The controversy around estimating deaths from medical error

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  1. Ron Worton

    Great article. Research leading to demonstrably inaccurate results can never be justified, and this includes ill concieved attempts to raise awareness.

  2. Joel Lexchin

    There’s a much larger meta-analysis, also published in the BMJ in 2019, that used 70 studies with over 337,000 patients. The estimate number of people with preventable severe harm or death was just over 2400, i.e., about 0.7% of the patients.

  3. Linda

    The problem with our broken, disfunctional health system has a great deal to do with a lack of accountability to the patients who rely on the training and expertise of the medical practitioners. In every business there is a mode of measurement to determine if operations are running the way they should be and the medical field should be no exception. Whether these stats are accurate or not in the writers opinion, is not the issue. The issue is that it does not take a special study to know that we are now having to rely on a medical system that is broken and sick people have to deal with doctors that may try to do their best, but rely heavily on 10 minute assessments and pharmaceutical drugs and have no time for the patient education or to properly assess the patients status, and that is just a remedy for mistakes. The attitudes of many healthcare practitioners, for whatever reason, are arrogant and cold, which does not promote a good patient doctor relationship in an industry that invades a person’s privacy to the extreme in order to do their job. The first stop to resolve these concerns is to the bean counters, that put the dollars before the life of patients, and the second to the doctors who are happy to earn very large dollars in lieu of taking less patients but doing a better job. There is also a distinct lack of effort for G.P. to update their education on diseases and alternatives to pharmaceutical drugs.
    Instead of skirting the issues in favour of a healthy financial gain, doctors need to be in the medical field for the right reasons(do no harm). The status quo of “work to rule” mentality from medical staff should no longer be tolerated by the taxpayers that put those large dollars in their pockets every year, whether they do a good job or not.

  4. Scott

    If the medical industry was as transparent as the aviation industry about safety incidents, we wouldn’t even be having this tangential conversation from the real issue of hidden data and denial of accountability.

    It is curious that so few studies have been conducted on medical harm and death.

    From what I understand, hospitals and physician organizations keep those numbers close to their chest. And government legislation in some jurisdictions prevents the data from being used in medical malpractice law suits.

    In all likelihood, medical error (death, harm, near misses, etc) is vastly underreported. I interview victims / survivors of medical errors on my podcast (Medical Error Interviews) and each and every one them experienced multiple medical errors.

    Compounding the harm and trauma of medical error, is the resistance and denial to make amends by hospitals and physician organizations. It only makes a bad situation worse for the harmed patient and their family.

  5. Patient Commando

    Great article. It highlights how we have become inured to what these mass numbers really mean, whether 250,000 or 25,000, in the human context.

    Building on the earlier comment citing the aviation industry, the former number would result in the crash of 1,250 Boeing 737 MAX aircraft with an average passenger capacity of 200 people. The latter number results in 125 crashes, or TWO crashes per WEEK.

    It took TWO crashes of the MAX for the global aviation industry to ground all of the planes.

    The debate over numbers is misleading, as I would think that there is general agreement that this is a serious problem. The more important question is, “why is there no public outcry over the lack of action from regulators, professionals, and policy makers to tackle a problem that is clearly killing lots of people”?

    Guns kill people. And we have to take action against that. Let’s admit that health care also kills people and find the brave leadership with the will to take action to remedy that.

    • Skeptical Scalpel

      No one is denying there’s a problem. Even 1 preventable death is a tragedy.

      Maybe you missed this in the article above: “Over the past three years, the value generated by the 2016 paper has been used by some groups to undermine physicians and their credibility. In a recent online dispute between the National Rifle Association and physicians regarding gun control, supporters of the NRA used this statistic to argue that doctors are more harmful than guns, and to de-legitimize the concerns doctors were raising about gun safety. A similar argument has been made by some naturopathic organizations and reported by alternative news sites to “warn” readers about the dangers of the health care system.”

      That’s where the harm of inflated numbers occurs. And those are not the only two groups trumpeting the 250,000 number.

  6. Kit

    I enjoyed this article as well as the range of reactions to it. But one thing is inescapable – unintended severe harm and death will continue to occur to patients if there is no analysis, learning or improvement based on the causes of these critical incidents. As long as we don’t have accurately reported, analysed and transparent data, the real number, causes and potential solutions will be speculative to some degree. A first step would be to remove the stigma practitioners and health safety professionals have around admitting fallibility, fatigue, distraction, under-staffing, poor labeling of drugs, illegible orders and instructions, misplaced case notes, faulty equipment, poor patient transfers and handoffs, etc. as causes of critical incidents. Let’s focus on systems that are not optimally coordinated, rather than the medical staff who are required to operate within them, as the things that need to be assessed and changed to improve patient safety.

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