How Common Are Medical Mistakes?

Last post 11-03-2009 12:58 PM by J828. 12 replies.
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  • 09-19-2009 1:50 PM

    How Common Are Medical Mistakes?

    They are too common. Although exact estimates are difficult to find, it is not surprising that an industry as stretched, complex, and burdened as the medical industry is fraught with errors. Many errors go unreported and tracking their exact prevalence is difficult. Nevertheless, bearing in mind that about 2.5 million deaths occur annually in the USA, here are some of the statistics and death rate estimates from various reports:

    • 42% of people believed they had personally experienced a medical mistake (NPSF survey)
    • 44,000 to 98,000 deaths annually from medical errors (Institute of Medicine)
    • 225,000 deaths annually from medical errors including 106,000 deaths due to "nonerror adverse events of medications" (Starfield)
    • 180,000 deaths annually from medication errors and adverse reactions (Holland)
    • 20,000 annually to 88,000 deaths annually from nosocomial infections
    • 2.9 to 3.7 percent of hospitalizations leading to adverse medication reactions
    • 7,391 deaths resulted from medication errors (Institute of Medicine)
    • 2.4 to 3.6 percent of hospital admissions were due to (prescription) medication events (Australian study)

    Various studies have been performed about medical errors. A phone survey by the National Patient Safety Foundation found that 42% of people believed they had experienced a medical error personally or to a relative or friend. The Institute of Medicine (IOM) reports on two studies estimating the hospital deaths due to medical errors at 44,000 to 98,000 annually, which would place medical errors in the top ten causes of death in the USA. Barbara Starfield's article in JAMA places the estimates even higher, citing a total of 225,000 deaths due to iatrogenic causes, which would place health-caused deaths as the 3rd leading cause of death in the USA. Holland et al (1997) estimates as many as 1 million patients are injured while in the hospital and approximately 180,000 die as a result, with the majority due to medication adverse reactions.

    Nosocomial infections caught during a hospital stay are also common, although these are not necessarily due to an identifiable error by medical personnel. On the other hand, many nosocomial infections would be prevented if hospital staff placed greater emphasis on preventive measures such as hand washing and sterilization. Estimates of nosocomial infections are as high as 2 million case annually or about 10% of hospital patients in the USA. Death rate estimates range from 20,000 annually to 88,000 deaths annually. The cost burden may be as high as $4.5 billion annually.

    IOM study: deaths from medical errors: An Institute of Medicine (IOM) study in 1999 cited two different studies placing the number of deaths due to medical error in hospitals at 44,000 and 98,000 annually in the USA. For comparison, the CDC reports that in 1999 there were roughly 2.4 million US deaths, which would mean the above estimates represent approximately 1.8% and 4.0% of deaths respectively. The CDC lists the following top ten causes of death in USA for 1999 (see deaths overview for more details):

    • 725,192 from heart disease,
    • 549,838 from cancer,
    • 167,366 from stroke or other cerebrovascular disease,
    • 124,181 from chronic lower respiratory disease,
    • 97,860 from accidents,
    • 68,399 from diabetes,
    • 63,730 from influenza and pneumonia,
    • 44,536 from Alzheimer's disease,
    • 35,525 from certain types of kidney disease,
    • 30,680 from septicemia, and
    • 484,092 from other causes.

    By either estimate, the results would place deaths from medical errors clearly into the top ten causes of death at either position 5 or position 9. Furthermore, since these reports were based only on hospital admissions, the real number of deaths from medical errors in a doctor's office, such as misdiagnosis or delayed treatment, may be much higher.

    The above reports were based on estimates of the rates of hospital admission that results in death from adverse events. The reports found rates of adverse events at 2.9 and 3.7 percent of hospitalizations respectively, and these were extrapolated to the annual rate of hospitalizations in the USA of 33.6 million admissions in the USA 1997. About half of these adverse events were due to errors: 58% and 53% respectively.

