Monday, June 17, 2013

A medical journal's abdication of editorial responsibility -- Part 2

#TPSER9 I spoke too soon when I referred below to a 2001 article in the Journal of Pediatric Surgery where the editors decided to ignore the death of Lewis Blackman in a summary of cases concerning elective surgery to repair a condition called pectus excavatum (sunken chest).  A more extensive review was published by the same journal several months later in March, 2002 (Vol. 37, No. 3).  From the abstract:

Methods: From 1996 to 2000, 68 PE patients underwent MIRPE at one hospital, and 139 underwent MRR at another hospital. Ages ranged from 5 to 19 years (mean, 12) for MIRPE, and 3 to 51 years (mean, 17.3) for MRR. The mean pectus severity index was 4.2 for MIRPE and 4.9 for MRR (normal, 2.5). Results: There were no deaths after MIRPE or MRR.

One of the hospitals included in the survey was the one in which Lewis Blackman had his surgery and died. But the sample described in the article ended in September 2000, and Lewis died in November.

It would be virtually impossible for the authors of this paper--including surgeons from the hospital in South Carolina--and for the editors of the journal to be unaware of the Blackman case.  The ethical issues I raised in my first post are only compounded by this expanded article.

By the way, in 2005, the state of South Carolina passed a law named the “Lewis Blackman Hospital Patient Safety Act” to deal with the issues raised by this case.  As summarized here, it required all clinical staff in hospitals to wear identification tags, labeling job and status. The law also mandated that patients be informed of how they can contact an experienced doctor or summon help quickly when they experience medical problems in a hospital.


e-Patient Dave said...

I don't want to seem too snippy here but my impression from reading this post is the common scenario after many investigations: "We're not saying anything happened here. But we've taken steps to make sure it never happens again."

Anonymous said...

I heard a useful way of asking for experienced help while sitting at a branch banker's desk while she was struggling with her back office on my behalf:

"Is there an escalation procedure here?"