No matter which estimate you believe to be accurate, Death by Medical Error ranks as a Top 10 cause of death in the US. Due to the extreme reluctance of hospitals and doctors to report the errors that lead to patient death, it is hard to define an accurate number of medical error related deaths each year. According to a Hearst Newspaper investigative report by Cathleen Crowley and Eric Nalder, " Within Health Care Hides Massive, Avoidable Death Toll", estimates vary from a low of 44,000 to 98,000 to as many as 200,000 per year depending on the study criteria and statistical assumptions made in each study. The CDC (Center for Disease Control) lists the Top 10 leading causes of death in the US:
- Heart disease: 631,636
- Cancer: 559,888
- Stroke (cerebrovascular diseases): 137,119
- Chronic lower respiratory diseases: 124,583
- Accidents (unintentional injuries): 121,599
- Diabetes: 72,449
- Alzheimer's disease: 72,432
- Influenza and Pneumonia: 56,326
- Nephritis, nephrotic syndrome, and nephrosis: 45,344
- Septicemia: 34,234
Even the most conservative estimate places Death by Medical Error at #9 on the list. This statistic does not even consider those left with permanent disabilities as a result of medical errors. The numbers are staggering and the personal stories are heartbreaking.
Current Progress to Improve Patient Safety.
According to the article, the National Institute of Medicine issued the report; "To Err Is Human: Building A Safer Health System", in November of 1999. Although this was the first time an authoritative voice backed such a study, its conclusions fell on mostly deaf ears. The report urged the medical profession and its critics to stop blaming doctors and nurses for these mistakes. "People make mistakes... medicine must design systems that can reduce errors and prevent harm from reaching the patient when a mistake is made." The report went so far as to define several steps that could be taken to improve patient safety. It is now 10 years since the report was released. The article notes that there has been some progress improving patient safety but," the positive steps are overshadowed by the continuing death toll." In their article, Crowley and Nalder quote Kathleen Sebelius, US Health and Human Services Secretary (which oversees the federal Agency for Healthcare Research and Quality (AHRQ), Medicare and the Food and Drug Administration), as saying the 2008 death toll from medical errors is 100,000 - the same as it was 10 years ago.
While lack of progress on such a preventable cause of death is enough to raise your blood pressure, the realty behind this statistic is even worse. Crowley and Nalder believe the death toll figure quoted by Ms Sebelius is most likely a reiteration of the dated statistic provided by the, "To Err is Human" report 10 years earlier. The AHRQ admits their most recent figures for death by medical error were gathered in 1984. Why don't we have more up-to-date information on this topic? According to the Crowley/Nalder article it is due to a lack of uniform and enforceable reporting requirements. Why is there a lack of reporting? The article states hospitals and doctors are afraid of additional medical malpractice lawsuits so they do not want to report the errors. They would rather continue making mistakes than address and correct them. To accept this as a valid excuse would be the same as excusing the child playing with matches who lights the trash can on fire then, lets the house burn down rather than call for help because he was afraid he would get in trouble for playing with matches. The child blames his fear of punishment on his mean parents while the medical profession wants to blame the mean and greedy lawyers for their inability to admit their mistakes - and correct them. Tort reform is the only answer, they claim. Limit malpractice awards and healthcare costs will go down.
Tort Reform Unnecessary with Improved Healthcare Quality
If that is true, a quick look at some of the states who have instituted limits on malpractice awards will tell us whether or not this type of tort reform reduces healthcare costs. Studies in Texas, and other states where legislation limiting malpractice awards has been enacted, show this type of tort reform does not reduce overall healthcare costs. Rather, Texas is now home to 3 of the most expensive cities in which to get healthcare. You can read more about this study in, "Most Expensive Places For Health Care." By Rebecca Ruiz at Forbes.com (08/10/09). (The Texas information is in the second half of the article.)
On the other hand, other healthcare cost containment studies* suggest that defining medical errors and addressing their causes actually leads to a decrease in overall healthcare costs. Reducing medical errors obviously reduces the cost of malpractice lawsuits and patient awards. Additionally, and more importantly, it reduces the costs associated with follow up healthcare for patients suffering needless complications. Follow up care due to medical complications is such a significant cost to insurance companies some insurers are now offering doctors bonuses when their patients experience complication free outcomes. Certainly, not all complications are the result of medical errors. However, with this type of bonus award system in place, doctors are more likely to be motivated to reduce patients' medical complications whenever possible; including reducing complications due to error. Tort reform will be unnecessary if we work to reduce medical errors and improve overall healthcare quality.
If you believe you or a family member has been the victim of medical malpractice in Pennsylvania, please use the form to contact Rosen Louik & Perry for a free evaluation of your claim.
(*) Editorial, Fixing Medical Mistakes, The Washington Post, p. A24, December 27, 1999.
Additional links and resources:
State by State summary of medical error reporting laws including Pennsylvania medical error reporting laws: http://www.yale.edu/yjhple/volume9issue1/p201-286_Feature%20TO%20PRINT.pdf
PA MCare Information: The 2002 Pennsylvania Medical Care Availability and Reduction of Error Act (MCARE Act), signed into law on March 20, 2002 by Governor Schweiker,
"Medical Errors: The Scope of the Problem" http://www.ahrq.gov/qual/errback.htm
20 Tips to Help Prevent Medical Errors. Patient Fact Sheet. AHRQ Publication No. 00-PO38, February 2000. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/consumer/20tips.htm