May 04--Heart disease, cancer ... and medical errors?
A new tally of mistakes made in American hospitals suggests that medical errors are the No. 3 cause of death in the U.S. At least 250,000 deaths each year can be attributed to medical care that has gone awry, according to a report published Tuesday in the British Medical Journal.
That means deadly mistakes are responsible for more fatalities than chronic respiratory disease, which currently ranks third on the U.S. Centers for Disease Control and Prevention's list of leading causes of death.
In 2014, 147,101 deaths in the U.S. were caused by chronic lower respiratory diseases, according to the CDC. Heart disease was the top killer that year with 614,348 deaths, and cancer ranked second with 591,699 deaths.
Fatal medical errors include cases in which patients received medications they were allergic to and instances in which patients died of preventable infections, among many other possibilities. Doctors and nurses are not necessarily involved, experts said -- sometimes a faulty computer program may be to blame.
"Medical care has become really complex," said Dr. David Classen, an associate professor of medicine at the University of Utah who was not involved in the study. "It's no longer one single physician taking care of a single person at a hospital. It's these huge groups of people now, and mistakes get made."
The authors, from the Johns Hopkins University School of Medicine, said that while human error is inevitable, medical errors don't have to be.
The CDC currently has no good way of tracking deaths that result from medical mistakes, the authors wrote. The agency's statistics are pulled from the International Classification of Diseases codes that appear on death certificates. These codes were instituted in 1949 and do not include any that indicate a death was the result of a mistake in the hospital.
"At that time it was under-recognized that diagnostic errors, medical mistakes and the absence of safety nets could result in someone's death," Dr. Martin Makary, the surgeon who led the study, said in a statement. "Because of that, medical errors were unintentionally excluded from national health statistics."
The estimate in the new report is based on four previous studies that analyzed death rate data from 2000 to 2008. Makary and coauthor Michael Daniel, a research fellow in the Hopkins department of surgery, extrapolated those findings to the total number of hospital admissions in 2013 to arrive at the 250,000 figure.
They note, however, that this estimate is probably low. The studies they relied on considered only errors that could be documented in health records, and included only deaths of patients being cared for in hospitals, they said.
One way to get a better picture of the toll of medical errors would be to create death certificates that ask whether a preventable complication in the patient's medical care contributed to the death, the authors wrote. That could help experts predict when and where medical errors are most likely to occur -- and take steps to prevent them.
"Standardized data collection and reporting processes are needed to build up an accurate national picture of the problem," they wrote. "Measuring the consequences of medical care on patient outcomes is an important prerequisite to creating a culture of learning from our mistakes."
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