect of this one particular drug you’re on to regulate your insulin. If we change you to this other one, it will go away.””
A Side Of Crazy
“Once transported a patient for suicidal ideations. Patient had suicidal thoughts and had resumed smoking after a 3-year hiatus shortly after being prescribed Reglan. She repeatedly voiced her opinion to her physician(s) that she was having side effects including wanting to kill herself; her doctor assured her the drug was safe- so safe he had prescribed it for his own mother. After she looked up side-effects on the Internet, she expressed concern to another doctor that her suicidal thoughts were caused by the drug, the doctor looked it up and reassured her that, while a possible side-effect, it was too rare to have caused her issues.
So, after a few days of this, she considers going out and buying a pistol. I forget if she called family or checked herself in, but she ended up in the ER and I transported her to a psych facility for evaluation. It was a very long trip, so we got to chat; poor girl was concerned she would be put into the proverbial “rubber room,” and I explained to her that wasn’t it at all.”
Right Up Main Street!
“When my dad was a resident he had a guy come in with a gunshot wound to the shoulder. The guy had been caught with another man’s wife and had been shot while running away naked. In addition to the shoulder, the patient kept saying he had been shot in the gut. Dad searched all over and couldn’t find a wound. But the guy kept complaining about excruciating pain in his lower abdomen. X-ray revealed that, indeed, there was a bullet in the abdomen. Took a while to find, but my dad finally found the entry wound… The guy had been shot directly in the a–hole. Swish.
A few years ago, I saw something very similar on ER. Guess if enough people get shot, there are bound to be a few one-in-a-million shots.”
Great Save
“This thread is pretty depressing, so i’ll lighten it up a bit. A few months ago, I accidentally ran a creatinine test on a patient when a comp metabolic wasn’t ordered. It turns out that the guy was in renal failure, and no one knew. He was about to go in for surgery ( I believe it was a bypass, but could be wrong), but I got the results in in time to stop them from putting him under. S— could have been messy. I’m glad I screwed up, and I’m sure he has no idea that he could have died.”
Side Effects
“Doctor saw Patient regularly for medication management. Patient came back for a follow up appointment with a very telling side-effect from a very low dose of a medication and no improvement in symptoms that the medication was intended to target. Because this particular side-effect is relatively mild early on and can also be caused by many other variables, Doctor was not duly suspicious of the medication being the cause of the side-effect and increased the dosage of the medication. Patient became very gravely ill several days later, and died a few days after that due to complications of the side-effect of the medication. It was a huge mistake and I can’t help but think if I had been the doctor, I wouldn’t have overlooked the side-effect, and Patient would still be alive.”
Blind Luck
“Dentist here. I was performing a simple extraction and preparing for the case when I didn’t realize that I had the xray flipped the wrong way the whole time. I was viewing the film backwards, and pulled out the wrong tooth. When I realized my mistake I started freaking out, only to find out that by some dumb luck, the tooth I extracted had to go as well.
For the record, this happened in dental school, so safe to say it was a learning experience. It was my first and very last time to make that mistake…. And yes, we are doctors.”
No Skin Off His Nose
“I once had my deviated septum corrected through surgery (and a nose job at the same time, I’m vain, sue me). When they cut up the inside of my nose and cracked all the bones and stuff, they made scabs and blood clots that had to be removed by sticking a thin hose up my nasal cavity that sucked all that crap and gunk away.
Well my doctor was up there and said, “Hmm, that’s a big scab…” and then sucked it off with the hose. Picture a desk fountain that trickles a steady stream of water around a zen garden. That started coming out of the back of my throat. That desk fountain is in Danzig’s study, and a river of blood gushed from my mouth.
The doctor turned white. He tried to suck away the blood, but it wouldn’t stop pouring out. He started to panic a bit, but I was calmish. I think it was the lack of blood. He finally decided to call an ambulance to get me to a hospital for an emergency cauterization. It was that, bleed out, or pack my nose with gauze that would have to stay in for three more weeks.
Mind you, this gauze sucks. It feels like you constantly have stuffed sinuses, you can’t taste anything, and it stays in for three fucking weeks.
I didn’t want to risk dying, so I went with the gauze.
