It is astonishing that medical errors are the third leading cause of death in America. The most recent data indicates that 251,000 deaths are due to medical errors, a frightening number. Every person should be concerned about this.
In 1999, the Institute of Medicine published that 98,000 deaths occurred annually due to medical errors. This was just an estimate and of course they suggested more studies to confirm this.
Recently, investigators at Johns Hopkins Medical Center updated those 1999 figures. They reviewed 4 studies of patients from throughout America between 2000 and 2008, representing over 37 million admissions to hospitals. Medical errors included mistake in medication administration (too much, too little, or given to the wrong patient), incorrect medical plan (patients got the wrong plan for their illness), failure in executing an order, physicians' omitting something that should have been done or ordered doing something incorrect, and medical actions that did not produce the intended benefit for the patients.
Fatal errors occurred in 0.71% of these hospital admissions. This percent seems small, but it means that among all hospital admissions in America, 251,000 patients would die annually. And to put this in perspective, 614,000 patients die from heart disease and 591,000 from cancer, making medical errors the third leading cause of death. More people die from medical errors than from lung diseases (147,000 deaths), from stroke (133,000 deaths) or from accidents (136,000 deaths).
In another study at Massachusetts General Hospital, one of the nation's best medical centers, 45% of all surgeries from 2013 to 2014 had drug errors or unintended drug side effects. These included incorrect labeling or dose, or medications ordered but not give. Astonishingly, there was a medication error in 1 of every 20 medications, and about 1 of every 2 surgical operations.
To make these estimates even more frightening, the studies did not include patients receiving outpatient care in their doctors' offices. Even additional errors, a few of them fatal, probably occur in non-hospital settings. But we have not data to precisely estimate this risk.
What can patients do to protect themselves? Here are Dr. Cary's suggestions for you.
• Be certain you have a good physician who will answer all your questions and will give you detailed advice.
• In preparing for surgery, you should ask your surgeon about her/his experience with the operation that is planned: how many does she/he do, what is the complication rate, and what is the mortality rate. Ask what steps will be taken to prevent any medical errors.
• If you are not satisfied with the answers, get a second opinion before any surgery is done. For advice on when and where to get second opinions, see my website and book Surviving American Medicine.
• At the hospital, check every medication you are given to be sure it is your medicine, and you know why it is being given.
• Before surgery, personally meet the anesthesiologist and ask what measures she/he will take to avoid errors. Be sure the physician, rather than just a nurse, is giving your anesthesia.
• And if you are having an operation on an arm or leg or breast, take the time to write on the arm (or leg or breast) "this one" and on the other "not this one". Silly maybe, but better to be safe than sorry!
• When any physician tells you what will be done to help you treat any condition, be certain to ask what alternatives exist and what the benefits and risks of each treatment will be. Get a list of all side effects of any new medication that is prescribed.
• Check with the pharmacist to be sure that no adverse or dangerous interactions may occur between a new medicine you will receive and all other prescriptions and even over-the-counter pills you are taking.
• Review your condition on the internet to get trusted information about the illness, usual treatments, and side effects. The more information you can take to your doctor, the better the questions you can ask and the better your care will be. For a list of trusted internet sites for any condition, see my website and book Surviving American Medicine.
• Remember to have another person (family member or friend) with you in the medical office or in the hospital to be certain all questions have been asked and answered, and that you understand everything.
• Review your medical records. Your physician probably has an electronic health record with your health information and latest visit note. Your hospital can provide you with copies of your physician and consultant notes from your admission. Read these carefully, because any errors (in family history, medications, allergies, past illnesses, treatments received) can be carried forward and account for subsequent errors in your treatment. Ask the doctors or hospital to correct any errors before they harm you.
Medical errors are not rare. Be an active part of your treatment team to be sure you are a survivor, not a victim.
The opinions expressed in this article are those of Dr. Cary Presant and do not represent opinions of City of Hope or any other organizations.