Friday, January 4, 2019

More than 4 lakh patients die from medical errors in the US: Medical errors are inevitable in medical practice

According to a new study published in the BMJ, online May 3, 2018, more than 2 lakh deaths in the US are due to medical errors.

Researchers from Johns Hopkins University School of Medicine examined four separate studies that analyzed medical death rate data from 2000 to 2008. Then, using hospital admission rates from 2013, they extrapolated that based on a total of 35,416,020 hospitalizations; they calculated 251,454 deaths were due to a medical error, which translates to 9.5% of all deaths annually in the US. This number is much higher than respiratory disease, which as per the CDC is the third leading cause of death and kills around 150,000 people in a year.

But, according to other organisations, the number of deaths due to medical errors is much higher than 2 lakhs and is around 440,000.

Medical errors are the third-leading cause of death in the US after heart disease and cancer.

Medical error-related deaths occur due to:

·         Preventable adverse effects
·         Error in judgment
·         Lack of care
·         Inadequately trained staff (most important)
·         Out of date computer systems that break down
·         Medication mix-ups
·         Undiagnosed complications after surgeries
·         Communication failures with patients

The number of medical error-related deaths will be much higher in India because of the large population; also, there is no system of reporting of errors of other pathies. This is further compounded by the fact that even non-qualified doctors are treating patients. 

The public, including the patients, needs to understand that medicine is an art, based on science, yet it is not an exact science. No two patients are alike and clinical decisions are tailored to individual patients. Therefore, uncertainty is a part of day-to-day medical practice, where errors are inevitable. 

So, for someone to be able to say it is negligence the following circumstances must be present:

·         Doing what the healthcare provider should not have done under the circumstances.
·         Not doing what the healthcare provider should have done under the circumstances.
·         Medical error must have caused identifiable injury

Because medical errors are bound to occur, there should not be a public media trial for making a mistake, unless the error is gross. If every medical error is flashed on the front page of newspapers and cases are filed against doctors in courts, it will adversely affect the doctor-patient relationship, which is already very fragile.

The possible answers can be:

·         Explain the cost right at the time of admission
·         Be transparent in your cost
·         Have a contract signed by the patient at admission, which explains about existing and non-existing facilities
·         Sign a contract about the liability limit for any possible mishap
·         Make likelihood of medical errors a part of informed consent process

Dr KK Aggarwal
Padma Shri Awardee
President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of India
Past National President IMA

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