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Iatrogenic Disease The 3rd Most Fatal Disease in the USA
How
Prepared are You to Not Become a National Statistic?
Researched and Written by Dr. Ronald Grisanti
Iatrogenic Disease is defined as a disease that is caused by medical treatment. Read major headlines around the globe on this serious disease. If a Jumbo Jet crashed and killed 280 people everyday.. 365 days a year.. year after year.. would you be concerned about flying?? Would you question the Federal Aviation Administration? Would you demand answers?? Think about it .. close to 100,000 people dying every year from plane crashes. Sounds Ridiculous??!! Well think again.. what if you were told that over 100,000 people are killed and over 2 million people maimed and disabled every year .. year after year from modern medicine.. would you believe it?? Well these may be my words.. but read the following articles from the most respected medical journals and institutions (Journal of the American Medical Association, Harvard University, Centers for Disease Control, British medical journal The Lancet, New England Journal of Medicine and national news (New York Times, Washington Post, CNN, US World Report) and you be the judge.. Writing in the Journal of the American Medical Association (JAMA), Dr. Starfield has documented the tragedy of the traditional medical paradigm in the following statistics:
Furthermore, these estimates of death due to error are lower than those in a recent Institutes of Medicine report. If the higher estimates are used, the deaths due to iatrogenic causes would range from 230,000 to 284,000. Even at the lower estimate of 225,000 deaths per year, this constitutes the third leading cause of death in the U.S. Dr. Starfield offers several caveats in the interpretations of these numbers: First, most of the data are derived from studies in hospitalized patients. Second, these estimates are for deaths only and do not include the many negative effects that are associated with disability or discomfort. Third, the estimates of death due to error are lower than those in the IOM report. If the higher estimates are used, the deaths due to iatrogenic causes would range from 230,000 to 284,000. In any case, 225,000 deaths per year constitutes the third leading cause of death in the United States, after deaths from heart disease and cancer. Even if these figures are overestimated, there is a wide margin between these numbers of deaths and the next leading cause of death (cerebro-vascular disease). Another analysis concluded that between 4% and 18% of consecutive patients experience negative effects in outpatient settings, with:
The high cost of the health care system is considered to be a deficit, but it seems to be tolerated under the assumption that better health results from more expensive care. However, evidence from a few studies indicates that as many as 20% to 30% of patients receive inappropriate care. An estimated 44,000 to 98,000 among these patients die each year as a result of medical errors. This might be tolerable if it resulted in better health, but does it? Out of 13 countries in a recent comparison, the United States ranks an average of 12th (second from the bottom) for 16 available health indicators. More specifically, the ranking of the U.S. on several indicators was:
It has been known that drugs are the fourth leading cause of death in the U.S. This makes it clear that the more frightening number is that doctors are the third leading cause of death in this country, killing nearly a quarter million people a year. These statistics are further confused because most medical coding only describes the cause of organ failure and does not identify iatrogenic causes at all. Care -- not treatment -- is the answer. Drugs, surgery and hospitals become increasingly dangerous for chronic disease cases. Facilitating the God-given healing capacity by improving the diet, exercise, and lifestyle is the key. Effective interventions for the underlying emotional and spiritual wounding behind most chronic disease is critical for the reinvention of our medical paradigm. These numbers suggest that reinvention of our medical paradigm is called for. =========== Dec. 7, 1999 | Representatives from all quarters of the health-care debate came together in the White House Rose Garden Tuesday to get behind a pretty simple premise: Health-care workers shouldn't make the kind of mistakes that cost the lives of as many as 98,000 patients a year. Flanked by representatives of the health-care industry, business, labor and government, President Clinton signed an executive memorandum directing his health-care quality task force to analyze last week's Institute of Medicine study that quantified the deaths attributable to medical errors, many of them as a result of wrong prescription-drug doses. The independent study estimated that medical mistakes kill between 44,000 and 98,000 Americans each year. About 7,000 deaths were attributed to errors in prescribing or dispensing drugs. The IOM found flaws in the way hospitals, clinics and pharmacies operate. "Once you know about a problem, you're under a moral obligation to deal with it," Clinton said when asked whether admitting mistakes might expose health-care professionals to increased lawsuits. "Whatever the consequences are, we have to go forward." ============================
