Research on Error-Related Hospital Deaths Is Flawed


The American news media is telling the public that medical errors are the third leading cause of death in America, based on a misleading article in the BMJ (formerly the British Medical Journal), states AAPS. But the article has such serious flaws that it should never have been published, according to an article by Gerard Gianoli, M.D., and John Dale Dunn, M.D., J.D., in the winter issue of the Journal of American Physicians and Surgeons.

Dr. Gianoli is a neuro-otologist practicing at the Ear and Balance Institute in Covington, La., and Dr. Dunn is an emergency physician in Texas.

The 251,454 “preventable medical deaths” per year that Makary and Daniel “found” for their BMJ article sound frightening, but they are actually just calculated or extrapolated from a mere fourteen (14) cases reported in the papers they cited. As the errors “may have”—or may not have caused the death, there may actually have been zero deaths caused by errors, Gianoli and Dunn point out.

Gianoli and Dunn ALSO note that Makary and Daniels did not do any new research but simply reviewed four studies published between 2000 and 2008. They disregarded other studies that would not have supported their hypothesis. And they used an expansive definition of error that includes an act that “did not achieve its desired outcome.”

The widely publicized studies relied on by the Institute of Medicine as well as Makary and Daniel screened charts for adverse outcomes, a method that encourages outcome bias. Gianoli and Dunn contrast these with the far more robust studies done for the Texas Medical Foundation, which actually reviewed 318,000 medical records. The TMF studies showed a positive patient safety picture, with a low rate of negligence events causing injury or death, stable for three decades. TMF studied high-risk Medicare patients, Gianoli and Dunn added.

“Death due to medical errors is an important and serious topic,” Gianoli and Dunn state. “It deserves careful consideration. However, exaggerating the severity of the problem of in-hospital medical errors supposedly leading to death does no service to the cause of improving patient safety.”

Exaggerating the problem has the political effect of denigrating the medical profession, and supporting the agenda of greater government control, with formerly independent professionals becoming servants of the system, they conclude.

The Journal of American Physicians and Surgeons is published by the Association of American Physicians and Surgeons (AAPS), a national organization representing physicians in all specialties since 1943.


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