Medical errors can cause illness or even death in patients, increase costs, and bring lawsuits for doctors and hospitals. Children can be more vulnerable than adults to errors—in large part because they are often too young to question what is happening to them and administer their own medications. A new study from doctors at Johns Hopkins University and the Agency for Health Research and Quality examined data from millions of hospitals to find out the impact of medical errors on children.

What the doctors wanted to know: How often do preventable medical errors happen to hospitalized children and how do errors affect their care in the hospital?

What they did: The researchers used data from the federal government's Healthcare Cost and Utilization Project, which has been collecting data from most hospitals around the country since 1988, pulling out 5.7 million hospital discharge records from 2000 from children younger than 19. They looked for children who, in the course of their hospitalization, had experienced various medical errors, such as complications of anesthesia, foreign objects left in the body during surgery, and lacerations on a teenage mother during childbirth. In addition to compiling the number of patients who were victims of medical errors, the researchers analyzed which procedures were most prone to error and which patients were at highest risk.

What they found: About 50,000 of the patients in the study were affected by medical errors in 2000. The highest rate of errors occurred in obstetrics. One in 10 new teen mothers were harmed while giving birth, and that rate jumped to 1 in 5 when the doctor used forceps or a vacuum to assist in the birth. Younger children, especially those under one year, were also more likely to experience errors in their treatment, as were children on Medicaid. The length of hospital stay was extended by as much as a month, on average, because of some hospital errors, particularly mistakes associated with surgery. Based on that increased length of stay, the authors estimate medical mistakes increased the costs of healthcare by more than $1 billion in 2000.

What it means to you: Medical mistakes are still the exception to the rule, but they are something to watch out for. The authors called on institutions and the government to improve oversight and programs that promote patient safety and said that their research forms the basis for further studies to determine the exact cost of medical errors. Individual patients or their parents, meanwhile, should not stop trusting healthcare providers but should pay attention to the care a child is receiving.

Caveats: The data used in this study, though better than most tools available, is not completely accurate. The indicators of medical errors may encompass natural injuries and likely don't include every injury sustained because of a medical error. In addition, discharge records are often different at different hospitals, so it is hard to combine them to create a uniform set of study criteria.

Find out more: The Agency for Healthcare Research and Quality, part of the Department of Health and Human Services, advocates for patient safety and quality of care. That website includes information about the data the researchers used in this study, from the Health Care Cost and Utilization Project.

Read the article: Miller, M.R. and Zhan, C. "Pediatric Patient Safety in Hospitals: A National Picture in 2000." Pediatrics. June 6, 2004, Vol. 113, No. 6, pp. 1741–1746.

Abstract online: http://pediatrics.aappublications.org