Patient Safety
Preventable medical errors kill as many as 440,000 Americans each year. Only heart disease and cancer kill more people. Medical malpractice isn't a crisis of lawsuits. It's a crisis of medicine.

Preventable medical errors kill tens of thousands of Americans every year. Several studies by medical researchers have confirmed it. The only question is just how many tens of thousands.

The issue was brought into focus by a 1999 study published by the Institute of Medicine of the National Academies titled “To Err is Human: Building A Safer Health System.” That report found that up to 98,000 patients die in hospitals each year due to preventable “adverse events” caused by medical treatment, not by an underlying condition. According to the authors, medical errors increased health care costs by nearly $30 billion a year because of the need for additional treatment and lengthier hospital stays.

The report was a bombshell that “arguably launched the modern patient-safety movement,” according to University of California, San Francisco, medical professor Dr. Robert Wachter. The estimate of as many as 98,000 deaths a year resulting from preventable errors has been described as “equivalent to two 737s crashing every day.” Some health care executives have objected to that comparison, but Wachter embraces it: “Although some have critiqued the ‘crash-a-day' spin as hyperbolic, I continue to believe it was masterful. Something was necessary to shake us out of our collective inattention, and it took the Jumbo Jet analogy to do it. (And just consider what our response would be if, in fact, a commercial airliner crashed for ‘just' two or three days in a row!)”

But further research suggests the 98,000 number – shocking as it is – may be an understatement.

A report released in 2010, by the Office of the Inspector General at the U.S. Department of Health and Human Services, found that one in seven Medicare patients are injured during hospital stays, and adverse events during the course of care contribute to the deaths of 180,000 patients every year (pdf). Only heart disease and cancer are responsible for more deaths in America. Another study published in 2010 showed about 18 percent of patients in hospitals are injured during the course of their care and that many of those injuries are life-threatening, or even fatal. A study published in 2011 showed that medical errors occur in one-third of hospital admissions, as much as ten times more common than previously estimated.

An even more stunning estimate of deaths from medical negligence comes from a study published in the Journal of Patient Safety in September 2013. It found as many as 440,000 preventable adverse events contribute to the death of patients each year from care in hospitals. That would make medical errors the third-leading cause of death in America, behind heart disease and cancer.

Events that medical experts say should never happen are shockingly common. A recent report by the Joint Commission estimates surgery is performed on the wrong body part—or the wrong patient—40 times a week across America. The University of Southern California Hospital had to shut down its kidney transplant program after a kidney was transplanted into the wrong patient. And a transplant team at the University of Pittsburgh Medical Center missed six chances to see that a kidney they were transplanting was being taken from a woman with potentially lethal hepatitis C; that kidney was then transplanted into a man who did not have the virus.

The California Department of Public Health regularly fines hospitals for “noncompliance with licensing requirements [that] caused, or was likely to cause, serious injury or death to patients.” These errors are considered completely preventable. The San Francisco Chronicle published details of a number of Bay Area deaths resulting from medical errors as part of Hearst Newspapers' “Dead By Mistake” series in August 2009. A two-year investigation by Las Vegas Sun reporters Marshall Allen and Alex Richards uncovered 969 instances of “preventable injuries, life-threatening infections or other harm” in Las Vegas hospitals just in the years 2007 and 2008. Their report was part of a 2010 series about Las Vegas hospital care titled “Do No Harm.”

The considerable evidence of medical errors serves as a reminder that the crisis of medical malpractice is not a crisis of lawsuits. It's a crisis of medicine. And our failure as a society to address that crisis puts future patients at risk.

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