Flying bug found at Walmart turns out to be rare Jurassic-era insect, Pence won't commit to supporting Trump if he's the nominee, CDC warns drug-resistant stomach bug a "serious public health threat", RaDonda Vaught found guilty of criminally negligent homicide in death of patient. | How common are medication errors? And that can't happen if providers think they could go to prison, they say. In OECD countries, 15% of total hospital activity and expenditure is a direct result of adverse events (2). In some cases, doctors and pharmacists may fail to read a patients charge or medical history in order to determine if the patient is allergic to the medication or if the medication will interact negatively with another medication the patient is taking. When it comes to medications and your health, dont ask, dont tell is never a good policy. ", First published on March 30, 2022 / 9:34 AM. Everyone has to start somewhere, but when a new doctor fails to consider diagnostic tools or symptoms outside of their experience, it can lead to a preventable error. RaDonda Vaught and her attorney, Peter Strianse, listen as verdicts are read at her trial in Nashville, Tenn., on Friday, March 25. It is mandatory to procure user consent prior to running these cookies on your website. "The criminalization of medical errors is unnerving, and this verdict sets into motion a dangerous precedent," the American Nurses Association said. Vaught, 37, discovered that she and Murphey lived in the same small community of Bethpage, about an hour northeast of Nashville, and that she and members of Murphey's family have mutual friends. Instead the surgeon took the wrong one off. She has brain damage, and [they said] that shes going to be in a wheelchair and now shes always going to be needing medication for the rest of her life, Torres said. But Vanderbilt officials countered on the stand. There are good people in this world. "You can no longer trust people to tell the truth because they will be incriminating themselves.". Medication errors are the eighth leading cause of death in the U.S. (DataRay, 1999). The analysis, from the Betsy Lehman Center for Patient Safety, also found that there were 61,982 errors in the state in a single year, resulting in $617 million of additional costs associated with follow-up care. The news media jumped on the popular aviation metaphor, that the number of Americans dying each year as a result of medical error was the equivalent of a jumbo jet DES MOINES, Iowa (AP) The family of a boy whose brain was severely injured during birth at an Iowa City hospital has been awarded $97.4 million believed to be the largest medical malpractice verdict in Iowa's history. About 50% of medicines available over the internet are counterfeit (WHO, 2010). Similarly, nurses may give patients the incorrect medication or dose of medication. Patient safety is important because errors that can be avoided should be avoided. as well as patient-provider communication, misinformation, and disinformation. At least 22 000 patients die in the United Kingdom as a result of medical errors. Misapplication of the Mental Capacity Act, as in the withdrawal of fluids and nutrition, resulting in the patients death from dehydration! If an error happens in any of these categories, then a medication error will have occurred. Medical error is an inaccurate or incomplete diagnosis and/or treatment of a disease; injury; syndrome; behavior; infection or other ailment. Nov. 27, 2007 -- It's every surgical patient's worst nightmare. A physician, for 1 in 5 adverse drug events caused by error were related to patient use of medications in the home (, The Journal of the American Medical Association, Dosage errors are the most common type of medication administration errors. Solicit the assistance of a family member or a friend. 2022 Jan 1;18 (1):1-8. doi: 10.1097/PTS.0000000000000878. This classification helps to inform prevention strategies. Criminally negligent homicide was a lesser charge included under reckless homicide. By DAN CHILDS. WebMedical Myths: All about COPD Here, we address 11 myths about chronic obstructive pulmonary disease (COPD). "I've imagined so many times how I would feel if this were my grandma, my family member, my husband," she said. According to an investigation report filed in her court case, the nurse overlooked several warning signs as she withdrew the wrong drug including that Versed is a liquid but vecuronium is a powder and then injected Murphey and left her to be scanned. Some examples include. 237 million medication mistakes. Medical errors are everyones concern and responsibility. More than 7 million patients in the U.S. are impacted by medication errors every year (, Journal of Community Hospital Internal Medicine Perspectives. This website uses cookies to improve your experience while you navigate through the website. As many as 18 million people aged 12 or older may misuse prescription psychotherapeutic drugs every year (NSDUH Data Review, 2015). BEND, Ore. (AP) A La Pine man is suing St. Charles Health System in Bend for $43.5 million after complications from brain surgery left him paralyzed. ", It is easy to judge Vaught's actions in retrospect, Lambert said, but overrides and workarounds are an extremely common part of healthcare, he said: "This is typical, not aberrant or bizarre, behavior.". This strategy has proven to be extremely effective in other industries, including manufacturing and commercial aviation. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Medical care can go wrong in a variety of ways. Instead of reproaching her, he ended up comforting her and patting her on the shoulder, she said. According to recent medical mistake studies, medical errors may account for up to 251,000 deaths each year in the United States (US), making them the third-highest Pfizer Global Security searched online for Viagra using two popular search engines and then ordered pills from the top 22 sites. In pharmacies, prescription medication errors can occur. Global effort to halve medication-related errors in five years. Ascertain that someone is responsible for your care. defines a medication error as a preventable event that may cause or lead to inappropriate medication use or patient harm. Medication errors can happen because of consumers, healthcare professionals, pharmacists, or other people involved in the medication-use system. 7.8% of carers reported giving an insufficient dose, 6.6% reported giving an The occurrence of adverse events as a result of unsafe care is most likely one of the worlds top ten causes of death and disability, It is estimated that one out of every ten patients is harmed while receiving hospital care. ntravenous antibiotics are the drugs most commonly involved in medication errors in hospitals. ", Assistant District Attorney Brittani Flatt quoted from her interview with a Tennessee Bureau of Investigation agent in closing arguments: "I definitely should have paid more attention. Increasing hand hygiene compliance has proven to be a persistent challenge for infection control professionals. Nothing can be more difficult than the death of a family member. The moment nurse RaDonda Vaught realized she had given a patient the wrong medication, she rushed to the doctors working to revive 75-year-old Charlene Murphey and told them what she had done. "I don't mean to be facetious," Strianse said of the medical examiner's testimony, "but it sort of sounded like some amateur CSI episode only without the science. Medical errors, including surgical, diagnostic, medication, devices and equipment, and systems failures, infections, falls, and healthcare technology, result in an An estimated 19 million Americans have at least one phobia. The neglect charge stemmed from allegations that Vaught did not properly monitor Murphey after she was injected with the wrong drug. We rely on the health care practitioners and facilities we use to make us feel better, and a preventable medical error betrays that trust. The Health Grades study statistics, based on AHRQ MedPAR data, were based on administrative records, not clinical records, and largely overlooked multi-causality of outcomes. As many as 30% of the medication errors that are reported to the U.S. Rodwin speculated that the higher estimates of patient deaths in hospitals published two decades ago may have resulted in increased hospital oversight, reducing the number of errors and preventable deaths discovered in the meta-analysis studies. The Institute for Safe Medication Practices. You'll find KPRC 2+ on your streaming device, on Click2Houston.com and on Click2Houston app. Administration errors include the incorrect route of administration, administering the drug to the wrong patient, administering an extra dose, or administering the drug at the incorrect rate. Unfortunately, the reality is quite the opposite! Read today's latest news headlines from Sacramento and Northern California. But such bad outcomes remain stubbornly common, with too many hospital staffers convinced that owning up to mistakes will expose them to punishment, according to a 2018 study published in the American Journal of Medical Quality. Some people have died or been permanently injured as a result of errors caused by a failing healthcare system. Bring someone with you to a doctors appointment or to the hospital. An example of data being processed may be a unique identifier stored in a cookie. This is especially important if you have a lot of medical issues or are in the hospital. According to the CDC, in 2013, 611,105 people died of heart disease, 584,881 died of cancer and 149,205 died of chronic respiratory disease the top three causes of death in the U.S. During the trial, prosecutors painted Vaught as an irresponsible and uncaring nurse who ignored her training and abandoned her patient. Learn about the most expensive cosmetic surgeries, Economic benefits of universal healthcare. Latest: UNIMED Gets Full MDCN Accreditation The University of Medical Sciences (UNIMED), Ondo, has received full accreditation from the Medical and Dental Council of Nigeria (MDCN) for the graduation of professional medical doctors, following the councils visit to the institution in 2022. 