{
  "id": "2003-february-digging-into-health-medicine",
  "slug": "2003-february-digging-into-health-medicine",
  "url": "https://dwillis.github.io/uplink/article/2003-february-digging-into-health-medicine.html",
  "year": 2003,
  "month": "February",
  "monthNum": 2,
  "headline": "Digging into health, medicine",
  "kicker": "SPOTLIGHT:",
  "author_name": "Megan Christensen",
  "author_title": "",
  "affiliation": "IRE and NICAR",
  "summary": "Medical errors cause tens of thousands of deaths annually, prompting journalists to use databases like MAUDE and state health records to investigate faulty medical devices, nursing shortcomings, and hospital safety issues. The article provides guidance on accessing and using various data sources for investigating medical errors and public health stories.",
  "keywords": [
    "errors",
    "databases",
    "hospitals"
  ],
  "topics": [
    "Data & Databases",
    "Health & Environment",
    "Investigative Methods"
  ],
  "technologies": [
    "MAUDE"
  ],
  "full_text": "The toll of medical errors - estimated at 44,000 to 98,000 a year - gained national attention after the National Institute of Medicine released \"To Err is Human\" a few years ago. Citing death rates greater than those from highway accidents or breast cancer, the report challenged the medical establishment to reduce errors by 50 percent in five years.\n\nJournalists were already on the story, using databases to examine faulty medical products and shortcomings in patient care. A variety of data sources can help with big-picture analysis and breaking public health news, whether it's suspicious hospital deaths or a product recall.\n\nWhen Michael Berens investigated the impact of errors by nurses for the Chicago Tribune (Story No. 17136 in the IRE Resource Center), he found that at least 1,720 patients had died and more than 9,500 had been hurt due to registered nurses \"besieged by cuts in staff and other belt-tightening in U.S. hospitals\" from 1995-2000.\n\nA major resource for the investigation was the Manufacturers User and Device Experience Database (MAUDE). This database from the U.S. Food and Drug Administration contains reports about injuries, deaths and accidents related to medical devices. It also contains information about the malfunctioning devices.\n\nThe Star-Ledger recently used MAUDE in its investigation of faulty medical devices. (See \"Databases show implant troubles\" on page 1).\n\nOne of the most useful features for journalists is a memo field detailing the incidents. It also contains references that can be used to request detailed records for each report.\n\nIt takes patience to cull through MAUDE, because incident reporting is voluntary and thus prone to gaps. Data entries also are inconsistent. Journalists using MAUDE can examine specific products or manufacturers, as the Tallahassee Democrat did for its report about automated drug pumps linked to accidental overdoses (Story No. 17311).\n\nMAUDE is available from the IRE and NICAR Database Library. For more detailed information about the data see www.ire.org/datalibrary/databases/maude/.\n\nBerens also used a database of investigative records from HCFA (now known as the Center for Medicaid and Medicare Services, or CMS) and a database of disciplinary records collected by the National Council of State Boards of Nursing (www.ncsbn.org), obtained from the state licensing agency and scanned into electronic form.\n\nAccess to health-system data varies by state. For example, Wilmington (N.C.) Morning Star reporter Cory Weiss knew that local hospitals would not share their internal investigation into rising staphylococcal infection rates. Instead, the state's death certificate database provided a window on staph-related deaths (Story No. 16583).\n\nDo some research to find out what your state regulates, what kinds of reports the statutes specify, and whether any records exist as databases. Or, if the state yields little, find local records collected nationally by the CMS.\n\nWhen planning a project, keep in mind that the medical profession has its own rigorous scientific standards for evaluating performance, and the media's methods need to be stringent. Many news organizations consult with independent experts. One major concern is making an accurate comparison among patient outcomes because of all the variables that affect risk in a diverse population with many different procedures and diagnoses. The Fort Worth Star-Telegram, for example, worked with a research scientist to analyze patient records (see article on page 8).\n\nHere are some available data sources:\n\nBirth and death records.\nInspection reports, mandated by state law or under the Medicare program.\nHealth maintenance organization financial data plus information on participating facilities and patient complaints.\nUniform billing records. These databases describe each patient's illness, any surgeries, age, insurance type, town or ZIP code and are available from state agencies. Everything will be anonymous, but you can ask for a unique patient identifier as a substitute for names.\nMedicare billing data can be obtained from CMS. Check with your local branch office for details on these requests; private companies often maintain and provide the records.\nFor more information on data sources, see tipsheet Nos. 1710, 407 and 643 in the IRE Resource Center.\nThe FDA Adverse Event Reporting System contains incidents related to pharmaceuticals and biological products like blood (available from NICAR; for details, go to www.ire.org/datalibrary/databases/AERS/).\n\nOther resources can help:\n\nNational Association of Health Data Organizations (www.nahdo.org)\nECRI (www.ecri.org) is a nonprofit specializing in medical device safety issues.\nThe Centers for Disease Control tracks public health data (www.cdc.gov). See its National Center for Health Statistics Data Warehouse (www.cdc.gov/nchs/datawh.htm)\nThe National Association of Health Data Organizations, 703-532-3282.\n\nSee the January-February 2003 IRE Journal for even more about investigating problems with hospitals. Berens of the Chicago Tribune details how he used patient billing records to help uncover infections in hospitals. The newspaper reported that three-quarters of the infections could have been prevented. Berens also shares tips for investigating your local hospital.\n\nContact Megan Christensen by e-mail at megan@nicar.org.",
  "provenance": {
    "extracted_by": "anthropic/claude-sonnet-4-6",
    "extracted_at": "2026-07-05",
    "verified": true
  },
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  "html_url": "https://dwillis.github.io/uplink/article/2003-february-digging-into-health-medicine.html",
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