CDC Asked to List Medical Error as ‘3rd Most Common Cause of Death in US’

Barbara Hollingsworth | May 9, 2016 | 1:15pm EDT
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( – Dr. Martin Makary, professor of surgery at Johns Hopkins University School of Medicine, and three of his medical students are asking the Centers for Disease Control and Prevention (CDC) to “list medical error as the third most common cause of death in the U.S.”

 “From studies that analyzed documented health records, we calculated a pooled incidence rate of 251,454 deaths per year,” or about 9.7 percent of all deaths nationwide, due to medical error, Makary and his students wrote in a May 1 letter to CDC director Thomas Frieden.

“The CDC should list medical error as the third most common cause of death in the U.S. after heart disease (611,105 deaths per year) and cancer (584,881 deaths per year) and replacing respiratory disease (149,205 deaths per year),” the letter stated.

According to the Johns Hopkins team’s analysis of the scientific literature on medical errors, which was published in BMJ (formerly the British Medical Journal) on May 3, deaths caused by medical error are far more common than CDC statistics indicate.

Medical error was defined as “death due to 1) an error in judgment, skill, or coordination of care; 2) a diagnostic error; 3) a system defect resulting in death or a failure to rescue a patient from death; 4) a preventable adverse event,” according to the letter to Frieden signed by Makary, and medical students Sarah Joo, Michael Daniel and Tim Xu.

“Currently, the CDC uses a deaths collection system that only tallies cause of death occurring from diseases, morbid conditions, and injuries” that are listed on International Classification of Diseases (ICD) billing codes.

But ICD codes do not allow physicians, medical examiners, coroners and funeral directors to “list medical error as the cause of death,” the letter stated. And that has “enormous implications for medicine,” the medical researchers pointed out.

“The U.S. government and private sector spend a lot of money on heart disease research and prevention. They also spend a lot of money on cancer research and prevention. It is time for the country to invest in medical quality and patient safety proportional to the mortality burden it bears.”

“Based on the prevalence of the problem of poor quality medical care, the human suffering and price tag due to error are significant and merits proportional funding,” the Johns Hopkins medical team noted.

But very few “project proposals aimed at reducing preventable harm” are funded, they pointed out, including their own grant proposal to reduce unnecessary cancer surgeries, which they said was not approved by the National Cancer Institute.

“Creating one additional field on the death certificate form to inquire if immediately preventable complications stemming from the patient’s medical care was the primary contributor to the patient’s death would advance the science of safety,” they wrote, urging Frieden to address “deaths from care, rather than from the disease that brought the person into care… with the same resources and vigor as other scientific endeavors.”

“Reducing costly medical errors is critical towards the important goal of creating a safer, more reliable health care system,” the letter concludes. “Measuring and understanding the problem is the first step.”

A 2010 report by the Dept. of Health and Human Services’ inspector general (IG) said that “an estimated 1.5 percent of Medicare beneficiaries [admitted to the hospital] experienced an event that contributed to their deaths, which projects to 15,000 patients in a single month."

Medical errors cost taxpayers an estimated $4.4 billion per year, the IG reported.

According to the American Medical Association’s Code of Medical Ethics, “physicians must strive to ensure patient safety and should play a central role in identifying, reducing, and preventing health care errors.”

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