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Medicine 2012-09-19 2 min read

Studies Show Fatigued Surgeons Pose Safety Risk to Patients

There are few situations in which a person is more vulnerable than when being operated upon. Doctors are human, and humans make more mistakes when they are fatigued.

September 19, 2012

A recent study published in the professional medical journal Archives of Surgery reveals startling results: On average, surgical residents spend half of the time they are awake at less than 80 percent of their full mental capacity, and one-third of the time at less than 70 percent.

The study tracked 27 orthopedic residents. The average resident got five hours of sleep per night, but some residents averaged as little as less than three. Overall, fatigue was very prevalent.

Residential surgeons are prohibited from working more than 80 hours per week, but that number is measured on a monthly basis, meaning some surgical residents may in any one given week work longer than 80 hours. Residents also cannot work longer than 24 hours in one shift. In order to have surgical residents at the hospital at all times, some may be put on "night-float" rotations, meaning they are always working nights and sleeping during the day. For night-float residents, fatigue was higher.

No actual medical errors occurred during the study, but its author, Dr. Frank McCormick, noted that the study did show an increase in the risk of surgical errors for doctors who have had little sleep.

Fatigue May Lead to Medical Errors

A 2009 study by Harvard associate professor Dr. Jeffrey Rothschild found that doctors who were called in for emergency surgery the night before were more at risk to commit medical errors or have complications the next day.

Chief of the Division of Sleep Medicine at the Brigham and Women's Hospital in Boston, Dr. Charles A. Czeisler, told CNN that performing surgery after a sleepless night was comparable to driving with a blood alcohol content of 0.1 percent, which would be illegal in all states. In 2006, Czeisler conducted a fatigue-related survey of 3,000 residents in their first postgraduate year, and 20 percent admitted to committing an error related to fatigue.

Perhaps that is why in 2010, a New England Journal of Medicine editorial urged doctors who perform elective surgery to tell their patients if they are sleep deprived before performing surgery. The patient could then choose to postpone the surgery or have another surgeon operate.

There are few situations in which a person is more vulnerable than when being operated upon. Doctors are human, and humans make more mistakes when they are fatigued. Anyone who has been harmed because of a medical error should contact a skilled medical malpractice attorney to discuss his or her legal options.

Article provided by Law Offices of Piazza, Simmons & Grant, L.L.C.
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