440,000 deaths each year from medical errors in the U.S.

Parallel to the opioid “epidemic” there is a much larger crisis happening in our healthcare system: The increasing mortality from medical diagnostic errors.

Deaths from med­ical diagnostic errors in the U.S.
are 
as high as 440,000 each year.

These numbers are almost 25 times the number of opioid overdose deaths (18,000), yet this has never emerged as an issue like the hysteria aroused over the comparatively small numbers (unless it’s one of your own) of opioid overdoses.

 1 in 10 patient deaths is esti­mated to be caused by errors in diag­no­sis.

The media pays no attention, no guidelines have been issued; diagnostic errors haven’t been tackled as the public health issue they truly are.

The fabricated “opioid crisis” is a diversion from much more serious problems in our medical system. (25 times more serious).  

Hospital “leaders” and administrators, who have been “cost cutting” necessary staff for years, are more than happy to go after doctors and patients using prescription opioids instead of working on their own problems.

 

These three articles from the last 3 months are  from reputable sources (The IOM and medscape.com) :

Will the IOM Report on Diagnostic Errors Make Any Difference? – The Center for Patient Protection | Oct 2015

The prog­no­sis for the IOM’s newest bomb­shell on diag­nos­tic errors is not encour­ag­ing.

[The IOM’s] first report in 1999 on med­ical errors (To Err Is Human: Building a Safer Health System) promised a 50 per­cent reduc­tion in 5 years.

Since then the num­ber of deaths has soared to the point where hos­pi­tal harm is the third lead­ing cause of death in the U.S. and Canada.  

 1 in 10 patient deaths is esti­mated to be caused by errors in diag­no­sis.  

the pres­ti­gious Insti­tute of Med­i­cine (IOM) revealed last week that most Amer­i­cans will at some point be affected by a diag­nos­tic error, often with adverse effects to their health

Even with the stun­ning fact that 1 in 10 patient deaths is esti­mated to be caused by errors in diag­no­sis, the main­stream media cov­ered the story for a day. And then moved on.

The report, called Improv­ing Diag­no­sis in Health­care, comes a decade-and-a-half after the IOM’s land­mark study on med­ical errors in the U.S. At that time, the Insti­tute esti­mated that up to 100,000 Amer­i­cans are killed in the clin­i­cal set­ting every year because of med­ical errors. But what hap­pened after the release of that report does not bode well for this lat­est, and even poten­tially more impact­ful, bombshell.

The first IOM report set a min­i­mum goal of reduc­ing hos­pi­tal errors by 50 per­cent over the next five years. That was in 1999. Not only was the tar­get not met, but the num­ber of med­ical mis­takes sub­stan­tially increased.

By 2010, a report from the Office of Inspec­tor Gen­eral for the Depart­ment of Health and Human Ser­vices warned that bad hos­pi­tal care con­tributed to the deaths of 180,000 patients in Medicare alone in any given year.

More research led to the dis­cov­ery of even higher num­bers, includ­ing the esti­mate in 2013 by John T. James, a NASA sci­en­tist who lost his son to a fatal diag­nos­tic mis­take, which put the num­ber of deaths from med­ical errors in the U.S. as high as 440,000 each year.

This makes med­ical errors, most of which occur in the hos­pi­tal set­ting, the third lead­ing cause of death in America.

Yet this is the same “medical industry” that claims the 18,000 annual deaths from prescription drug overdoses (not necessarily even opioids) is a “crisis” and an “epidemic”.

All the resources are being mobilized against opioid prescribing instead of medical errors, which cause 24.5 times as many deaths. Is this a diversionary tactic?

Add to that fig­ure the num­ber of U.S. patients harmed by hos­pi­tal errors, which is esti­mated to be 15 mil­lion each year, and you have to ask what really was the impact of this 1999 report, which most health­care experts describe as groundbreaking.

This contrasts sharply with the numbers harmed by opioids, which is a mere fraction of those harmed by hospital errors.