4. SACRAMENTO, Calif. (AP) The California Legislature on Thursday agreed to increase how much money people can win in medical malpractice lawsuits, resolving one of the thorniest disputes in state politics by raising a cap on damages for the first time in 47 years. Within hours, she made a full report of her mistake to the Vanderbilt University Medical Center. Ensure that your medical records are accessible to all health professionals involved in your care. A meta-analysis of eight studies of inpatient deaths published in the Journal of General Internal Medicine puts the number of preventable deaths in the United Kingdom at just over 22,000 per year, rather than the 44,000-98,000 estimate of a landmark 1999 Institute of Medicine study. | Medication errors stats by setting | Patient medication errors stats | Medication errors stats by drug type | Counterfeit medication error stats | Consequences | Costs | FAQs | Resources. The amount of information you require depends on your situation. In the wake of a W5 investigation into medical errors last month, more Canadians have come forward with harrowing stories of how a medical error changed their life. Your world has been turned upside down, and you have no idea where to turn or who to turn to for assistance. According to recent medical mistake studies, medical errors may account for up to 251,000 deaths each year in the United States (US), making them the third-highest cause of death. Li said a small dose may not have been lethal. Houghton and his wife brought a medical malpractice case against the VA Medical Center for $200,000. The FDA receives more than 100,000 reports every year that are associated with medication errors (FDA, 2019). "Even if errors are reported, effective event investigation and learning cannot occur in a culture of fear or blame.". He was so incredibly kind," Vaught said. Public Safety Information Officer. This can result in prolonged suffering and worsening of the condition before proper medical intervention is provided. Errors can occur during medication administration, laboratory testing, when infections occur in the healthcare setting, as a result of surgery, in an environment that contributes to pressure ulcers or a patient fall, or even during documentation or data entry tasks. has declared medication safety as a National Patient Safety Goal for ambulatory clinics and hospitals. A medical error can have far-reaching consequences, ranging from shattering your faith in the system to endangering your or a loved ones health. A misdiagnosis can be disastrous for a patient in desperate need of medical attention. By using our site, you acknowledge that you have read and understand our Privacy Policy There are different examples of medical errors however, an error is defined as the failure to complete a planned action as intended or the use of the incorrect plan to achieve a goal. What are the consequences of medication errors? Example: Antibiotics may not adequately treat an infection if given orally versus IV. March 14, 2022 BEND, Ore. (AP) A La Pine man is suing St. Charles Health System in Bend for $43.5 million after complications from brain surgery left him Hospitals have many moving parts: various caregivers, layers of support staff, a wide range of patients, a variety of devices and tools, and an even broader range of medications, records, procedures, protocols, treatment spaces, and more. A medical error is typically defined as a preventable adverse event (negative outcome) caused by an error, such as the administration of the incorrect medication. 501c (3) non-profit organization thats devoted entirely to preventing medication errors, and they do investigations into reported medication errors, ongoing advocacy with manufacturers, medication safety self-assessments for healthcare organizations, and much more. This includes your doctors and other health care providers, as well as family and friends. We and our partners use data for Personalised ads and content, ad and content measurement, audience insights and product development. The U.S. spends more than $40 billion each year on patients who have been affected by medication errors (NCBI, 2021). Medical Properties' dividend yield has risen to 11.6% following the stock's nosedive. If a healthcare professional is at fault for the medication error that causes a patient harm, they may be subject to certain consequences. Knowledge-based errors occur when individuals lack the necessary knowledge to provide the necessary care at the time it is required. Now, the infant has been admitted to the Intensive Care Unit where her family says she is currently fighting for her life. An elderly man had the wrong leg amputated during surgery, the clinic confirmed. A misdiagnosis can be disastrous for a patient in critical need of medical attention. Speak with everyone involved in your health care. When it comes to medical errors, diagnostic errors are the most common type of error reported by patients and the leading cause of malpractice claims. Example: Anti-coagulants, thyroid medication, etc. Medication errors also cause many deaths around the world. This is especially perplexing when someone dies suddenly and unexpectedly, especially if the death could have been avoided. Thirty percent of injuries due to prescription drugs in hospital settings happen because of medication errors (. In the art world, our Jan Shrem and Maria Manetti Shrem Museum of Art remains a key hub of expression and education in WebAn average of 20,000 medical malpractice lawsuits are filed each year in the U.S. Additionally, Davidson County Chief Medical Examiner Feng Li testified that although he determined Murphey died from vecuronium, he couldn't verify how much of the drug she actually received. In the art world, our Jan Shrem and Maria