Are medical errors really the third most common cause of death in the U.S.?

Posted 19 February 2020

Promoters of “alternative medicine” have exploited previous estimates of hospital deaths “due to medical error” to undermine the public confidence in medicine. Dr David Gorski has assessed the most recent Yale study and has provided an analysis of the study, below.

The claim that medical errors are the third leading cause of death in the US has always rested on very shaky evidence; yet it has become common wisdom that is cited as though everyone accepts it. But if estimates of 250,000 to 400,000 deaths due to medical error are way too high, what is the real number? A recently published study suggests that it’s almost certainly a lot lower.

David Gorski on February 3, 2020

I say this at the beginning of nearly every post that I write on this topic, but it bears repeating. It is an unquestioned belief among believers in alternative medicine and even just among many people who do not trust conventional medicine that conventional medicine kills. Not only does exaggerating the number of people who die due to medical complications or errors fit in with the world view of people like Gary Null, Mike Adams, and Joe Mercola, but it’s good for business. After all, if conventional medicine is as dangerous as claimed, then the quackery peddled by the likes of Null, Adams and Mercola starts looking better in comparison. Unfortunately, there are a number of academics more than willing to provide quacks with inflated estimates of deaths due to medical error. The most famous of these is Dr. Martin Makary of Johns Hopkins University, who published a review (not an original study, as those citing his estimates like to claim) estimating that the number of preventable deaths due to medical error is between 250,000 and 400,000 a year, thus cementing the common (and false) trope that “medical error is the third leading cause of death in the US” into the public consciousness and thereby doing untold damage to public confidence in medicine. As I pointed out at the time, if this estimate were correct, it would mean that between 35% and 56% of all in-hospital deaths are due to medical error and that medical error causes between 10% and 15% of all deaths in the US. The innumeracy that is required to believe such estimates beggars the imagination.

Of course, even with academics providing them with hugely inflated estimates of deaths due to medical error, quacks remain unsatisfied. Perhaps the most famous estimate written by quacks is Gary Null’s Death by Medicine, each new version of which increases the estimate of the number of people who die because of medical errors and “conventional medicine,” to the point where his estimate approaches 800,000 deaths per year, or more than one third of all deaths in the US. (I strongly suspect that Null will find a way to get that estimate up over one million before too long.) That’s why it was refreshing to read a new meta-analysis written (PDF) by investigators at Yale University last week. It provides an estimate that’s significantly larger than the last paper on the topic that I discussed, but more than ten-fold lower than the inflated “third leading cause of death” numbers.

Continue reading at Science-Based Medicine

Small fraction of deaths in hospitals found to be preventable

Based on a systematic review that yielded eight studies of deaths of hospitalized patients, researchers from Yale University School of Medicine and VA Connecticut Healthcare System found that only 3.1% were judged to have been preventable. Two of the studies offered data on preventable deaths for patients with at least 3 months of life expectancy and reported that between 0.5% and 1.0% of those deaths were preventable. Considering the number of annual deaths of hospitalized patients in the USA, the researchers estimated that approximately 22,165 preventable hospital deaths annually and up to 7,150 preventable deaths among patients with greater than 3 months life expectancy. These numbers are much smaller than previous, much criticized, estimates of deaths due to medical error reported by the Institute of Medicine and in other studies.

Reference: Rodwin BA and others. Rate of preventable mortality in hospitalized patients: a systematic review and meta-analysis. J Gen Intern Med. Jan 21, 2020

According to the Yale study, most of the hospital errors involved poor monitoring or management of medical conditions; diagnostic errors; and errors related to surgery and procedures.
Reference: Hathaway B. Estimates of preventable hospital deaths are too high, new study shows. Yale-news. Jan 28, 2020

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