Do you think that death certificates should along with stating the cause of death, also figure a column that states whether a preventable complication stemming from the deceased’s care contributed to the death – in simple words, if the death was caused due to a medical error? In case you are wondering what brought about this question, here is a startling fact – according to a report published in BMJ, medical error is the third leading cause of death in the US. The first two positions go to heart disease and cancer.
Martin Makary, MD, MPH, Professor of Surgery and Michael Daniel, research fellow, from Johns Hopkins University School of Medicine and authors of the report, believe that medical errors should be the top priority for research and resources. However, information with regards to death caused due to medical errors is not easily available. The CDC (Centers for Disease Control and Prevention) uses death certificates to rank causes of death and accordingly establish health priorities. The cause of death as stated on the death certificate is based on the ICD (International Classification of Diseases) code, which unfortunately does not have any code attached to human or system errors. Given the fact that 117 countries use the ICD system to code their death certificates and use the resultant data as the primary health status indicator, we can begin to see how difficult it is to collate data regarding death due to medical errors. It should be remembered that the medical coding system was originally designed to help physicians with their billing and not for collecting health data. Using data collected from this system to prioritize health status does leave room for error.
How would anyone benefit from knowing the numbers related to death due to medical errors? Public health priorities and research funding are based on data released by the CDC, stating top ranked causes of death in the country. Hence, heart disease and cancer, being the top two ranks in causes of death, receive tons of funding and attention, resulting in further research and improvements in trying to reduce their incidence. Since data regarding death caused due to medical errors does not feature on any recognized and standardized method of collection, the incidence rates in this case have never been a part of the health status priority. But, if the report is any indicator on the gravity of this issue – death caused due to medical errors should feature on the health status priority list and immediate steps should be taken to create strategies for reducing it.
According to the CDC, heart disease claimed 611,105 lives, 584,881 died due to cancer and 149,205 lives were lost to chronic respiratory disease in the year 2013. However, examining four studies that analyzed data from 2000 to 2008 on the death rates and using hospital admission rates from 2013, the authors extrapolated that based on the 35,416,020 hospital admissions, 251,454 deaths resulted due to medical errors. This puts death due to medical errors at 9.5% of all deaths each year and makes it the third leading cause of death in the US.
Suggesting several changes that include making errors more visible, for example by adding them as a reason in the death certificates, would help in understanding and reducing this problem, according to the authors. Hospitals need to carry out quick and efficient investigation to determine if medical errors played any role in the death of the patient, suggested the authors, adding that there should be a standardized data collection system related to death caused due to medical errors to help build an accurate picture for prioritizing this problem.
According to the authors, “Human error is inevitable, but we can better measure the problem to design safer systems mitigating its frequency, visibility and consequences. Most errors are not caused by bad doctors but by systematic failures and should not be addressed with punishment or legal action.”
- Frellick, M. (2016, May 03). Medical Error Is Third Leading Cause of Death in US. Retrieved May 05, 2016, from http://www.medscape.com: http://www.medscape.com/viewarticle/862832?nlid=104512_3901&src=wnl_newsalrt_160503_MSCPEDIT&uac=236862HJ&impID=1084165&faf=1
- Martin A Makary, p. M. (2016, May 03). Medical error—the third leading cause of death in the US. Retrieved May 05, 2016, from http://www.bmj.com: http://www.bmj.com/content/353/bmj.i2139