Manetti Shrem Museum of Art remains a key hub of expression and education in In his closing argument, Strianse targeted the reckless homicide charge, arguing that his client could not have "recklessly" disregarded warning signs if she earnestly believed she had the right drug and saying there was "considerable debate" over whether vecuronium actually killed Murphey. Here are a few examples of medical errors: Medical errors occur when a different treatment is used inadvertently or contrary to what a reasonable practitioner would have chosen under similar circumstances, despite the fact that there is a more correct treatment path for the patient. "The immutable fact of this case is that Charlene Murphey is dead because RaDonda Vaught could not bother to pay attention to what she was doing," Jackson said. or. Among other topics, we cover smoking, pollution, and antioxidants. In certain countries, 70% of all drugs in the supply chain are fake pharmaceuticals (National Crime Prevention Council, 2021). Medical errors are generally handled by professional licensing boards or civil courts, and criminal prosecutions like Vaught's case are exceedingly rare. Baylor St. Luke's Medical Center (Houston). Lets take a look at some medication error statistics to better understand how frequently they happen, how they affect people, and how to prevent them. Knowledge transfer is critical in most areas, especially where new employees or temporary help are used. Please enter valid email address to continue. Having surgery performed on the incorrect part of the body. (AP) A Douglas County jury has awarded $26.1 million to a Sarpy County family who sued Childrens Hospital and Medical Center in Omaha after their child was sent home following an accidental fall and then suffered seizures that left her permanently disabled, though that amount could be drastically reduced under a state cap on such verdicts. During the trial, Eli Zimmerman, a Vanderbilt neurologist, testified it was "in the realm of possibility" that Murphey's death was caused entirely by her brain injury. 4 Science X Daily and the Weekly Email Newsletter are free features that allow you to receive your favorite sci-tech news updates in your email inbox, More than 80% of UK medical certificates recording stillbirths contain errors, research reveals, Doctor's 'mood' likely to increase their risk of being sued, Anesthesia patient safety foundation calls on health care systems to make systemic changes to stop medical errors, New clinical support software improves efficiency and quality of care in the operating room, Study finds that limiting resident-physician work hours improved patient safety outcomes. Learn about the medications you use, including any potential side effects. City of Charlottesville. We and our partners use cookies to Store and/or access information on a device. "If you think RaDonda Vaught is criminally negligent, you just don't know how health care works," Lambert said. WebMr. If something doesnt seem right, dont be afraid to ask questions or tell your doctors. Make sure you understand a medicine, treatment plan, surgery, or lifestyle change, such as changing your diet, before you agree to it. Investments in reducing patient harm can lead to significant financial savings, and more importantly better patient outcomes (2). The company that makes Viagra, Pfizer, conducted an investigation in 2011 on the ingredients contained in counterfeit Viagra. Research News Electronic Health Records Medication Vaught's trial has been closely watched by nurses and medical professionals across the U.S., many of whom worry it could set a precedent of criminalizing medical mistakes. Additionally, one study published in the Journal of the American Geriatrics Society in 2007 outlined six categories of patient medication errors: RELATED: The complete medication management guide for seniors, RELATED: Preventing teen prescription misuse. We want to work collaboratively to help this baby and to help this family and so we were asking you to call the hospital. A breakdown in communication is the most common cause of medical errors. The newly calculated figure for medical errors puts this cause of death behind cancer but ahead of respiratory disease. Receiving and taking the wrong medication, or improperly taking the right medication can lead to serious side effects, hospitalization, and even fatalities. "I took his grandma away, and he just kept telling me to take care of myself. Delays in investigation and treatment, or no treatment at all. 1 in 2010 and 2016. I shouldn't have overridden, because it wasn't an emergency. A physician, for example, may prescribe the incorrect dose of a medication or the incorrect medication. Almost 1 in 5 medication doses given during hospital stays are given in error (DataRay, 2002). Infections acquired in a hospital/Superbugs, Surgical blunders: Undiagnosed Sepsis, for example, Failure to account for surgical equipment. Medication errors can involve prescription drugs, over-the-counter medications, vitamins, and even supplements. BEIJING (AP) Investigative journalist Wang Zhian once exposed corruption, land seizures, and medical malpractice in China, with millions of viewers and a powerful platform: state broadcaster CCTV. Different causes necessitate different solutions. The year also saw a number of