    How common are medication errors? The IOM report gives much detailed information about deaths and adverse events due to errors in medication. The report estimates that 7,391 deaths resulted from medication errors in 1993. The IOM report cites one study finding that about 2% of hospital admissions experienced a preventable adverse drug event, although the majority were not fatal. Medication error was cited as the cause of death for 1 in 131 outpatient deaths and 1 in 854 inpatient deaths. Errors in prescription and dispensing are known but difficult to quantify. For example, the IOM report cites an Australian study for 1988-1996 finding that 2.4 to 3.6 percent of hospital admissions were due to medication events, of which 32 to 69% were preventable. For more details, see medication errors.

    Surgical errors: Death rates from anesthesia in surgery have declines massively to about 1 per 200,000-300,000 cases compared to 2 per 10,000 in the early 1980s.

    Starfield JAMA article: Barbara Starfield's JAMA article (Volume 284, No. 4, 2000), gives very large estimates of death due to medical treatment. A total of 225,000 deaths are attributed to various iatrogenic causes. This figure puts them at the 3rd highest cause of death, only after heart disease and cancer. With roughly 2.4 million US deaths in 1999, these estimates would put iatrogenic causes at approximately 9.3% of deaths.

    However, not all of these deaths are necessarily from "mistakes" with 106,000 deaths due to "nonerror adverse events of medications". In other words, people had adverse reactions to a medication but it was not an error because they had no previous indication of a risk factor. Another 80,000 deaths are attributed to nosocomial infections, which are also not necessarily due to a particular "error" since there is always a risk of infection in hospitals. Her report also cites 12,000 deaths from unnecessary surgery, 7,000 deaths from medication errors in hospitals, and 20,000 deaths in hospitals from causes other than medication errors.

    National Patient Safety Foundation Survey: The National Patient Safety Foundation (NPSF) commissioned a phone survey in 1997 to review patient opinions about medical mistakes. The findings showed that 42% of people believed they had personally experienced a medical mistake. In these cases, the error affected them personally (33%), a relative (48%), or a friend (19%).

     

    References

    • National Patient Safety Foundation at the AMA: Public Opinion of Patient Safety Issues, Louis Harris & Associates, September 1997.
    • Centers for Disease Control and Prevention (National Center for Health Statistics), Deaths: Final Data for 1997. National Vital Statistics Reports: Deaths: Leading Causes for 1999. Volume 49, Number 11, October 12, 2001
    • Institute of Medicine (IOM), "To Err Is Human: Building a Safer Health System", 2000, online.
    • Barbara Starfield, MD, MPH, Is US Health Really the Best in the World?, JAMA, Volume 284, No. 4, July 26, 2000, html, PDF
    • Lazarou J, Pomeranz BH, Corey PN. Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies. JAMA 1998 Apr 15;279(15):1200-5, html, PDF
    • JAMA / volume:279 (page: 1216) Drugs and Adverse Drug Reactions: How Worried Should We Be? David W. Bates, MD, MSc April 15, 1998 html, PDF
    • EILEEN G. HOLLAND, PHARM.D., and FRANK V. DEGRUY, M.D. Drug-Induced Disorders, Volume 15, No. 7, November 1, 1997, html
    • Phillips DP, Christenfeld N, Glynn LM. Lancet 1998 Feb 28;351(9103):643-4 Increase in US medication-error deaths between 1983 and 1993. medline
    • National Academies, "Preventing Death and Injury From Medical Errors Requires Dramatic, System-Wide Changes" November 29, 1999, (press release)
    • Richard J. Bonnie, Carolyn E. Fulco, Catharyn T. Liverman, Editors; Committee on Injury Prevention and Control, Institute of Medicine, Reducing the Burden of Injury: Advancing Prevention and Treatment, online
    • Schuster M, McGlynn E, Brook R. How good is the quality of health care in the United States? Milbank Q. 1998;76:517-563. http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?db=m&form=6&Dopt=r&uid=9879302

     

  • 09-20-2009 7:49 PM In reply to

    Re: How Common Are Medical Mistakes?

