Iatrogenic Disease: The 3rd Most Fatal Disease in the USA
What Causes Errors
When asked what may have caused their doctors to make such errors, patients cited carelessness, stress, faulty training and bad communication.
Three out of four believe the best solution to the problem would be to bar health care workers with bad track records.
But Leape disagreed, arguing that punishment simply encourages people to cover up their errors. "We need to shift emphasis away from individuals," he said. "Errors are not the disease, they're the symptoms of the disease."
Instead, he said, poorly designed health care systems may be largely to blame. Doctors and nurses often work double shifts, making them more prone to error. And in this age of computer technology, Leape noted, the hand-written drug prescription should be a relic of the past.
Medical Mistakes: A Legal and Ethical Dilemma for Doctors and Patients
Experts say medical mistakes occur all the time, and doctors often fail to tell patients about them. A recent report estimates that up to 98,000 patients a year die from medical errors.
Deaths in England Due to Medical Errors up 500%
About 1,200 people died in public hospitals in Britain last year because of mistakes in prescribing and administering medicine, according to a report published by a government watchdog group.
Outlined in a report by the Audit Commission, the errors included administering the wrong medicine - in one case, a breast cancer patient was given the sleeping drug Temazepam instead of the cancer drug Tamoxifen - to giving out the wrong dosage of the right drug, to unknowingly prescribing a drug that caused a fatal reaction.
The death toll was five times higher than that in 1990, according to the report.
In addition, the thousands of patients who survive medicine-related mistakes each year invariably become sicker, requiring more treatment that create an extra expense for the National Health Service, the report said.
"The health service is probably spending $725 million a year making better people who experienced an adverse incident or errors, and that does not include the human cost to patients," said Nick Mapstone, an author of the report.
"The number of drugs is increasing, the effectiveness - and therefore often the toxicity - of drugs is increasing, the number of people on multiple medications is increasing, and that increases the risk of interaction," Dr. Pickersgill told the BBC.
A number of highly publicized cases of drug-related error in recent months has brought home the problem. In one case, a cancer patient was prescribed and administered a drug at 1,000 times the recommended dose, according to the report.
In another case, at Queen's Medical Center in Nottingham, a teenager, who was a cancer patient in remission, fell into a coma and died after an anticancer drug was mistakenly injected into his spine.
"The recent events at Queen's Medical Center illustrate how day-to- day pressures can lead to acknowledged best practice being ignored," the report said.
Jackie Glatter, a spokeswoman for the Consumers' Association, which lobbies for patients' rights, said: "The report shows there is a strong need for detailed and clear patient information about treatments and medicines - not just in hospitals, but also when people are taking medicine at home."
Deaths from Medication Errors on Increase
Deaths caused by medication mistakes more than doubled between 1983 and 1993, according to findings published in the British medical journal The Lancet on Saturday.
Deaths caused by medication mistakes more than doubled between 1983 and 1993
The study by a research team at the University of California at San Diego found that the sharpest increase in deaths was among outpatients.
Deaths from accidental poisoning by drugs and other medicines climbed from 851 to nearly 2,100. Of those, outpatient deaths increased from under 200 to just under 1,500.
By 1993, outpatients were 6.5 times more likely to die from medication mistakes than inpatients.
The report was based on death certificates, and it was unclear whether the deaths were caused by a medical professional's error or patient error.
Drug Reactions Kill an Estimated 100,000 a Year
Adverse reactions to prescription and over-the-counter medicines kill more than 100,000 Americans and seriously injure an additional 2.1 million each year, researchers say.
Such reactions -- which do not include prescribing errors or drug abuse -- rank at least sixth among causes of death in the United States, behind heart disease, cancer, lung disease, strokes and accidents, according to a report published in this week's Journal of the American Medical Association. The report was based on an analysis of existing studies.
"Serious adverse drug reactions are frequent ... more so than generally recognized," the researchers said.
Researchers at the University of Toronto examined 39 studies and estimated that an average of 106,000 deaths at U.S. hospitals in 1994 were due to bad reactions to drugs.
Medical Mistakes Triple All Gun Deaths
For years, the American Medical Association, hospitals, medical magazines and various other health care groups have been beating the drums for more gun laws.
And some of us have pointed out their chutzpah, since -- according
to the official figures, the National Center for Health Statistics, more than
twice as many are killed every year in medical accidents than in gun
Yesterday, an independent report from the Institute of Medicine, an arm of the National Academy of Sciences, said the number of deaths from medical mistakes every year may total 98,000 -- about three times the number of deaths due to accidents, homicides and suicides with firearms.
