Medical errors are No. 3 cause of death in the US, study unveils

The CDC lists chronic respiratory diseases as the No. 3 cause of death in the U.S., behind heart disease and cancer, but researchers from Baltimore-based Johns Hopkins beg to differ. They analyzed data from an eight-year period and found medical errors are the true third leading cause of death in the U.S.

Research published in The BMJ May 3 shows medical errors kill more than 250,000 Americans each year, while the CDC says respiratory disease kills close to 150,000 every year.

To find those numbers, researchers examined four separate studies analyzing medical death rate data from 2000 to 2008. They then used hospital admission rates from 2013 and extrapolated how many deaths stemmed from medical errors.

Martin Makary, MD, lead author of the study, says the discrepancy comes from the way the U.S. compiles national health statistics. "Our national health statistics…do not take medical care gone wrong as a cause of death," he says. Things like diagnostic errors, medication errors, communication breakdowns or system errors that can lead directly to a patients' death are not counted, because national health statistics are based on ICD billing codes.

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While the number of medical errors is clearly troubling, the larger problem lies in how the statistics are calculated. "The list we generate each year as a country of our national health statistics is a big deal," Dr. Makary says. "It informs our NIH [National Institutes of Health] funding, public health campaigns and awareness efforts in the medical community and the public."

Because national health statistics don't recognize the role of medical errors, research on the problem is "vastly underfunded, and it's very difficult for patient safety and quality researchers to get the support and funding it deserves relative to other causes of death listed in the national health statistics," says Dr. Makary.

To fix the problem, Dr. Makary says the nation needs to allow physicians to branch beyond ICD codes to list the true cause of death. Additionally, physicians need to be able to discuss medical errors "without creating a litigation frenzy," he says.

Dr. Makary and three colleagues from Johns Hopkins also penned an open letter to Thomas Frieden, MD, the director of the CDC, urging him to add medical errors to the CDC's list of most common causes of death in the county and to move away from using ICD codes to allow physicians to list medical error as a cause of death.

Bob Anderson, chief of the CDC's mortality statistics branch, told NPR that medical care complications are in fact listed on death certificates and captured in ICD codes, but the underlying condition is what is used in national health statistics. Additionally, he said because the current way of counting causes of death aligns with international guidelines, it would be hard to change "unless we had a really compelling reason to do so."

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