While the doctor was preparing to put it in, I took a picture with my phone doing a thumbs up. I don’t know why I did this.
So anyway, he shoves it in, and I instantly regret not just bleeding out. He starts to apologize profusely but I realized two things. One, he had to cancel all of his patients because of this emergency which sucks for business and sucks for him. Two, he was just doing what he was doing for the last five cleanings (this was the last trip on the process and the last scab, go figure).
F’ing people make mistakes. So do doctors. Some times mistakes are out of our control. I can’t predict what the human body is going to do every time. So thanks for what you do, and for taking it on the chin when we hate you for fucking up.
Also thanks to my doctor, my nose is solid as a rock.”
Do your Best
I have 2 (that i know of)
Tried to protect the kidneys of a gentleman who had to get just a TON of contrast. ended up giving him too much fluid and pushed him into pulmonary edema. spent about an hour on bipap but did OK after.
did an FAST ultrasound on a trauma patient. thought it was negative, but in retrospect had a small pericardial effusion. He coded about 30 min later after said effusion expanded. had so much head trauma everyone told me he wouldn’t have lived anyway… but still feel awful about it.
EVERY resident and doctor makes mistakes and the ER is basically a perfect storm of the factors that contribute to errors (multiple patients, constant interruptions, fast paced environment, lack of familiarity with patients, ETOH/drugs, incomplete histories, and multiple providers). you just hope that when they happen your mistakes are small.
Our hospitals and programs try VERY hard to have a blame free work environment as when you review common medical errors they are usually caused by a culmination of circumstances rather than one person just not doing their job right. Residents routinely present M&Ms (morbidity and mortality conferences) that go through the scenarios that led to the mistake and analyze the reasons and fixes that can be made. Its universally thought of as our best conference because you can often see how very easily one could have made the same mistake in the other persons shoes.
as has been said, we try our best to do right by patients and to get the right answer. I work with incredibly smart people every day who are driven, committed, and who have excelled their whole life in order to be incredible doctors. unfortunately errors are part of the job. We just need to do your best to recognize them, learn from them, and most importantly prevent them from occurring more than once.”
Glass In The Works
“Here is a good one I didn’t cause but “saved the day” as a resident that was surgically assisting. C-section for failure to progress and ugly looking fetal strip…all went perfect, time to take cord blood and I am to fill up the test tube..surgeon looks at it and it has one very large chunk of glass broken off of the rim (3x4cm)…there is an open abdomen in front of us with blood clots everywhere. So as safely as possible we are sticking our hands around to try and find this glass…if it is inside the abdomen the chance of even seeing it on x-ray is minimal and this will dice up this patients bowels/blood vessels and God knows what else. After approx 3-4 min (felt like 10) I feel an edge of something firm just inside the edge of the incision…pull up a blood clot with the glass piece inside…didn’t go into the cavity and all is well. Surgeon said she’d buy me a drink…never did get it
Mistakes Happen, Own Them,
“When I was a student rotating through OB/Gyn, and I wrote an order for a woman’s post-partum continuation of magnesium sulfate, as she was pre-eclamptic ante-partum. I was super careful, because I knew what could happen with magnesium toxicity, and double-checked the order with the resident afterwards.
The nurse, instead of hanging one bag of mag-sulfate and another of I forget what, hung two bags of mag-sulfate, one of which she slammed into the patient over a minute, instead of slow-infusing over 12 hours.
The woman told the nurse she didn’t feel right, and the nurse poo-pooed it. I happened to be walking by, and stopped in to see what was up. There they were, two bags hanging, both marked in a bright red warning label. We called for the fast response team.
They, and my team, got there in time and took over, but she still went into respiratory depression and ended up in the ICU.
We all make mistakes, some of which are dangerous. I’ve absolutely made my fair share. I’ve missed diagnoses, or tried to save patients from a trip to the ER and they’ve ended up in the ER anyway, just later. As long as you recognize your mistake and make an effort to improve afterwards, and it wasn’t too neglectful/egregious, I understand.
But I reamed the nurse when I overheard her laughing about the incident like she hadn’t just almost killed someone. I don’t know what she thought, getting told off by a rotating student, but I was pissed at the time.”