Medical errors may be responsible for far more deaths than previously realized, according to a new study published today in the BMJ medical journals.
Researchers from Johns Hopkins University School of Medicine found that deaths from medical errors may be responsible for more than a quarter of a million deaths annually. Data in the studies was taken from a combination of Medicare and 13 other hospitals, which researchers examined to determine that the estimated annual rate of deaths from medical errors is 251,454 in the U.S.
That number would make it the third leading cause of a non-violent death in the U.S. ahead of chronic lower respiratory disease which leads to 147,101 deaths annually, according to data from the U.S. Centers for Disease Control and Prevention.
Dr. Martin Makary, lead author of the study and professor of Surgery and Health Policy and Management at Johns Hopkins University, said he hoped the study would reveal how much needs to be done to address patient safety.
"I like many doctors have been aware that people die from fragmented care, diagnostic errors, preventable complications and the problem is serious," Makary told ABC News. "The concern I had was 'Why is this not a national funding priority…why does it receive a comparable fraction of the funding" for cancer or heart disease?
Makary pointed out that identifying medical errors after a patient's death is incredibly difficult. In most cases when a patient dies their cause of death is documented by a physician. That medical cause of death is then assigned a code used in billing and it is this code that the CDC uses to measure mortality statistics. These measurements can often miss complicated deaths according to researchers pointing to a case where a final cause of death was unsuccessful CPR but the patient had suffered a liver laceration during unnecessary testing days earlier.
To come up with their number researchers used information from four past studies and then extrapolated the mean number from that data to determine that more than a quarter of a million deaths were likely related to medical error.
Makary said there should be better measurements to identify medical error and said this was not a case of doctor being bad at their job.
"This problem should not be framed as we have bad doctors, it’s a system problem…a failure to impact normal human error," said Makary.
The American Hospital Association released a statement in reaction to the study pointing out a decline in hospital-acquired conditions in recent years.
"No matter the number, one incident is one too many. Important progress has been made since 2008, the latest year the study examines," association officials said in a statement. "Most recently, the Department of Health and Human Services estimated that through the hard work of hospitals, physicians and others, hospital-acquired conditions declined by 17%, saving 87,000 lives between 2010 and 2014. Hospitals are constantly working to improve patient safety. But there is more work to do and hospitals are committed to quickly adopting what works into every step of care provided."
Dr. David Classen, patient safety expert and associate professor at University of Utah, said this large analysis comes after years of data estimating medical error deaths at more than 200,000 and pointed out some studies have estimated it to be closer to 400,000 people a year.
"If you had this many deaths in aviation industry…you’d shut it down," said Classen. "It’s amazing that in all these other industries we never tolerate this kind of death."
Classen said it's key that this report lead to increased funding and research into patient safety and especially identifying when there are errors. Classen is currently developing ways of using electronic medical records to keep real time data of medical error and said he thinks self-reported errors represent just 10 percent of the actual problems.
"We’ve reached a point where an average patient comes in on 20 medications and has 10 different med problems and it’s hard for anyone human to sort it out," said Classen. "We now deliver care not by an individual but by teams because it’s way too complicated."
Both Classen and Makary say it's key that patients advocate for themselves in the hopsital and both recommend having family members or other caregivers go to a hospital with a patient.
Mary Burton, vice president of Performance Measurement at National Committee for Quality Assurance, said standardizing data and national reporting of causes of death could be key in helping cut down on deaths or injuries related to medical error.
"We would be supportive of that kind of message either on death certificates or potentially in some other standardized place in a record because of course not every medical error...results in death," Burton told ABC News.
Burton said these studies should drive the medical community to take action to protect patients and improve hospital care.
"Why if we’re the first world...then shouldn’t we be passionate about patients safety?," said Burnton. "Shouldn’t we be vigorous and unrelenting in terms of developing system improvements in regards to safe guards?"