Health care's deadly
secret:
Accidents routinely happen
INQUIRER STAFF WRITER
It is also representative of modern American hospitals in another respect: In the last decade alone, records show, hundreds of MCP Hospital patients have been seriously injured, and at least 66 have died after medical mistakes. The hospital's internal records cite 598 incidents reported by medical professionals to the hospital administration in the last decade. In some of those cases, patients or survivors were never told that the injuries were caused by medical errors. None of the doctors involved in the incidents was subjected to disciplinary action. For patients of all ages, serious injury and death caused by medical errors are well-known facts of life in the medical community. But they are rarely reported to the general public. MCP Hospital's records came to light only because of bankruptcy proceedings last year, when its new owner publicly filed a detailed account of the 598 incidents reported at the facility from January 1989 through June 1998. hose numbers mirror what is happening across the country. Lucian Leape, a Harvard University professor who conducted the most comprehensive study of medical errors in the United States, has estimated that one million patients nationwide are injured by errors during hospital treatment each year and that 120,000 die as a result. That number of deaths is the equivalent of what would occur if a jumbo jet crashed every day; it is three times the 43,000 people killed each year in U.S. automobile accidents. "It's by far the number one problem" in health care, said Leape, an adjunct professor of health policy at the Harvard School of Public Health. In their study, Leape and his colleagues examined patient records at hospitals throughout the state of New York. Their 1991 report found that one of every 200 patients admitted to a hospital died as a result of a hospital error. Researchers such as Leape say that not only are medical errors not reported to the public, but those reported to hospital authorities represent roughly 5 to 10 percent of the number of actual medical mistakes at a typical hospital. "The bottom line is we have a system that is terribly out of control," said Robert Brook, a professor of medicine at the University of California at Los Angeles. "It's really a joke to worry about the occasional plane that goes down when we have thousands of people who are killed in hospitals every year." Brook's recognition of the extent of hospital errors is shared by many of medicine's leaders. ==========
=========
====== Study slams medical error rate in nation
By Andrea
Gerlin
A panel of the National Academy of Sciences,
in a highly critical report, yesterday called for a major national
effort to reduce medical errors by developing a mandatory reporting
system and asking Congress to establish a center to study them.
INQUIRER STAFF WRITER
The 220-page report, written by a 19-member committee of the Academy's Institute of Medicine, set as a goal a 50 percent reduction in the nation's "stunningly high rate of medical errors" within five years. It estimated that errors from medical treatment kill up to 98,000 people in U.S. hospitals every year and characterized the problem as among the nation's leading causes of death and injury. Several members of the committee said in interviews yesterday that the report was intended as a loud call to action for the health-care industry, which it said has not acted swiftly enough to address the causes of errors. "What it says is 'enough already,' " said Lucian Leape, a committee member and adjunct professor of health policy at the Harvard School of Public Health. "It's a matter of holding people's feet to the fire and stop talking about errors and start doing something." =============
Medical mistakes often unreportedAbout 3,500 patients die and no one has to knowBy Sarah A. Webster / The Detroit News Twenty states require hospitals to report serious mistakes, but Michigan isnt among them.
Patients reported 2,027 complaints about health care organizations to the state, but Tom Lindsay, director of the Michigan Bureau of Health Services, said those likely represent just a fraction of the mistakes. I cant tell you how many deaths or injuries result from medical mistakes, Lindsay said. Several institute members said mandatory reporting of serious mistakes is the first step to reducing the errors. It is asking Congress to establish a nationwide mandatory reporting system for medical errors that cause injury or death.
