Evidence mounts of terrible toll of preventable medical error

hospital-bed-300x144Although hospitals continue to try to shrug it off, the damning evidence is building that far more Americans die of preventable causes in their care than previously thought, and “approximately 200,000” such deaths each year in the United States is “not unreasonable” as an estimate.

Those are the top-line findings from a team of doctors and public health experts who have published new research in the Journal of Patient Safety. Theirs was the fourth study in recent times to try to quantify what one of the research groups has described as potentially the “third leading cause of death in the United States,” those from medical error, especially occurring in hospitals.

A year ago, the Heartland Health Research Institute looked at Iowa and six surrounding states to assess what experts call preventable adverse events, and examining the existing studies that might offer national insights on the issue. These researchers found that it was reasonable to conclude that “250,000 patients [die] annually in U.S. hospitals due to preventable mistakes.”

Two months later, The Leapfrog Group—a sometimes controversial, national nonprofit that includes 1,800 member hospitals and seeks to improve quality and safety in care-giving institutions—estimated that more than 206,000 avoidable deaths occur in hospitals annually. A month later, as I have written, a study team led by a Johns Hopkins surgery professor published its research. They found that medical errors claim the lives of roughly 685 Americans per day─ more people than die of respiratory disease, accidents, stroke and Alzheimer’s. They accordingly ranked medical errors as the third leading cause of death in the U.S., behind only heart disease and cancer.

The authors of the latest study, led by Kevin Cavanaugh, a doctor and leader at Health Watch USA, an organization whose mission is to promote health care transparency, competition and patient advocacy, support the sizable hospital death figures. They say that research in this area needs to recognize that voluntary and required reporting of serious incidences like hospital deaths or harms tend to under- rather than over-reported.

They chide hospitals for trying to down play negative data and reporting by arguing, for example, that it is affected by patients’ age, health or life choices. It is unacceptable, regardless, if an aged or terminal patient dies prematurely due to medical error, they say, noting, “Medicine does not have the moral authority to discount or disregard days, weeks, or months of life.”

The authors say hospitals and other care-giving institutions, rather than expending so much energy challenging or ignoring adverse studies, should generate their own data to show it is more credible and reliable.

Their research, they say, equates to five or so potentially preventable deaths per year per hospital in the United States or one every 2 to 3 months. This figure also “should be doubled by accounting for deaths from diagnostic errors. In what other industry would such a record be tolerated, let alone defended? Would the airline industry and public ever tolerate even a single preventable airline crash? We can and must do better.”

In my practice, I see the huge harms that patients suffer while hospitalized, and I have struggled with my clients as powerful, moneyed hospitals pull out all the stops to assail their one-time charges, rather than admit their own flaws, negligence, and wrongdoing. We all want great medical care that is accessible, affordable—and safe. This desire unites rather than divides us. Hospitals can’t surface and correct errors, especially grievous ones, without a willingness to acknowledge their fallibility, and, yes, then their humanity. The growing information about the scope and scale of preventable error and deaths in hospitals is both shocking and unacceptable.

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