We’ve long written about the issue of botched surgeries and diagnostic errors. In prior studies, researchers noted that mistakes occur more often than realized and these types of errors are almost always fully preventable.
In 1999, the Institute of Medicine (IOM) published the famed “To Err Is Human” report, which indicated that as many as 98,000 people die every year due to hospital errors, according to Philly.com. In 2010, the Office of Inspector General for Health and Human Services indicated that some 180,000 Medicare patients died due, in part, to inappropriate hospital care. Meanwhile, a new study, published in the Journal of Patient Safety, indicates that these numbers might be higher and involve 210,000-440,000 hospital patients annually who suffer from a preventable harm that contributed to their death, according to Philly.com. If the figures are accurate, medical errors would be the third leading cause of death in the United States, just behind cancer and heart disease.
John T. James, a toxicologist at NASA’s space center in Houston led the study. James also runs the advocacy organization called Patient Safety America and wrote a book concerning the death of his 19-year-old son over what James described as negligent hospital care, according to Philly.com.
Although a spokesman for the American Hospital Association said that the group believes the IOM’s lower estimates from 1999 are more credible, ProPublica requested a review of James’ study by three prominent patient safety researchers, which all found his methods and findings to be credible. “We need to get a sense of the magnitude of this,” James said in an interview, according to Philly.com.
For his estimates, James utilized findings from four recent studies and a screening method called the Global Trigger Tool. The Tool, explained Philly.com, guides reviewers through medical records and looks for signs of infection, injury, or error. In the four studies, which examined records of more than 4,200 patients hospitalized between 2002 and 2008, researchers discovered that significant adverse events occurred in at least 21 percent of cases reviewed; lethal adverse events were as high as 1.4 percent, Philly.com reported. James combined the findings and .
By combining the findings and based on 34 million hospitalizations in 2007, James concluded that preventable errors contribute to 210,000 hospital patient fatalities every year. The figure, noted James, is a baseline. The actual figure is likely double because the Tool does not catch errors that involve treatment that should have been, but was not, provided; medical records that do not indicate evidence of harm; and diagnostic errors that were missed, according to Philly.com.
Dr. Lucian Leape, a Harvard pediatrician known as “father of patient safety,” and who was on the “To Err Is Human” committee, told ProPublica that he is confident in the studies and James’ estimates. The Institute of Medicine committee was aware its estimates were low; “It was based on a rather crude method compared to what we do now,” Leape said, Philly.com reported. Dr. David Classen, lead developer of the Tool, said the James study is a sound use of the Tool and represents a “great contribution,” noting that the “To Err Is Human” report should be updated. Dr. Marty Makary, a surgeon at The Johns Hopkins Hospital who wrote “Unaccountable” and has sought increased transparency in health care, said eliminating medical errors must become a national priority. Leape, Classen and Makary all agreed that the 98,000 figure is no longer relevant. Dr. David Mayer, the vice president of quality and safety at Maryland-based MedStar Health, said any estimate represents crisis. “Way too many people are being harmed by unintentional medical error,” Mayer said, “and it needs to be corrected.”
We recently wrote that a large study found medical malpractice claims are most commonly associated with missed cancer and heart attack claims. The researchers concluded that: “This review of malpractice claims in primary care highlights diagnosis and medication error as areas to be prioritized in developing educational strategies and risk management systems.” Another study on which we wrote found that diagnostic errors are the most common, most expensive, and most dangerous errors that U.S. physicians make, leading to roughly 160,000 permanent patient injuries or deaths, according to researchers from Johns Hopkins University.
Research conducted last year indicated that surgeons make thousands of errors yearly in the U.S. The so-called “never events,” said The Wall Street Journal, are those mistakes that should not occur in medicine such as surgery on the wrong patient and leaving sponges inside patients’ bodies. Research suggests these serious medical errors occur with distressing regularity. Lead study author, Makary, said surgical mistakes are “totally preventable.”