==== MEDICAL MISTAKES During 1999 mainstream
institutions revealed that one of the ** The NEW YORK TIMES reported
that 5% of people admitted to ====
High-Tech Cure for Medical Mistakes
Imagine that we had an airline crash every day, taking the lives of more than 250 Americans. The country would be outraged, the president would be demanding action, and Congress would be passing emergency legislation. And yet a tragedy of similar proportions is occurring right now in American hospitals. As many as 98,000 people are needlessly dying in our hospitals every year because of inappropriate medical treatment, according to the report "To Err Is Human" by the Institute of Medicine (IOM). The number of people who die every day in hospitals because of inappropriate medicine is double the number who died in last week's Concorde crash. The time has come for Congress and the president to act on behalf of all Americans. It is time to stop defending inefficiency and to drag health care into the 21st century by insisting on modern management and information systems. According to IOM's initial report, inappropriate medical treatment is the fifth leading cause of death in the United States. And that number does not include deaths resulting from home care, ambulatory care or outpatient visits, those that occur in nursing homes or those at patients' homes after they have received inappropriate care in the hospital. ========== A new poll from the
nonprofit National Patient Safety Foundation (NPSF) finds that 42
percent of people say they've been affected by physician errors, either
directly or through a friend or relative. If the survey of roughly 1,500
people accurately represents the general public, it could mean that more
than 100 million Americans have experience with medical mistakes. Wrong
Diagnosis, Treatment The survey found that 40 percent of the people
who had experienced a medical mistake pointed to misdiagnoses and wrong
treatments as the problem. Medication errors accounted for 28 percent of
mistakes. And 22 percent of respondents reported slip-ups during medical
procedures. What
Causes Errors In fact, prescription errors may be among the easiest to avoid. Within five years, most hospitals, clinics and pharmacies should be using computerized drug tracking programs that allow a doctor or pharmacist to know exactly what drug is being called for. Bad penmanship should not be a risk factor for patients. =========== Medical mistakes: A legal and ethical dilemma for doctors and patients
Ask John Hawley about medical mistakes, and he'll tell you how he lost half a lung to a misdiagnosis of cancer. Ask his wife, and she'll tell you about the fear that she felt through the ordeal. They'll both tell you they were stunned that his doctors never told them about the mistake. Experts say medical mistakes occur all the time, and doctors often fail to tell patients about them. A recent report estimates that up to 98,000 patients a year die from medical errors. Hawley, a retiree from the U.S. Navy, went into surgery in late January 1998 at Lawnwood Regional Medical Center in Fort Pierce, Florida. Half of one lung was cut out, and tissue was sent to the pathology lab for a follow-up analysis. For the year following the surgery, the Hawleys say they lived in fear, worrying that John's cancer might reoccur. The Hawleys say they were astonished to find out that allegedly the doctors had known, but had not told them, that the post-surgery pathology lab analysis had revealed that Hawley apparently had been misdiagnosed with cancer. "I was tickled to death for about 30 seconds," says Hawley, "then I got really mad, figured that I went through all of this pain and been drug through everything, and back for appointments to see the people who done it, and they never mentioned a word to me. And I was pretty mad." Hawley is suing Lawnwood hospital and some of its doctors. All the defendants declined to comment, citing the lawsuit. ========== Deaths in England Due to Medical Errors up 500%By Sarah Lyall About 1,200 people died in public hospitals in Britain last year because of mistakes in prescribing and administering medicine, according to a report published by a government watchdog group. Outlined in a report by the Audit Commission, the errors included administering the wrong medicine - in one case, a breast cancer patient was given the sleeping drug Temazepam instead of the cancer drug Tamoxifen - to giving out the wrong dosage of the right drug, to unknowingly prescribing a drug that caused a fatal reaction. The death toll was five times higher than that in 1990, according to the report. In addition, the thousands of patients who survive medicine-related mistakes each year invariably become sicker, requiring more treatment that create an extra expense for the National Health Service, the report said. "The health service is probably spending $725 million a year making better people who experienced an adverse incident or errors, and that does not include the human cost to patients," said Nick Mapstone, an author of the report. Mr. Mapstone said that many of the most common errors are avoidable and could be rectified if the health service introduced computerized patient record and prescription systems. As it is now, patients'
