After last month’s bombshell report from the British Medical Journal (BMJ) that medical errors are the third leading cause of death in America – accounting for an astounding 10 percent of annual deaths in the U.S. – people are starting to worry.
According to the Center for Disease Control and Prevention (CDC), in 2011 more than 720,000 people acquired an infection in a hospital. And as if that isn’t bad enough, a recent study at a top-tier U.S. hospital revealed that almost 50 percent of surgeries “involve some kind of medication error or unintended drug side effect.”
The lead author of the study, Karen C. Nanji, said of the shocking number, “There was not a lot of surprise because everybody knew the self-reported error rates were too low.” Everybody knew? The only thing more surprising than these numbers is the lack of surprise those in charge seem to be expressing.
Maybe this is why there is such a high number of adverse drug events in hospitals. The wrong drug administered to a patient can have harmful, sometimes fatal consequences. The most common medical errors include:
- Adverse drug effects
- Hospital acquired infections
- Injuries during birth
- Falls
There are, of course, many other mistakes that happen in hospitals. After all, it’s human to make errors, but it’s inhumane not to report them.
A Problem without Publicity
The number 1 and 2 killers in America, heart disease and cancer, receive a tremendous amount of federal funding because the CDC makes the country aware of how deadly these conditions are. Martin Makary, one of the authors of the BMJ report, has petitioned the CDC in an open letter to add death from medical errors to the list of leading causes of death.
This is important because, right now, people do not understand the magnitude of the problem. Makary places the average number of deaths, per year, from medical error to be over 250,000. Medical errors, then, are responsible for more deaths than Alzheimer’s disease, Diabetes, Influenza and Pneumonia combined. By putting deaths from medical errors on this list, more research and funding would go towards protecting patients. “It is time,” writes Makary, “for the country to invest in medical quality and patient safety proportional to the mortality burden it bears.”
Any positive change will begin first by recognizing the problem, and all Makary is asking for is that the healthcare system admit that there is a problem. A huge problem. But don’t expect the CDC to make this important change any time soon.
CDC’s Response to Report: Is U.S. Healthcare Really That Inadequate?
Bob Anderson, chief of the mortality statistics branch at the CDC, argues that their approach is consistent with World Health Organization (WHO) guidelines. Such guidelines allow common measurement between nations. A change, such as the one Makary is proposing, would be tricky, and the CDC would not make such a change, according to Anderson “unless we had a really compelling reason to do so.”
Apparently, a quarter million lives each year is not a compelling reason.
Skeptics have said that Makary’s numbers are too high. While these numbers were published in one of the most prominent peer-reviewed journals in the world, for the sake of argument, let’s cut Makary’s numbers in half. That would still mean 125,000 people die each year from medical errors. This reduced figure would still be high enough to land medical errors in the Top 5 leading causes of death.
It’s clear that the in-house fighting between government agencies needs to stop, and that the CDC needs to recognize medical mistakes for the cause of harm and death it really is. Until they do, hospitals can – and will – continue to underplay the truth.
Aviation: A Possible Model for Change?
In the aftermath of a preventable plane crash, there are investigations, lessons learned, and policies changed. Flying will always have risks, but passengers know that every effort has been taken to minimize mistakes and anticipate new problems. A patient ought to feel the same way about procedures they undergo in a hospital, but that might be wishful thinking.
If there is a mistake made in a hospital, it’s almost always settled out-of-court with a “gag-order” preventing both the injured patient and the healthcare professional from ever speaking about it. While this secrecy is certainly good for a hospital’s reputation, it’s hurting patients. In an article in the Journal of the American Medical Association, Ashish Jha and Peter Pronovost argue that hospitals need to do a better job of measuring, reporting, and responding to mistakes. They write:
“Despite thousands of deaths each year related to unsafe care, policy actions have not matched the scale of the problem . . . Better data, valid metrics, and greater transparency represent the best formula for making the United States a world leader in patient safety.”
Hospitals operate in a competitive industry; being open about their mistakes is not something they want to do. Airlines, too, operate in a competitive market, yet they are able to admit and learn from their mistakes. Until our healthcare system can recognize the problem and make commonsense changes, hundreds of thousands more Americans will die or be disabled due to medical errors.
