Medical errors the 3rd leading cause of death??

Pangea Reunited, ASN, RN · May 4, 2016

It doesn't say they "are", it says they "may be". I think it makes sensational headline, but I'm not sure I'm on board with the conclusion. I don't doubt that medical errors occur, but people subjected to medical errors are often very ill to start out with. I also don't like their definition of "error".

ShaneTeam · May 4, 2016

Hey Pangea,

I am not getting may be from what I have been reading, but is. Although, the number might be higher, since it looks like they are only talking about acute care hospitals, and not including surgery centers, LTC's, LTAC's, clinics, etc. Here is the original article they have all been referring to in The BMJ

Medical errorâ€”the third leading cause of death in the US | The BMJ

The following is an example taken from the article above:

Case history: role of medical error in patient death

A young woman recovered well after a successful transplant operation. However, she was readmitted for non-specific complaints that were evaluated with extensive tests, some of which were unnecessary, including a pericardiocentesis. She was discharged but came back to the hospital days later with intra-abdominal hemorrhage and cardiopulmonary arrest. An autopsy revealed that the needle inserted during the pericardiocentesis grazed the liver causing a pseudoaneurysm that resulted in subsequent rupture and death. The death certificate listed the cause of death as cardiovascular."

I do see where they are shedding light on this, and maybe death certificates should be altered to better study this.

Susie2310 · May 4, 2016

I am not surprised that medical errors have been found to be the third leading cause of death in the US, and I can quite believe the figures. Although my family members do not comprise large statistical evidence in themselves they have experienced a number of errors in care during their hospitalizations, and friends/neighbours of mine report similar experiences. The last time a family member of mine was hospitalized there were errors in care that could have progressed to causing their death had they not been caught - one incidence involved an emergency physician's initial plan to discharge my family member and treat them as an outpatient (they had been previously discharged from hospital within 30 days) when they had sepsis - this doctor finally ended up admitting them to a monitored unit for sepsis whereupon they spent three days in hospital receiving IV fluids and antibiotics.

On another occasion my family member's IV rate was not turned down after they no longer needed an increased rate of fluids (this was not spotted until the night before they were discharged, and was noticed by the receiving nurse on another unit). My family members have experienced medical/nursing errors and near misses virtually every time they have been hospitalized; fortunately some of the nurses/doctors have intervened to remedy or prevent some errors, and I have intervened to help prevent some errors. Some of my family members cannot easily recover from even relatively small errors in care that would not likely cause serious harm to patients who are fairly young and in fairly good health.

Editorial Team / Admin · May 4, 2016

[h=1]Johns Hopkins study suggests medical errors are third-leading cause of death in U.S.[/h]

Analyzing medical death rate data over an eight-year period, Johns Hopkins patient safety experts have calculated that more than 250,000 deaths per year are due to medical error in the U.S.

And how many of those errors could be eliminated by adequate staffing? Sure, this focuses on physicians, but what about all of those medication errors and failure to rescue that occur because nurses are pushed beyond the point of rational workloads?

Pangea Reunited, ASN, RN · May 4, 2016

Hey Pangea,
I am not getting may be from what I have been reading, but is. Although, the number might be higher, since it looks like they are only talking about acute care hospitals, and not including surgery centers, LTC's, LTAC's, clinics, etc. Here is the original article they have all been referring to in The BMJ
Medical errorâ€”the third leading cause of death in the US | The BMJ
The following is an example taken from the article above:
"Case history: role of medical error in patient death
A young woman recovered well after a successful transplant operation. However, she was readmitted for non-specific complaints that were evaluated with extensive tests, some of which were unnecessary, including a pericardiocentesis. She was discharged but came back to the hospital days later with intra-abdominal hemorrhage and cardiopulmonary arrest. An autopsy revealed that the needle inserted during the pericardiocentesis grazed the liver causing a pseudoaneurysm that resulted in subsequent rupture and death. The death certificate listed the cause of death as cardiovascular."
I do see where they are shedding light on this, and maybe death certificates should be altered to better study this.

Here is another quote from the same article: "We have estimated that medical error is the third biggest cause of death in the US and therefore requires greater attention."

And from this article:

Researchers: Medical errors now third leading cause of death in United States - The Washington Post

"Their analysis, published in the BMJ on Tuesday, shows that "medical errors" in hospitals and other health care facilities are incredibly common and may now be the third leading cause of death in the United States..."

The example you give is certainly significant, but one of your articles states (about medical errors): "...the category includes everything from bad doctors to more systemic issues such as communication breakdowns when patients are handed off from one department to another."

I find that a bit vague.

