Medical Malpractice: Does Teamwork Cause or Contribute to It?

A piece in the NY Times questions a long-held assumption that physician fatigue contributes to medical error. Instead, the article advances the theory that the makeup of an operating team determines its efficacy.

The former theory has reigned over much conversation among the health community for over a decade. In 2003, a law was passed prohibiting doctors-in-training from working over 80 hours per week. That law arose from the LIbby Zion case involving doctors-in-training who were working in excess of 80 hours per week and found to have fatigue contributing to patient errors. Hospitals have since focused on improving their doctors' lifestyles.

However, transplant surgeons have to be on call round the clock, as determined by a donor's time of death. Kidney and liver transplants have recently been studied. The results have determined that late-night transplants leave greater adverse effects upon patients than do those during the day. This therefore supports the fatigue theory.

On the other hand, a report published this week in the Journal of the American Medical Association conducted a more comprehensive study. As opposed to surveying just one institution as the former two studies did, this one investigated each of the nearly 30,000 chest (heart and lungs) transplants in the United States over the past decade.

Surprisingly,  equal results were found when comparing late-night chest transplants to mid-day chest transplants. Upon closer examination, the study noted that most of the teams at night and during the day consisted of the same surgical team. After all, chest transplant surgeons are in short supply and they tended to handle other, non-transplant operations during regular hours. Many surgeons keep the same specialized assistants around for non-transplant duties.

Therefore, if a specialized team is gathered for other operations like they normally are for cardiothoracic operations, then the incidence of medical error will not necessarily depend on fatigue.

As a practicing medical malpractice, wrongful death attorney in New York, I deal with malpractice issues like these every day. If you would like more information about how medical malpractice cases work in the state of New York, I encourage you to explore my educational medical malpractice website. If you have legal questions, pick up the phone and call me at 516-487-8207 or by e-mail at lawmed10@yahoo.com to answer your questions. That's what I do every day. I welcome your call.