A provocative article in the prestigious medical journal BMJ (May 3, 2016) was titled “Medical Error–The Third Leading Cause of Death in the U.S.” The patient safety experts from John Hopkins went on to suggest that anywhere from 210,000 to 400,000 deaths a year are “associated with medical errors among hospital patients.” Many doctors have a hard time accepting that medical mistakes and deaths are their responsibility as you will read in their rebuttals.
The lead investigator, Martin Makary, MD, has noted that such statistics might actually underestimate the true incidence of the problem. That’s because physicians rarely list medical mistakes as contributing factors in mortality on death certificates.
Medical Mistakes and Deaths in Outpatients:
Perhaps equally alarming is the lack of data on outpatients. No one appears to be tracking deaths due to medical errors in nursing homes, clinics or outpatient surgical centers.
The CDC tracks annual deaths from heart disease (614,348), cancer (591,699), respiratory diseases (147,101), accidents (136,053) and stroke (133,103). Nowhere are medical mistakes and deaths included in national records.
Shooting the Messenger:
Not surprisingly, there has been a backlash from other health professionals who challenge the linkage between medical mistakes and deaths in the BMJ research paper.
One physician/researcher responded in the BMJ (June 2, 2016) regarding the idea “that medical errors constitute the 3rd leading cause of death in the U.S.”:
“First, the estimate fails the plausibility test. Of around 2.5 M deaths in the US each year, approximately 700,000 occur in hospital. We–and many clinicians and researchers–find it very hard to believe that one in 10 of all US deaths, or a third of inpatient deaths (the 251,454 estimated by Makary and Daniel) result from ‘medical error'”…
“As people who care deeply about patient safety, we are troubled by at [sic] figures that produce lurid headlines but distract from areas where harm may be most amenable to interventions. As researchers, we fear for efforts to engage with clinicians when they are confronted by headline-grabbing numbers that fly in the face of their clinical experience. And, finally, as concerned citizens, we would rather not have medical care characterized as more dangerous than firearms or motor vehicles.”
Another doctor based his analysis on his personal experience:
“I have practiced medicine for 33 years in the US and know of only a few deaths where medical error may have been a factor. During those 33 years, there have been approximately 80 million deaths in the US, mostly under medical care. So intuitively and with some authority, I know that this absurd article is junk dressed up as science.”
A number of physicians question the authors numbers as well as their conclusions. One surgeon seemed to suggest that quality problems and errors were due in part to nurses and techs who are “stretched so thin and then have to do all the meaningless EMR [electronic medical record] data entry.”
One doctor went so far as to call for a retraction of the original article:
“The statistics have been shown by multiple respondents to be bunkum, no need to repeat…There appears to be no attempt to reach standards which would make this article suitable for publication in this journal.
“Why is this sensationalist nonsense still here.
“Why was it published in the first place in fact?
“Meanwhile it serves as a lightning rod for all the goggle-eyed anti-doctor types looking for proof of their misperceptions and stands a good chance of causing real harm by inciting people to avoid necessary medical care.”
“Be brave, BMJ, admit the mistake.”
Should Medical Mistakes and Deaths Be Kept Secret?
According to our calculations, “treatment-attributable deaths” may actually be much higher than Dr. Makary projects in his BMJ article. That’s because the FDA concludes that adverse drug reactions account for more than 100,000 deaths annually in hospitals. If you include medication-related deaths in nursing homes and other outpatient settings it is clear that pharmaceuticals alone are the fourth leading cause of death in the U.S.
Infections In Hospitals:
They used to be called HAIs or hospital-acquired infections. The new name is “healthcare-associated infections.” Perhaps that makes the institution seem less threatening if the infection is “associated” with care rather than “acquired” while in the hospital. The CDC estimates that there are 722,000 HAIs in US hospitals and 75,000 deaths each year.
Our Bottom Line Differs from Most “Official” Reports:
Should you wish to see our analysis of the total number of deaths from health care harm each year (788,558), we encourage you to visit this link: Will Medical Mistakes Kill You or Someone You Love?
Medical Mistakes and Deaths are NOT the Only Tragedy:
Focusing on death does not tell the entire story. Medical errors and adverse drug reactions often lead to permanent disability and substantial suffering. Such complications are rarely captured in standard statistics. Here are just two of the hundreds of heart-breaking stories reported on our website:
“As a member of the healthcare community I would like to share my personal experience with fluoroquinolone antibiotics. I had been given Cipro in the winter of 2013 for an uncomplicated bout of bronchitis. At the time, I was in my early 40s and passionate about running.
“Within three months of finishing the antibiotic I sustained three spontaneous tendon ruptures. I had surgery and spent months regaining my range of motion and strength.
“In October of 2014 I again had unconfirmed bronchitis and was prescribed Cipro so I could return to work as quickly as possible. While taking the antibiotic I began to experience deep hip pain, knee pain, and ankle pain. By the end of November the pain was so disabling that I took a week off from work.
“I have spent the past 19 months trying desperately to heal. The first six months I was unable to walk any distance at all or to stand for more than a few minutes. I went from running miles and miles at competitive speeds to being disabled.
“I finally was forced to take an extended leave from work. I suffered tendon pain and rupture, joint pain, peripheral neuropathy, insomnia and anxiety.”
Another visitor to our website shared this story:
“My cousin went to the emergency room suffering from abdominal pain. She was given so many enemas that she died within 8 hours from a perforated colon.
“Her sister’s husband was misdiagnosed and given medications that nearly killed him when he was suffering from an autoimmune disease. His kidneys were destroyed and he died within a few years. Both were only in their 60s. No action was taken to prevent these problems from happening again.”
We Refuse to Sweep Medical Mistakes and Deaths Under the Rug!
Adverse drug reactions along with medical errors account for untold suffering and death. As much as health care professionals would like to believe that health care harm is an uncommon problem, we suggest that it may well be the leading cause of death in America.
Patients and their families must be well informed about the pros and cons of all medications and notified about which symptoms could represent life-threatening complications. When people become actively involved in their own care they may be able to reduce the growing epidemic of health care harm.
We provide you with an overview of how to protect yourself and those you love at this link.
When we wrote Top Screwups Doctors Make and How to Avoid Them we actually thought we would be invited by medical schools and pharmacy schools to come and give lectures on how to reduce medical mistakes and deaths. Clearly, we were totally naive. Even patient safety “experts” found our message challenging. To date we have not received a single invitation to speak to physicians or pharmacists.
Should you wish to find out for yourself why this message is so challenging to health professionals, here is a link to the book. Do take a moment to read some of the reviews and comments:
We welcome your thoughts in the comment section below. If you are a health professional we welcome your reaction to Dr. Makary’s research in the BMJ and the desire by some physicians to see the article retracted.