notes are often illegible, incomplete or missing altogether, the report
said, making it impossible for doctors and nurses
to have accurate information. Addressing the issues raised by the report, Dr. Trevor Pickersgill, a spokesman for the junior doctors' committee of the British Medical Association, said that understaffing in hospitals and the increasing complexity of modern drug therapy have created a culture "where mistakes unfortunately do happen." "The number of drugs is increasing, the effectiveness - and therefore often the toxicity - of drugs is increasing, the number of people on multiple medications is increasing, and that increases the risk of interaction," Dr. Pickersgill told the BBC. "We must also remember that one in six pharmacy posts in hospitals are unfilled, and new doctors who are doing the work on the wards are overworked as well," he said. A number of highly publicized cases of drug-related error in recent months has brought home the problem. In one case, a cancer patient was prescribed and administered a drug at 1,000 times the recommended dose, according to the report. In another case, at Queen's Medical Center in Nottingham, a teenager, who was a cancer patient in remission, fell into a coma and died after an anticancer drug was mistakenly injected into his spine. "The recent events at Queen's Medical Center illustrate how day-to- day pressures can lead to acknowledged best practice being ignored," the report said. Jackie Glatter, a spokeswoman for the Consumers' Association, which lobbies for patients' rights, said: "The report shows there is a strong need for detailed and clear patient information about treatments and medicines - not just in hospitals, but also when people are taking medicine at home." New York Times ========== Medical errors kill tens of thousands annually, panel says
WASHINGTON (CNN) -- More people die each year in the United States from medical errors than from highway accidents, breast cancer or AIDS, a federal advisory panel reported Monday. The report from the National Academy of Sciences' Institute of Medicine cited studies showing between 44,000 and 98,000 people die each year because of mistakes by medical professionals. "That's probably an underestimate for two reasons," noted Dr. Donald Berwick of the Institute of Medicine. "One is, there are many different kinds of errors we never learn about -- even in retrospective studies -- because they are never written down. And second, these studies did not include other areas of care like home care, nursing homes and ambulatory care centers," Berwick said. =========
========== Study: Drug reactions kill an estimated 100,000 a yearCHICAGO (CNN) -- Adverse reactions to prescription and over-the-counter medicines kill more than 100,000 Americans and seriously injure an additional 2.1 million each year, researchers say. Such reactions -- which do not include prescribing errors or drug abuse -- rank at least sixth among causes of death in the United States, behind heart disease, cancer, lung disease, strokes and accidents, according to a report published in this week's Journal of the American Medical Association. The report was based on an analysis of existing studies. "Serious adverse drug reactions are frequent ... more so than generally recognized," the researchers said. Researchers at the University of Toronto examined 39 studies and estimated that an average of 106,000 deaths at U.S. hospitals in 1994 were due to bad reactions to drugs. ============= Medical Mistakes Triple All Gun DeathsNov. 30 update -- For years, the American Medical Association, hospitals, medical magazines and various other health care groups have been beating the drums for more gun laws. And some of us have pointed out their chutzpah, since -- according to the official figures, the National Center for Health Statistics, more than twice as many are killed every year in medical accidents than in gun accidents. Some experts have long said the real numbers of what are euphemistically called "Medical Misadventures" are many times higher than officially acknowledged. Yesterday, an independent report from the Institute of Medicine, an arm of the National Academy of Sciences, said the number of deaths from medical mistakes every year may total 98,000 -- about three times the number of deaths due to accidents, homicides and suicides with firearms. The study says medical mistakes may cost the nation as much as $29 billion a year and may be the fifth highest cause of death -- behind heart disease, cancer, stroke and lung obstructive lung diseases. That 98,000 total is over twice as many as die in auto crashes each year. =============
