Iatrogenesis third cause of death after heartdisease and cancer in the USA**
From data on Adverse Events in Healthcare given by the National Patient’s Safety Agency (NPSA) UK, 2005 * the average rate of medical errors across several countries in the developed world based on hospital admissions is estimated to be 10%. This figure is generally accepted as a reasonable estimate. Using this figure for medical error rate and extrapolating from calculations of the UK Medical Error figures the following table has been constructed. The Chief Medical Officer (UK) Prof. Sir Liam Donaldson stated in his Paper: ‘Organisation with a Memory’ (2000) that it was estimated that 10% of patient hospital admissions in the UK would suffer a medical error ( 850,000 per year). This means that there were approximately 8 mill admissions to hospital in one year (representing 13% of population). Of these errors 1% would be very serious causing death or permanent injury ( 80,000). Estimated deaths in UK 34,000 per year and 40,000 seriously injured. It was decided to lower the expected number of hospital admissions to 10% of the population from 13% as in the UK, so that the data would not be overestimated. Using these percentage figures as a base the following can be extrapolated for Europe. We emphasise that the data have been extrapolated because there are no official data available.There is general consensus that many of the medical errors are preventable, possibly as many as 50 %.
*NPSA report Building a Memory:Preventing harm, reducing risks and improving patient safety, London July 2005 p.53
* ‘Quality in Australian Health Care Study’:
Med J Australia (vol 163,1995) by R. Wilson, W. Runciman & R.Gibberd
**Journal of the American Medical Association (JAMA) in an article(vol.284,nr 4, 2000) by
Dr B. Starfield estimated that deaths in the USA due to medical errors could be as high as
225,000 per year.
Other sources (‘To Err is Human’, 1999) puts deaths at 100,000 per annum)
In 2006 within Europe there is still no mandatory, official system of registration of medical errors. Nor is there mandatory root cause analysis; nor are there systems established to prevent the occurrence of medical errors. In comparison, motor vehicle accidents have been for decades routinely and systematically registered with the recording of deaths and injuries. For fear of litigation victims of medical errors usually do not receive follow-up genuine diagnostic tests or genuine remedial medical care***. This is unethical and inhuman. We are aware that various necessary initiatives in the area of Patient Safety and research into the occurrence of medical errors are being implemented in many countries throughout Europe. This is indeed a very positive development. However, top priority should be given to the organisation of remedial medical care for the innocent and suffering iatrogenic patient regardless of legal liability of the respective Health Institution.
***Bismark,M Paterson R. No fault compensation in New Zealand:harmonizing injury compensation, provider accountability and patient safety. Health Aff(Milwood)2006;25:278-83
Bismark,M Paterson R .’Doing the right thing’ after an adverse event. N Z Med.J..2005 July 29; 118(1219):U1592
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