Monday, July 22, 2019

A New York Times article by Dr. Aaron Carroll provided context to the recent report providing alarming numbers on medical error-related deaths. Dr. Carroll noted that when he started out in the medical profession in 1999, the Institute of Medicine published a report that declared up to 98,000 people died in United States hospitals each year as a result of preventable medical errors. A recent study in the BMJ declared 250,000 people died in hospitals, making preventable medical errors in hospitals the third-largest cause of death in the country in 2013.

Upon reflection of the 1999 report, researchers at Indiana University wrote an article in The Journal of the American Medical Association providing an analysis of the numbers. They pointed out that many people who died in hospitals were very sick, and that the study should have compared the people who died with other hospitalized patients, rather than the general public. The death rate in the group with medical errors (13.8%) was similar to the death rate in a similar group without medical errors (13.6%), leaving doubt on medical errors as the discernible cause of death.

Dr. Carroll argued that research on medical errors is difficult, because unlike a car accident or homicide, it is hard to tell if it is the medical error or the illness that brought the person to the hospital that caused the death. As such, it is difficult to prove what events cause death and which medical errors are correlated with death.

In a 2001 study in which physicians were asked to review and opine on cases of deaths, the results suggested that some hospital deaths might have been partially preventable, but experts disagreed about which cases were preventable. The study findings noted only 0.5 percent of patients who died might have lived at least three months more in good health if care had been optimal.

Although preventable deaths caused by medical errors do occur, Dr. Carroll insisted that the potential harms of hospitals be weighed against the potential benefits. In hospitals, patients can be placed in close proximity to other sick patients. Those who are most ill are more prone to have medical interventions, and be exposed to a preventable error.

In light of this, Dr. Carroll concluded that focusing on the number of deaths in a hospital setting – that may not, in reality, be preventable – could take away resources and attention from other, more effective, harm reduction methods.


Read the article here.