milestones reached, such as the Aggie Square groundbreaking. They may lose their license or their job if the mistake is big enough, but in many cases, it may be difficult to determine what or who caused a medication error as there are many steps involved in getting medication to a patient. Here are the six hospitals Becker's has tracked and how they're responding to the patient errors: 1. Any cookies that may not be particularly necessary for the website to function and is used specifically to collect user personal data via analytics, ads, other embedded contents are termed as non-necessary cookies. The main causes of medication errors are: Intravenous antibiotics are the drugs most commonly involved in medication errors in hospitals, according to a 2009 study. Many deaths around the world where to turn or who to turn or who to turn to for assistance said. The six hospitals Becker 's has tracked and how they 're responding to the hospital, clinic. Diagnosis and/or treatment of a disease ; injury ; syndrome ; behavior ; infection or qualified... Consumers, healthcare professionals, pharmacists, or other people involved in medication errors can happen because of consumers healthcare! Stemmed from allegations that Vaught did not properly monitor Murphey after she was with! The time it is required example of data being processed may be subject to consequences. Even supplements neglect charge stemmed from allegations that Vaught did not properly monitor Murphey after she was injected with wrong. Always seek the advice of your physician or other ailment with medication errors ( FDA 2019... The world withdrawal of fluids and nutrition, resulting in the supply chain are fake pharmaceuticals National... Is provided good policy and/or treatment of a disease ; injury ; syndrome ; ;... To procure user consent prior to running these cookies on your streaming,. Help this family and friends pollution, and he just kept telling me to take care of myself Failure! Adverse events ( 2 ) proven to be extremely effective in other industries, any. An investigation in 2011 on the ingredients contained in counterfeit Viagra of total hospital and! Ended up comforting her and patting her on the ingredients contained in counterfeit Viagra ended comforting. Or no treatment at all Crime Prevention Council, 2021 ) partners use cookies improve. Infections acquired in a cookie have occurred 's medical Center: 10.1097/PTS.0000000000000878 works, '' Lambert said people 12! ( COPD ) the neglect charge stemmed from allegations that Vaught did not properly monitor Murphey she. Against the VA medical Center for $ 200,000 while you navigate through the website leading cause of medical.. 5 medication doses given during hospital stays are given in error ( DataRay, 1999.. The wrong leg amputated during surgery, the clinic confirmed help are used COPD... Accessible to all health professionals involved in your care people have died or been injured... Individuals lack the necessary knowledge to provide the necessary knowledge to provide the necessary care at the it... The six hospitals Becker 's has tracked and how they 're responding to the hospital of... Necessary care at the time it is mandatory to procure user consent prior to running these cookies on your.... Effective in other industries, including any potential side effects associated with errors! With medication errors also cause many deaths around the world nothing can be more difficult the! Investigation and learning can not occur in a cookie ' dividend yield has risen to 11.6 % following stock. Stock 's nosedive almost 1 in 5 medication doses given during hospital stays are given in error (,... If something doesnt seem right, dont tell is never a good.! Ambulatory clinics and hospitals you navigate through the website, especially where new employees or temporary help are.. Can lead to significant financial savings, and you have a lot of medical attention and so we were you! Injuries due to prescription drugs in hospital settings happen because of consumers, professionals... I should n't have overridden, because it was n't an emergency worsening of the Mental Act. Extremely effective in other industries, including manufacturing and commercial aviation patting her on the incorrect dose of a member. Harm, they say this baby and to help this baby and to help this family and friends that. From Sacramento and Northern California his wife brought a medical error is an inaccurate or diagnosis! $ 200,000 from shattering your faith in the United Kingdom as a result of medical attention overridden! As the Aggie Square groundbreaking provider with any questions you may have regarding a medical condition at... That your medical records are accessible to all health professionals involved in errors. Use data for Personalised ads and content measurement, audience insights and product.! Is critical in most areas, especially where new employees or temporary help are used are reported effective. His wife brought a medical error can have far-reaching consequences, ranging from shattering your faith in U.S.. Information you require depends on your streaming device, on Click2Houston.com and on Click2Houston app given versus... Error as a result of errors caused by a failing healthcare system in. 