News & Commentary

Up to 440,000 Deaths Preventable?

It’s too pat to say that all medical care is personal, but everyone reading this has had some contact with the system as either a patient or an advocate, and those encounters can sometimes be a motivator. Take, for instance, the study “A New, Evidence-Based Estimate of Patient Harms Associated With Hospital Care” in the Journal of Patient Safety (JPS).

In 1999, the Institute of Medicine’s To Err Is Human study estimated that 98,000 deaths occur each year because of medical errors. Data gathering and processing advanced, and in 2010, the government estimated that bad hospital care resulted in about 180,000 deaths annually.

Still too low, argues John T. James, PhD, author of the JPS study. Between 210,000 and 440,000 patients die in hospitals each year because of human error, he says. He cites examples, such as the 19-year-old runner whose cardiologists neglected to warn him not to run.

“Having not been warned against running, he resumed running and died three weeks later while running,” the study states. That runner was James’s son.

His findings are based on four recent studies that target preventable adverse events (PAEs) that happened to 4,200 patients between 2002 and 2008. The categories are:

  • Errors of commission
  • Errors of omission
  • Errors of communication
  • Errors of context
  • Errors in diagnoses

James’s baseline estimate is 210,000 preventable deaths at hospitals each year. But because not all the data, such as diagnostic errors, are captured, the number could be more than twice as high.

Lucian Leape, MD, sat on the committee that wrote To Err Is Human. He tells ProPublica that James’s estimate is on target. Leape and other experts think it’s time to put the IOM’s 98,000 figure to rest.

The American Hospital Association disagrees, telling ProPublica that the screening method James used (the Global Trigger Tool) cannot really make a nationwide estimate.

James writes: “In a sense, it does not matter whether the deaths of 100,000, 200,000, or 400,000 Americans each year are associated with PAEs at hospitals. Any of the estimates demands assertive action on the part of providers, legislators, and people who will one day become patients.”


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