MSNBC NEWS SERVICES



July 24, 2001

Shocking studies that have blamed up to 98,000 patient deaths each 
year on medical errors probably overestimated the problem, with the 
real total perhaps 5,000 to 15,000, according to a study released 
Tuesday.

  	  	 

  	  	 

   IN A STUDY in Wednesday1s Journal of the American Medical 
Association, researchers said the previous studies were flawed 
because there was little consensus among the doctors consulted on 
what constitutes a deadly error.



 Also, the previous studies did not consider whether the patient 
would have died even if the error hadn1t occurred, according to the 
report.



 3Our results suggest that these [earlier] statistics are probably 
unreliable and have substantially different implications than has 
been implied in the media and by others,2 said the researchers, 
Rodney Hayward and Timothy Hofer of the U.S. Veterans Affairs Ann 
Arbor Healthcare System and the University of Michigan Schools of 
Medicine and Public Health.



 Two years ago, a blistering report by the Institute of Medicine 
said that medical mistakes in hospitals kill up to 98,000 
hospitalized Americans a year ­ more than highway accidents or 
AIDS ­ and it demanded major changes. The mistakes included 
prescription drug errors and misused or malfunctioning equipment. 	





The numbers drew the attention of government officials ­ earlier 
this month the Health and Human Services Department made a series 
of recommendations to reduce medical errors ­ and hospitals 
nationwide have implemented new protections, such as computer 
programs to catch errors.



 But while improvements are welcome, the number of medical 
errors that actually cause death is probably overblown, researchers 
said.



 Hayward estimates that between 5,000 and 15,000 deaths 
annually are due to errors. But he acknowledged those numbers are 
rough estimates.



 3This is not to suggest that medical errors are unimportant,2 
Hayward said. Instead, he said: 3The argument is to be careful about 
what you implement.2



 He said he worries that reports about errors will discourage 
people from seeking needed treatment, and that hospitals with 
systems that flag every error 3might cause some to turn the system 
off because of all the false positive alerts that are no big deal.2

       

STUDY DETAILS



 The study involved reviews of 111 deaths at seven VA hospitals 
in 1995 and 1996 to determine whether the deaths were truly 
preventable. Fourteen doctors were assigned to review medical 
records. 	


 The study authors found that only 23 percent of the deaths were 
rated possibly preventable through better medical care, and just 6 
percent were rated probably or definitely preventable.



 But on closer examination, the researchers found that in almost 
every case in which one of the consulting doctors said error caused a 
death, the opinion was not that of the majority of the reviewers, and 
often there was no good evidence to support the finding.



 Researchers also found widely varying opinions among the doctors 
on whether an error directly led to death, and even on what 
constituted an error, said Hayward, a professor of medicine and 
public health at the University of Michigan.



 After factoring in the patients1 three-month prognosis and other 
variables, the study concluded that 3clinicians estimated that only 
0.5 percent of patients who died would have lived three months or 
more in good cognitive health if care had been optimal.2



 The report said the figure represents roughly one patient per 
10,000 admissions to the hospitals involved in the study.

       

FINDINGS DISPUTED



 Dr. Lucian L. Leape of the Harvard School of Public Health, co-
author of the Institute of Medicine report, defended his findings and 
said the new study1s conclusions were based on too small of a 
sample and were derived by way of 3statistical torturing.2



 He said that some medical professionals have argued that his 
study actually underestimated the number of medical errors that 
caused deaths.



 Carmela Coyle, senior vice president for policy for the American 
Hospital Association, said the new study is interesting but added: 
3It1s not about the numbers, but focusing on improving patient 
safety. This does not change the immediate task at hand.2

       

  Avoiding medical mistakes

 	Become an expert on what ails you. Ask your doctor all about it 
and do your own research.

 	Know all about your medications. Thousands die each year from 
medication errors. Know what you're taking, what the name is, what 
the strength is and what it's for.

 	After taking new medications, watch for new symptoms that 
could be side effects.

 	Bring all of your medicines to the doctor with you -- even 
over-the-counter drugs and herbal remedies -- so your doctor can 
see everything you are taking.

 	Know your lab results. Call your doctor if you don't receive 
notification after lab tests.

 	Be on guard, even in the hospital. Every time a drug is about to 
be administered, even intravenously, ask what it is.



Source: NBC News





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