Mistaken translations can cause trouble

Language barriers are seen as a huge potential source of medical errors for the 19 million English-deficient residents of the United States.

By Andis Robeznieks, AMNews staff. Jan. 27, 2003.

Patient-safety literature repeats over and over again how important it is to maintain open communication in the doctor-patient relationship, highlighting that miscommunication can lead to medical errors.

But Glenn Flores, MD, believes that a key topic has been missing from the discussion: Errors made in language translation.

"This is a previously unrecognized root cause of medical errors," said Dr. Flores, an associate professor of pediatrics, epidemiology and health policy at the Medical College of Wisconsin in Milwaukee. "I think it's a huge quality issue."

Translation errors were not mentioned in "To Err is Human," the Institute of Medicine's 1999 report on medical errors, Dr. Flores noted. But he said the potential for harm in this area is enormous given U.S. Census reports estimating that the United States has 19 million residents with limited command of the English language.

According to a report by Dr. Flores and colleagues published in the January Pediatrics, translation errors occurred more frequently than one might expect, and a majority of these errors had the potential for clinical consequences.

Researchers analyzed 474 pages of transcripts generated from 13 encounters where interpreters were used at the outpatient clinic of a Boston hospital. A mean of 31 translation errors occurred per patient visit, with a mean of 19 of these errors (63%) having potential clinical consequences.

Errors committed by "ad hoc" interpreters (nurses, social workers, siblings) had potential clinical consequences 77% of the time compared with 53% of the time with professional translators.