Nursing
mistakes kill, injure thousands Cost-cutting exacts toll on
patients, hospital staffs
By Michael J. Berens Overwhelmed and inadequately trained nurses kill and injure thousands of patients every year as hospitals sacrifice safety for an improved bottom line, a Tribune investigation has found. Since 1995, at least 1,720 hospital patients have been accidentally killed and 9,584 others injured from the actions or inaction of registered nurses across the country, who have seen their daily routine radically altered by cuts in staff and other belt-tightening in U.S. hospitals. =========
Blunders By
Doctors Kill 40,000 people a Year In Britain
By Lois Rogers MEDICAL error is the third most frequent cause of death in Britain after cancer and heart disease, killing up to 40,000 people a year - about four times more than die from all other types of accident. Provisional research figures on hospital mistakes show that a further 280,000 people suffer from non-fatal drug-prescribing errors, overdoses and infections. The victims spend an average of six extra days recovering in hospital, at an annual cost of £730m in England alone. A pilot study investigating the issue - the first attempt to measure the problem in Britain - shows that one in 14 patients suffers some kind of adverse event such as diagnostic error, operation mistake or drug reaction. Charles Vincent, head of the clinical risk unit at University College London, who is leading the study, has pioneered efforts to examine the extent of clinical errors in Britain. His team has so far concentrated on two London hospitals. The first data from one hospital showed that 32 out of 480 patients in four different departments were victims of hospital mistakes. Vincent's estimate of 40,000 deaths comes from studies showing that 3-4% of patients in the developed world suffer some kind of harm in hospital. For 70% of them the resulting disability is short-lived, but 14% subsequently die. "It is a substantial problem," Vincent said. "There is a need to find out the true extent of error, what kind of things are going wrong and the cost." He believes the death rate may be even higher than indicated by the preliminary figures. Britain's death rate is comparable to that in America, where recommendations in a report produced by the Kellogg Foundation three weeks ago are likely to result in the creation of a new federal agency to protect patients from medical error The report drew on studies that examined the records of 30,195 patients and found a 3.7% error rate. Of those injured, 14% died. Researchers concluded that 70% of the errors - and 155,000 deaths - were avoidable. Department of Health officials are now examining a proposal for a £1.2m three-year national study of 20 hospitals and 10,000 medical records to establish exactly how these avoidable deaths occur and how to prevent them. ==============
Drugs and
Medical Errors Killing 1 of Every 5 Australians
In a recent emailed response to the British Medical Journal (BMJ), Ron Law, Executive Director of the NNFA, in New Zealand and member of the New Zealand Ministry of Health Working Group advising on medical error, offered some enlightening information on deaths caused by drugs and medical errors. He notes the prevalence of deaths from medical errors and also from properly researched and prescribed medications in Australia and New Zealand, which serves as a reminder to us that the US is not alone in having this problem. He cites the following statistics and facts:
According to Mr. Law:
Put another way, the equivalent of New Zealand's second largest city (Christchurch) has been killed by preventable medical error and deaths from properly researched, properly registered, properly prescribed and properly used drugs in Australasia in the past decade and its biggest city Auckland either killed or permanently maimed.
Put another way, more than 5 milion people have been killed by Western medical practice in the past decade (Europe, USA, Canada, Australia, and NZ) and 20 million killed or permanently maimed. Sounds like a war zone, doesn't it? Put another way, the economic impact of deaths due to preventable medical error and deaths from properly researched, properly registered, properly prescribed and properly used drugs is approximately $1 trillion over the past decade. He notes that only 0.3% of these deaths are properly coded and classified in official statistics as being attributed to these causes. British Medical Journal November 11, 2000; 321: 1178A (emailed response) =========== Study: Tools left in 1,500 patients yearly By Jeff Donn
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