diagnosis

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It is a major cause of death in the United States, third only to heart disease and cancer.

It claims more lives than respiratory disease, accidents, and stroke.

And it happens at the hands of the very people who are supposed to help protect us from the health issues listed above.

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Patient safety experts at Johns Hopkins analyzed death data over an eight-year period and found that more than 250,000 deaths per year are caused by medical errors in the U.S.

The research, led by Dr. Martin Makary, a professor of surgery at the Johns Hopkins University School of Medicine, found that medical mistakes in hospitals and other medical facilities are very common, and include bad doctors, systemic issues, surgical complications that go unnoticed, and medication errors.

But if you look at the statistics for leading causes of death on the Centers for Disease Control and Prevention (CDC) website, you won’t see medical errors listed at all. For 2015, heart disease is ranked as the top cause with 614,348 deaths, followed by cancer with 591,699, and chronic lower respiratory diseases ranks third, with 147,101 deaths.

Why does the CDC omit such a significant cause of death from their statistics?

According to the new study, published in The BMJ, death certificates in the U.S., which are used to compile national statistics, have no option for accounting for medical mistakes. “Medical error” is not considered a disease, but if it was, it would rank as the third leading cause of death, says the study.

Dr. Makary, who is an authority on health reform, explains:

Incidence rates for deaths directly attributable to medical care gone awry haven’t been recognized in any standardized method for collecting national statistics. The medical coding system was designed to maximize billing for physician services, not to collect national health statistics, as it is currently being used.

From the press release:

In 1949, Makary says, the U.S. adopted an international form that used International Classification of Diseases (ICD) billing codes to tally causes of death.

“At that time, it was under-recognized that diagnostic errors, medical mistakes and the absence of safety nets could result in someone’s death, and because of that, medical errors were unintentionally excluded from national health statistics,” says Makary.

The researchers say that since that time, national mortality statistics have been tabulated using billing codes, which don’t have a built-in way to recognize incidence rates of mortality due to medical care gone wrong.

For their study, the researchers examined four separate studies that analyzed medical death rate data from 2000 to 2008, including one by the U.S. Department of Health and Human Services’ Office of the Inspector General and the Agency for Healthcare Research and Quality. Then, using hospital admission rates from 2013, they extrapolated that based on a total of 35,416,020 hospitalizations, 251,454 deaths stemmed from a medical error, which the researchers say now translates to 9.5 percent of all deaths each year in the U.S.

Dr. Makary told The Washington Post that he and co-author Michael Daniel, also from Johns Hopkins, conducted the analysis to bring attention to a problem that many hospitals and health care facilities try to avoid discussing:

It boils down to people dying from the care that they receive rather than the disease for which they are seeking care.

We all know how common it is. We also know how infrequently it’s openly discussed.

In an interview with NPR, he said:

You have this overappreciation and overestimate of things like cardiovascular disease, and a vast underrecognition of the place of medical care as the cause of death. That informs all our national health priorities and our research grants.

Dr. Makary and the study’s co-authors are calling on the CDC to immediately add medical errors to its reporting on top causes of death. In an open letter to the agency, they state:

We define death due to medical error 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, or 4) a preventable adverse event.

They go on to suggest that the CDC allow clinicians to list medical error as the cause of death, and ask that the agency update its current statistics to list medical error as the third leading cause of death in the U.S.

Dr. Markary says that most medical errors are not caused by inherently bad doctors – they are the result of systematic problems. He adds that more research on preventing medical errors is needed:

Top-ranked causes of death as reported by the CDC inform our country’s research funding and public health priorities. Right now, cancer and heart disease get a ton of attention, but since medical errors don’t appear on the list, the problem doesn’t get the funding and attention it deserves.

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