Reports of 44,000 to 98,000 patient deaths a year from medical errors are greatly exaggerated, according to three researchers at Indiana University Medical School.
Those error estimates grabbed national headlines last November when the Institute of Medicine's report on medical errors was published, but that "hot and shrill" message could lead to bad public policy, researchers Clement McDonald, M.D., Michael Weiner, M.D., and Siu Hui wrote in the July 5 issue of the Journal of the American Medical Association.
In an occasional JAMA feature titled "Controversies," the authors argue that the IOM data "do not support IOM's claim of large numbers of deaths caused by adverse events (preventable or otherwise). Clearly, more study with careful attention to risk levels is needed to determine the true impact of adverse events on death rates among hospitalized patients."
The authors don't offer a death estimate but write that the number of deaths "due to adverse events above the baseline death rate could be very small."
The IOM report last year shocked the public, led Congress to hold hearings and propose legislation, and prompted suggestions by medical organizations on how to address the problem.
There's considerable debate in the medical community on how best to reduce potential errors. Others have questioned whether the death estimates are correct. But this is the first published article critiquing the death estimates.
A rebuttal in the same issue of JAMA by Lucian Leape, M.D., a participant in the IOM study group and a researcher at the Harvard School of Public Health, argues that the error estimates are correct--even conservative--because they only count deaths in the hospital setting.
Andrew Balas, M.D., director of the Center for Health Care Quality at the University of Missouri-Columbia, conceded there might be some problems with the IOM methodology but added he thinks the IOM stats are basically correct.
"The comment that many patients would have died anyway is troubling," Balas said. "Ultimately, all patients and also their physicians will die but that does not justify healthcare errors to speed up the process."