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American death certificates fail to show medical error as possible cause of death

Medical error is the third biggest cause of death in the United States, only exceeded by heart disease and cancer.

Medical error is the third biggest cause of death in the United States, only exceeded by heart disease and cancer.

Martin Makary and Michael Daniel at Johns Hopkins University School of Medicine in Baltimore, Maryland, say US death certificates do not acknowledge medical error and call for better reporting of medical error cases.

When a death is certified in the US an International Classification of Disease (ICD) code is assigned, yet other causes of death, such as human error or system failure, are not recorded.

The World Health Organization (WHO) says 117 countries use the ICD system to record mortality statistics, including the UK and Canada. This means there is a dearth of accurate data on deaths due to medical error.

Accurate data on deaths associated with medical error is lacking, but recent estimates suggest a range of 210,000 to 400,000 a year among hospital patients in the US.

Using studies from 1999 onwards – and extrapolating to the total number of US hospital admissions in 2013 – the researchers calculated a mean rate of death from medical error of 251,454 a year. They compared their estimate to the annual list of the most common causes of death in the US from the Centers for Disease Control and Prevention (CDC), and found that medical error is the third most common cause of death.

‘Sound scientific methods, beginning with an assessment of the problem, are critical to approaching any health threat to patients,’ they write.

‘The problem of medical error should not be exempt from this scientific approach.’

Reference

Makary M, Daniel M (2016) Analysis: Medical error – the third leading cause of death in the US. BMJ.

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