A new study in the latest edition of BMJ suggests most medical errors go unobserved, at least in the official record.
The study, from doctors at Johns Hopkins, suggests medical errors may kill more people than lower respiratory diseases like emphysema and bronchitis do. That would make these medical mistakes the third leading cause of death in the United States. That would place medical errors right behind heart disease and cancer.
Through their analysis of four other studies examining death rate information, the doctors estimate there are at least 251,454 deaths due to medical errors annually in the United States. The authors believe the number is actually much higher, as home and nursing home deaths are not counted in that total.
Dr. Martin Makary and Dr. Michael Daniel, who did the study, hope their analysis will lead to real reform in a health care system they argue is letting patients down.
"We have to make an improvement in patient safety a real priority," said Makary, a professor of surgery and health policy and management at Johns Hopkins.
"Billing codes are designed to maximize billing rather than capture medical errors," Makary said.
The study gives an example of exactly how limited the death certificates are when it comes to recording medical errors. One example involved a patient who had a successful organ transplant and seemed healthy, but had to go back to the hospital for a non-specific complaint. During tests to determine what was wrong, a doctor accidentally cut her liver and hadn't realized it. The hospital sent her home, but she returned with internal bleeding and went into cardiac arrest and later died. It was the cut that led to her death, but her death certificate only listed a cardiovascular issue as the cause.
Makary believes there should be a space on the certificate that asks if the death is related to a medical error. If the answer is yes, Makary suggests the doctor should have some legal protection so the certificate is not something that could be used in a lawsuit. "I don't believe we have diabolic leaders in health care," Makary said. He believes instead that there could be better systems put in place at hospitals to make them safer.