How Many Americans Die from Hospital Mistakes?

Experts have long tried to determine how many people die as a result of medical errors in hospitals. In 1999, a report called “To Err is Human” shook up the medical community by suggesting up to 98,000 patients died from preventable errors in hospitals each year. Now a new report says the actually number of deaths from medical errors is likely much higher — from 210,000 to 440,000 patients each year.

The findings were published in the Journal of Patient Safety and indicate the number of patient deaths from preventable errors is cause for concern. If hospital errors kill between 210,000 and 440,000 people every year, then these errors are the third leading cause of death in this country, behind heart disease and cancer.

Findings Stir Debate

The 1999 report initially faced criticism. Medical professionals and others in the healthcare industry disputed the study. But eventually it became accepted as a reasonable estimate of hospital mistakes.

The new study is entitled “A New, Evidence-based Estimate of Patient Harms Associated with Hospital Care.” Its author, John T. James is a toxicologist and patient safety advocate who founded Patient Safety America after the death of his son.

The new estimates were extrapolated from four studies on preventable adverse events in hospitals. James combed through medical records looking for signs of mistakes and had them analyzed by doctors.

In those four studies, serious adverse events occurred in up to 21 percent of cases reviewed. Lethal adverse events were present in as many as 1.4 percent of cases. Applying these rates to the 34 million hospitalizations in 2007, James estimated a baseline of 210,000 fatalities.

Because some types of errors were not caught—including those where treatment should have been provided and wasn’t, where medical records are missing information on harm, and where diagnostic mistakes were not caught — the rate is likely far more than the 210,000 baseline, possibly even doubling.

The estimates are being recognized as based on solid methods.

Earlier Researcher Supports New Report

ProPublica asked three prominent patient safety experts to look over the data. All reported back that the study and findings were credible.

One of the authors involved in the 1999 study, Dr. Lucian Leape of Harvard, says that researchers at the time knew their estimate of 98,000 fatalities was likely low. He said the methods used were “crude” compared with those now. He says the latest study offers a far more accurate estimate.

Clearly doctors need to be discussing the risks of hospitalization with their patients. Dr. Marty Makary, an expert on medical errors and surgeon at Johns Hopkins, says eliminating medical errors must become a top priority for the U.S. healthcare system. He and many others say it’s time to stop citing the 98,000 estimate as the standard and admit that wrongful death and fatalities related to preventable errors are likely much, much higher.