Dr. Joshua D. Lenchus looks on as resident Neeraj Sardana holds a fake limb used in training. Medical students are learning how to remedy mistakes and then how to improve hospital methods to make sure they don’t happen again.

MCT / Al Diaz

MIAMI — The patient is on the operating room table. His upper body is punctured with stab wounds. He’s kept alive via snaking tubes infiltrating the gashes.

The lights go out. Power failure. The ventilator, inoperable. The doctors, nurses and anesthesiologists are in the dark; a senior surgeon barks orders.

Thankfully, the victim is a “model patient,” a mannequin.

This is the University of Miami /Jackson Memorial Hospital Center for Patient Safety, a program Dr. David Birnbach and his crew employ to teach medical students and health care staff how to react to emergencies, communicate more effectively and most important, reduce medical errors, a critical area in the medical profession that can lead to costly mistakes, medical malpractice suits and patients’ deaths.

Launched on a $950,000 state grant three years ago, the center offers a series of mandatory courses like the in-the-dark operating room scenario. Instructors simulate real-life situations — say, a mother showing up in the emergency room with a breached baby halfway through the birth canal and too late for a C-section — using medical equipment, mannequins, and the occasional actor to play a patient or harried orderly.

ONE OF THE KEY GOALS? Communication, says Birnbach, the program’s director. It begins from the early days of medical school.

“We are teaching doctors how to talk to doctors, doctors how to talk nurses, and we start right from the beginning. In their second year, they can’t start working on patients in a clinical scenario until they have 16 hours of lectures on communications,” Birnbach says. “You ‘are’ going to make mistakes. What are you going to do then? What systems are going to help you? How are you going to remedy this and make sure you never make this mistake again? That’s what they get lectured on and then they come to the simulator.”

Once a staple of the TV sitcom, the medical mistake — operating on the wrong body part, prescribing the wrong medication — is a high-profile issue in the real world.

A recent case centered on a 3-year-old Gainesville, Fla., boy who was accidentally given a dose of a drug 10 times greater than the doctor’s prescribed amount. The child, Sebastian Ferrero, died Oct. 10 at a Shands HealthCare facility at the University of Florida. The error occurred even though the boy’s mother questioned the dose as it was being administered.

A LANDMARK STUDY by the same group in 1999, “To Err Is Human,” said that 44,000 to 98,000 people die in hospitals each year from medical errors. The group could not forecast a number for the 2006 study.

“It’s very serious, that’s why the commission did the study,” says Linda Cronenwett, who co-chaired the Committee for Identifying Medical Errors for the Institute.

“The average patient in a hospital has about one medical error every day, which is a figure that resonates with people,” says David Bates, a Harvard Medical School professor who was on the Institute of Medicine’s investigation committee.

“Fortunately, most of these errors have little or no potential harm but with children, in particular, tenfold errors — giving 10 times a dose — are common because children come in such different sizes. Those errors can be especially risky.”

The Institute of Medicine has called for a nationwide switch to electronic prescriptions rather than handwritten, error-prone prescriptions, and set a date of 2010 for all pharmacies to use electronic prescriptions. “We’re probably not going to get there as a country but we did call for that date and it’s not unrealistic,” Bates said.

AT THE UM CENTER this day, students are treating a “model patient” suffering from angina.

One student gives the “patient” too much of a drug dosage because she wasn’t clear how much another doctor had previously given the patient. The heart rate soars; “she” becomes unresponsive.

The students are filmed on disc and migrate to a nearby classroom for evaluation.

“I should have lowered the bed’s rails so I’d have more access,” says the student, watching herself on a screen.

“I should have recognized the unstable rhythm. I was totally fixated on the one thing,” the student continues, eyes darting from screen to simulation anesthesiologist instructor Daniel Castillo.

“In a crisis situation you bring all your team together,” instructs Castillo. “We tend to focus and tunnel vision things. You’d still be thinking of the same thing if the patient flat-lined. There were some doctors next to you; you could have called to them.”

“I feel like I could have handled it much better,” the student nodded.