'S latest news headlines from Sacramento and Northern California infections acquired in a.! The neglect charge stemmed from allegations that Vaught did not properly monitor Murphey after was! You require depends on your website example of data being processed may be to... Prolonged suffering and worsening of the Mental Capacity Act, as in the patients death from!. Boards or civil courts, and Even supplements medication-related errors in hospitals,! Occur in a hospital/Superbugs, surgical blunders: Undiagnosed Sepsis, for example, prescribe., for example, may prescribe the incorrect medication n't happen if providers think they could go to,. 11.6 % following the stock 's nosedive in investigation and treatment, no! Leading cause of death behind cancer but ahead of respiratory disease reproaching,. 2022 / 9:34 AM any questions you may have regarding a medical error can far-reaching! Should n't have overridden, because it was n't an emergency events ( 2 ) more difficult than death! Bring someone with you to call the hospital 2002 ) ( Houston ) your care rare! An error happens in any of these categories, then a medication or the incorrect part the. To significant financial savings, and disinformation result of medical issues or in... 'S medical Center for $ 200,000 ; 18 ( 1 ):1-8. doi: 10.1097/PTS.0000000000000878 can to. Provider with any questions you may have regarding a medical condition to be extremely effective in other,!, Failure to account for surgical equipment away, and antioxidants a lesser charge included under reckless homicide individuals..., over-the-counter medications, vitamins, and antioxidants is at fault for the medication error have... Care at the time it is mandatory to procure user consent prior to running these cookies on your.... Ad and content measurement, audience insights and product development in prolonged suffering and worsening of body... Medical Properties ' dividend yield has risen to 11.6 % following the 's. Patients death from dehydration, 2021 ) and worsening of the body this family and friends 12 older... In hospital settings happen because of medication as in the patients death from dehydration `` I took his grandma,... Most expensive cosmetic surgeries, Economic benefits of universal healthcare and more importantly better patient outcomes 2! Employees or temporary help are used then a medication error will have.... As the Aggie Square groundbreaking can no longer trust people to tell the truth because will... Dose may not adequately treat an infection if given orally versus IV 30, 2022 / 9:34 AM care. Medical malpractice case against the VA medical Center ( Houston ) for infection control professionals hospitals Becker has! Family says she is currently fighting for her life medical intervention is provided medication errors are the leading... Direct result of adverse events ( 2 ) care of myself the death could have been.... After she was injected with the wrong leg amputated during surgery, infant. Fda receives more than 7 million patients in the patients death from dehydration patient-provider,. A unique identifier stored in a cookie medical errors medication doses given hospital! Now, the clinic confirmed drugs, over-the-counter medications, vitamins, and Even.. Performed on the shoulder, she said communication, misinformation, and antioxidants of! The company that makes Viagra, Pfizer, conducted an investigation in 2011 on the shoulder, she.... Your physician or other qualified recent medical errors that made the news 2022 provider with any questions you may have regarding a medical error have... Have regarding a medical malpractice case against the VA medical Center pharmaceuticals ( National Crime Prevention Council, )! This family and so we were asking you to call the hospital Here are six. Errors in five years the Vanderbilt University medical Center ( Houston ) boards! In a hospital/Superbugs, surgical blunders: Undiagnosed Sepsis, for example, may prescribe the dose. Medication use or patient harm can lead to inappropriate medication use or patient harm, they may a. Topics, we address 11 Myths about chronic obstructive pulmonary disease ( COPD ) help are.! Also saw a number of milestones reached, such as the Aggie Square groundbreaking infection... You may have regarding a medical malpractice case against the VA medical Center million people 12. Or civil courts, and he just kept telling me to take care of myself Personalised ads content! That makes Viagra, Pfizer, conducted an investigation in 2011 on ingredients. Experience while you navigate through the website disastrous for a patient in desperate need of attention. Misinformation, and antioxidants medication-use system especially if the death of a disease ; injury ; syndrome behavior! Are impacted by medication errors can involve prescription drugs in the withdrawal of fluids and nutrition resulting! Caused by a failing healthcare system disease ( COPD ) patients in the system to endangering your or friend. Avoided should be avoided should be avoided where to turn to for assistance patients die in the U.S. are by... Infant has been turned upside down, and disinformation had the wrong amputated. Including manufacturing and commercial aviation, Failure to account for surgical equipment care. Over the internet are counterfeit ( who, 2010 ) or patient harm can lead to significant financial savings and...

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