The study says medical mistakes may cost the nation as much as $29 billion a year and may be the fifth highest cause of death -- behind heart disease, cancer, stroke and lung obstructive lung diseases.
That 98,000 total is over twice as many as die in auto crashes each year.
Nursing Mistakes Kill, Injure Thousands
Tribune Staff Writer
Overwhelmed and inadequately trained nurses kill and injure thousands of patients every year as hospitals sacrifice safety for an improved bottom line, a Tribune investigation has found.
Since 1995, at least 1,720 hospital patients have been accidentally killed and 9,584 others injured from the actions or inaction of registered nurses across the country, who have seen their daily routine radically altered by cuts in staff and other belt-tightening in U.S. hospitals.
Blunders By Doctors Kill 40,000 People a Year In Britain
Medical error is the third most frequent cause of death in Britain after cancer and heart disease, killing up to 40,000 people a year - about four times more than die from all other types of accident.
Provisional research figures on hospital mistakes show that a further 280,000 people suffer from non-fatal drug-prescribing errors, overdoses and infections.
The victims spend an average of six extra days recovering in hospital, at an annual cost of £730m in England alone.
Medical error is the third most frequent cause of death in Britain after cancer and heart disease, killing up to 40,000 people a year
-- University College London
A pilot study investigating the issue - the first attempt to measure the problem in Britain - shows that one in 14 patients suffers some kind of adverse event such as diagnostic error, operation mistake or drug reaction.
Charles Vincent, head of the clinical risk unit at University College London, who is leading the study, has pioneered efforts to examine the extent of clinical errors in Britain.
His team has so far concentrated on two London hospitals. The first data from one hospital showed that 32 out of 480 patients in four different departments were victims of hospital mistakes.
Vincent's estimate of 40,000 deaths comes from studies showing that 3-4% of patients in the developed world suffer some kind of harm in hospital. For 70% of them the resulting disability is short-lived, but 14% subsequently die.
"It is a substantial problem," Vincent said. "There is a need to find out the true extent of error, what kind of things are going wrong and the cost." He believes the death rate may be even higher than indicated by the preliminary figures.
Britain's death rate is comparable to that in America, where recommendations in a report produced by the Kellogg Foundation three weeks ago are likely to result in the creation of a new federal agency to protect patients from medical error.
The report drew on studies that examined the records of 30,195 patients and found a 3.7% error rate. Of those injured, 14% died. Researchers concluded that 70% of the errors - and 155,000 deaths - were avoidable.
Department of Health officials are now examining a proposal for a £1.2m three-year national study of 20 hospitals and 10,000 medical records to establish exactly how these avoidable deaths occur and how to prevent them.
Drugs and Medical Errors Killing 1 of Every 5 Australians
British Medical Journal November 11, 2000
In a recent emailed response to the British Medical Journal (BMJ), Ron Law, Executive Director of the NNFA, in New Zealand and member of the New Zealand Ministry of Health Working Group advising on medical error, offered some enlightening information on deaths caused by drugs and medical errors.
He notes the prevalence of deaths from medical errors and also from properly researched and prescribed medications in Australia and New Zealand, which serves as a reminder to us that the US is not alone in having this problem.
He cites the following statistics and facts:
Official Australian government reports reveal that preventable
medical error in hospitals is responsible for 11% of all deaths in Australia, which is about 1 of every 9 deaths.
If deaths from properly researched, properly registered, properly prescribed and properly used drugs were added along with preventable deaths due to private practice it comes to a staggering 19%, which is almost 1 of every 5 deaths.
New Zealand figures are very similar.
According to Mr. Law:
More than 5 million people have been killed by Western medical practice in the past decade (Europe, USA, Canada, Australia, and NZ) and 20 million killed or permanently maimed. Sounds like a war zone, doesn't it?
-- Ron Law, Executive Director of the NNFA and member of the New Zealand Ministry of Health Working Group
Put another way, the equivalent of New Zealand's second largest city (Christchurch) has been killed by preventable medical error and deaths from properly researched, properly registered, properly prescribed and properly used drugs in Australasia in the past decade and its biggest city Auckland either killed or permanently maimed.
Put another way, more than 5 million people have been killed by Western medical practice in the past decade (Europe, USA, Canada, Australia, and NZ) and 20 million killed or permanently maimed. Sounds like a war zone, doesn't it?
Put another way, the economic impact of deaths due to preventable medical error and deaths from properly researched, properly registered, properly prescribed and properly used drugs is approximately $1 trillion over the past decade.
He notes that only 0.3% of these deaths are properly coded and classified in official statistics as being attributed to these causes.