Writ­ing about the emo­tional dam­age to patients and fam­i­lies, Dr. Don­ald­son noted, “Too often, health­care orga­ni­za­tions, through their inept and unfeel­ing responses, amplify these later waves of harm rather than mit­i­gat­ing their dam­ag­ing effects.”

In a stun­ning moment of frank­ness rarely seen at his level of global pro­fes­sional esteem, Dr. Don­ald­son also observed that “…too many health­care orga­ni­za­tions espouse the goal of safer care while regard­ing harm as the cost of doing business.”

To bol­ster its case about the con­di­tions that can lead to diag­nos­tic errors, the IOM report high­lights three real-life sto­ries. In two of those exam­ples, the patients and their fam­i­lies were either not lis­tened to or had their con­cerns dis­missed out of hand — both with dire consequences.

Unfor­tu­nately, even after care­fully not­ing the evi­dence about the dam­age of diag­nos­tic fail­ures, and the harm they may por­tend for the future, the IOM still does not rec­om­mend manda­tory report­ing, in a pub­licly acces­si­ble fash­ion, of diag­nos­tic errors.

Even as they play up and broadcast the supposed “overwhelming harm” of opioids and require many levels of reporting about their use.

The pub­lic is left out in the cold when it comes to being able to assess the per­for­mance of its health­care insti­tu­tions in diag­nos­tic errors as well as more gen­eral med­ical mistakes.

Gov­ern­ment agen­cies, like the U.S. Cen­ters for Dis­ease Con­trol and Health Canada, which track causes of death from var­i­ous con­di­tions and dis­eases such as stroke and breast can­cer, will not even acknowl­edge that there is a cat­e­gory called med­ical errors which rep­re­sents the third lead­ing cause of death in both countries.

Yet this same agency has no problem setting unscientfically stringent limits of opioid prescribing to counter the number of overdose deaths.

The IOM appar­ently has no rec­om­mended treat­ment for myopic politi­cians who don’t rec­og­nize a health­care cri­sis when it’s right in front of them.  


5% of Patients Experience Diagnostic Error, Says IOM | Sep 2015

Diagnostic errors are a factor in 10% of patient deaths, account for as much as 17% of hospital adverse events, and are a leading driver of medical malpractice claims, according to a sweeping report released Tuesday by the Institute of Medicine.

The report, Improving Diagnosis in Health Care, calls diagnostic errors “a blind spot” in healthcare delivery that has been around for decades which persists across all care settings and harms “an unacceptable number of patients.”

“Despite the pervasiveness of diagnostic errors and the risk for serious patient harm, diagnostic errors have been largely unappreciated within the quality and patient safety movements in healthcare,” the report said. “Without a dedicated focus on improving diagnosis, these errors will likely worsen as the delivery of healthcare and the diagnostic process continue to increase in complexity.”

The report blamed diagnostic errors on “a wide variety of causes, including:  

  • Inadequate collaboration and communication among clinicians, patients, and their families;
  • A healthcare work system that is not well designed to support the diagnostic process;
  • Limited feedback to clinicians about diagnostic performance;
  • A culture that discourages transparency and disclosure of diagnostic errors—impeding attempts to learn from these events and improve diagnosis.”

The Persistent Problem of Diagnostic Error | Dec 2015

As an anatomic pathologist who grew up in the autopsy room, I know that people who die have often been misdiagnosed during their lives

As a forensic pathologist who has studied sudden, unexpected, and unattended death in adults, I know that a large number (as many as half, by my data) of such deaths that would have been diagnosed as heart disease were found, on autopsy, to be related to many other causes but not heart disease.

As a clinical pathologist who has supervised the performance of millions of lab tests, I know that physicians often order the wrong tests and subsequently misinterpret the results and fail to act appropriately

In 2015, the IOM, now of the National Academies of Sciences, Engineering, and Medicine, has turned its attention to Improving Diagnosis in Healthcare.

They described errors in diagnosis as a gigantic problem of largely undefined but vast scope, one that will require extensive and warranted changes.

The committee concluded: “Improving the diagnostic process is not only possible, but it represents a moral, professional, and public health imperative.”

 

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6 thoughts on “440,000 deaths each year from medical errors in the U.S.

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