This Is The Third Leading Cause of Death in the U.S.

This Is The Third Leading Cause of Death in the U.S.

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A Leading Cause of Morbidity And Mortality

For several years, a controversial debate has divided members of the medical profession. Some patient care advocates suggest that medical errors account for a far higher number of serious patient health problems and fatalities than health care professionals like to admit. The issue gained widespread media attention recently, when testimony before a Senate subcommittee suggested that preventable medical errors may account for as many as 1,000 deaths daily in the United States and cost the medical system up to $1 trillion annually. The journal Health Affairs published a report in 2011 suggesting that, if medical mistakes explained 1% of patient deaths in hospitals every year, these incidents would pose the third leading cause of death in the United States, outnumbered only by deaths due to heart disease and cancer.

A Troublesome Statistic

Of course, determining the precise number of cases of morbidity and mortality caused by avoidable medical mistakes remains exceedingly difficult. Several factors contribute to this problem:

• Medical institutions often won’t divulge statistics about physician errors, due to liability concerns;
• Sometimes, mistakes become clearcut only in hindsight;
• Establishing whether a particular patient suffered adverse consequences from a physician’s avoidable mistake or as a result of disease complications often proves exceedingly time consuming and difficult;
• In some cases, causes of mortality only become clear after an autopsy.
• The precipitating cause of some diseases and deaths remains unknown, or idiopathic, even following an autopsy.

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Determining when a physician makes a gross and avoidable treatment error often proves difficult also because medical professionals do not always agree about the best way to treat certain disease conditions. Since practitioners use their best judgment in caring for patients, this issue incites strong emotions on both sides of the public debate.

The Movement to Identify Medical Errors

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Yet medical health care system reformers have presented strong evidence supporting the notion that flaws in medical systems likely do contribute to a significant percentage of preventable serious patient illnesses and deaths.

NASA toxicologist John T. James recently conducted a meta-analysis to extrapolate information about the numbers of patients impacted by preventable medical errors from data in four studies. His research rests on medical records gathered between 2002 and 2008 in four studies covering the cases of 4,200 patients. He found that as many as 1.4% died from “lethal adverse events” and slightly over one in five suffered “serious adverse events”. Extrapolating these findings to the 34 million patient hospitalizations during 2007, he concluded that preventable medical errors accounted for as many as 210,000 fatalities.

An Illustration

Several types of medical errors contribute to problems every year. These scenarios include:

• Medication errors;
• Poor infection control procedures;
• A failure to screen blood products adequately;
• Inadequate tracking of patients within the health care system to avoid duplications and conflicting prescriptions;
• Poorly coordinated patient health care delivery.

Registered nurse Joanne Disch, a professor at the University of Minnesota School of Nursing, furnished members of Congress with a specific illustration of an avoidable medical error. She recounted the plight of a healthy patient who underwent unnecessary surgery after a lab confused her results with another patient’s breast cancer biopsy findings. The mistake only became known post-operatively.

The Future

Growing public awareness about medical errors as a likely source of significant morbidity and mortality may hold the key for improving the delivery of health care services. As patients and their families grow more proactive in demanding safer hospitals, medical practitioners may implement additional safeguards to reduce physician errors.

This outcome would benefit both patients and the medical profession. It would promote the ancient Hippocratic admonition to physicians: “first, do no harm.”

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