I don't doubt the errors, I'm just not convinced that they are the cause of death in so many cases.

dream'n, BSN, RN · May 4, 2016

I read this article on CNN yesterday. Ok, if it is correct, what do we do about it? It sure gets the public up in arms, but changes need to come from the top and the article I read gave very little advice related to solving this problem (well except for recommending patients question their Dr or nurse). I work in acute care and give the best and safest care I can possibly give. I give everything I have for my patients. I also have spoken out to administration concerning staffing, acuity ratios, unsafe conditions, etc. I critically think and prioritize. What else can I, and other hard working nurses possibly do?? Nurses are human, physicians are human.

If the public wants to solve some of this issue, maybe they need to support nurse ratios. Perhaps they could fight Press-Ganey and let the nurses handle real issues, instead of harping on getting ice or a warm blanket quickly. Maybe some of the customer service BS could go bye-bye.

KatieMI, BSN, MSN, RN · May 4, 2016

I absolutely believe in it.

With people routinely taking 10 to 30 different medical preparations daily and situation when pretty much anybody can demand a provider to prescribe something that he just saw in an advertisement with a pretty good chance to get it, and insurance companies insisting on "keeping up with the guidelines", the number looks rather low.

It is debatable if chains like "lumbar injection for chronic pain (no evidence of being effective) + 2 prescription opioids + lorazepam + mucle relaxant + two anticoagulants =>> fall =>> intracranial bleed, coma and death" or "coumadin + heparin + Plavix + full dose aspirin =>> retroperitoneal hematoma =>> acute renal failure, shock, death" can be directly named as "medical mistakes" but the result is pretty much the same.

Anonymous865 · May 5, 2016

Here is another quote from the same article: "We have estimated that medical error is the third biggest cause of death in the US and therefore requires greater attention."
And from this article:
Researchers: Medical errors now third leading cause of death in United States - The Washington Post
"Their analysis, published in the BMJ on Tuesday, shows that "medical errors" in hospitals and other health care facilities are incredibly common and may now be the third leading cause of death in the United States..."
The example you give is certainly significant, but one of your articles states (about medical errors): "...the category includes everything from bad doctors to more systemic issues such as communication breakdowns when patients are handed off from one department to another."
I find that a bit vague.
I don't doubt the errors, I'm just not convinced that they are the cause of death in so many cases.

Medical professionals state that x number of lives are saved each year because of vaccinations. They also regularly announce the number of lives saved by mammograms, colonoscopies, pap smears, etc. There is no way to know how many lives are saved. They are estimates, but no one challenges those numbers.

There is no way for them to study how many lives are lost due to medical mistakes, because hospitals and physicians are very careful to conceal those numbers.

Does your hospital publish any information on the lives lost due to medical errors at their institution? That is the problem. Medical errors are reported on incident reports which are not available to researchers. The information is not included in medical records and not included on death certificates. Researchers have to extrapolate from the little data available to them.

Since there are over 5,000 hospitals in the US. If there are 250,000 deaths due to medical errors each year, that is about 50 deaths per hospital due to medical errors. That doesn't surprise me.

KRVRN, BSN, RN · May 5, 2016

Regarding the example of the young woman that had a needle graze her liver during a pericardiocentesis... I'm guessing that's a known possibility of the procedure. Does that still make it medical error? Some medical procedures are inherently dangerous and that's part of the informed consent.

ShaneTeam · May 5, 2016

Regarding the example of the young woman that had a needle graze her liver during a pericardiocentesis... I'm guessing that's a known possibility of the procedure. Does that still make it medical error? Some medical procedures are inherently dangerous and that's part of the informed consent.

What I am getting from the article that the example came from, I think it would still be considered a medical error, since it would be an unexpected outcome, even though it would also be a possible risk.

The reasons they are estimating the amount of deaths is that no one is tracking them at this time. There is no standard procedure to report the deaths as being possibly due to medical error. And this study is not done to lay blame on anyone, but to shed light on a problem that should be addressed. If the numbers are correct, and in one of the articles they are stating it could be as high as 400,000 per year, shouldn't the healthcare industry be looking at this?

Libby1987 · May 5, 2016

I have a friend who had a grave error committed repeatedly with multiple staff and depts involved, not a single one questioned it. Of course no one is/was being forthcoming. We wouldn't have even known the cause had there not been nurses in the family looking up some things and then o_O holy moly how did no one catch that??!! In hind sight, the patient had questioned the treatment but was defensively shut down while in the meantime the whole team continued to cause great harm.

I've personally and professionally caught an unreasonable amount of errors without even digging so I guess I don't find it unbelievable.