    Inna, I'm in the category of people that have had a medical mistake take place.  It almost cost me my life but thankfully I survived.  I would say medical mistakes are pretty common.

  • 09-21-2009 8:20 AM In reply to

    Re: How Common Are Medical Mistakes?

     Medicine is not perfect and doctors are not gods. The number of people that die every year because of medical errors is slim compared to the number of people who are better off because of medicine.

    We have become brainwashed into believing that doctors are suppose to be perfect, medicine is as much an art as a science, and all to often the patient is just as responsible for there own faith because they don't follow the recommendations by doctors and abuse medications, self medicate and don't inform doctors of underlieing ailments that may cause reactions to treatment.

    Just go back 100 years ago and look at the life expectancy of an average person and look at todays life expectancy, you'll see how far medicine has come.

    Also the number of people in this country has tripled in the last 100 years ( 300 milliom plus today ) so looking at the numbers of people treated successfully campared to the number of mistakes, the overall health care of society is much better off today.

    Nothing in this world is perfect, but lawyers file suits against doctors because we have been brainwashed into believing that doctors are suppose to be perfect.

    As for medications there are always going to be those who have a reaction to one medication or another, this does not mean a medication is bad for the overall population, but once again lawyers have brainwahed us into believing that medications are suppose to be perfect for everyone.

    The only problem with medicine is lawyers.

     

  • 10-18-2009 9:17 PM In reply to

    Re: How Common Are Medical Mistakes?

    I agree with what Majik said about medications and the expections.

  • 10-19-2009 1:50 AM In reply to

    Re: How Common Are Medical Mistakes?

     medical mistakes may or may not be common; but, if people keep suing and winning, pretty soon, there'll be just a few doctors to treat the population.

    as the above poster stated quite succinctly: the problem with medicine is the lawyers

  • 10-19-2009 2:18 AM In reply to

    Re: How Common Are Medical Mistakes?

    I have had more then my share of med mistakes just having my kids , they almost killed me both times . I am very lucky to be walking . I reported the mistakes both times and the hospital lied both times and got away with it . but said I did not have to pay the bill .
  • 10-19-2009 2:19 AM In reply to

    Re: How Common Are Medical Mistakes?

    i would definitely agree with what majik13 stated on his post. 

     

  • 10-19-2009 4:51 AM In reply to

    Re: How Common Are Medical Mistakes?

    Ditto.

    We have way tooo many lawyers.  They are the only ones getting rich and better.

  • 10-19-2009 2:14 PM In reply to

    Re: How Common Are Medical Mistakes?

    This country is run by lawyers.

  • 11-03-2009 11:29 AM In reply to

    Re: How Common Are Medical Mistakes?

     I do not think Medical Mistakes are Common. But some times it occer.I think that is not countable.

  • 11-03-2009 12:32 PM In reply to

    Re: How Common Are Medical Mistakes?

    You need to read the article then.

  • 11-03-2009 12:56 PM In reply to

    Re: How Common Are Medical Mistakes?

    majik13:
     Medicine is not perfect and doctors are not gods. The number of people that die every year because of medical errors is slim compared to the number of people who are better off because of medicine.
     

    But they sure act like them sometimes :P People need to understand that medicine won't cure everythin, and the doctors aren't always the ones to blame!

  • 11-03-2009 12:58 PM In reply to

    Re: How Common Are Medical Mistakes?

    majik13:
     Medicine is not perfect and doctors are not gods. The number of people that die every year because of medical errors is slim compared to the number of people who are better off because of medicine.
     

    But they sure act like them sometimes! :P Back in the old days people died and the doctors weren't necessarily to blame. Medicine can't cure everything.  There are times doctors make mistakes, but I would bet more often people are just not happy with the outcome and want to blame someone.

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