Iatrogenic Death
What does "Iatrogenic" mean? Iatros means "physician" in Greek and -genic, means "induced by" - derived from the International Scientific Vocabulary. Thus, iatrogenic means "physician-induced". Medical definition: "induced by a physician's words or therapy (used especially of a complication resulting from treatment). Thus Iatrogenic death is death resulting directly or indirectly from a physician's words or therapy.

In 2000, a presidential task force labelled medical errors a "national problem of epidemic proportions." Members estimated that the "cost associated with these errors in lost income, disability, and health care costs is as much as $29 billion annually." In the same year the Journal of the American Medical Association carried a study by Dr. Barbara Starfield (John Hopkins School of Hygiene and Public Health) that put Iatrogenic deaths in America at the astounding number of 225,000! 

Dr. Starfield cautioned that as startling as this research was, it only represented hospitalized patients - it did not include deaths in nursing homes, emergency rooms, or in doctor’s offices. It did not include negative effects that are associated with disability or discomfort. And, these estimates of death due to error are lower than those in other published reports. Nevertheless, 225,000 iatrogenic deaths per year constitute the third leading cause of death in the United States, after deaths from cancer and heart disease! The most significant number of these unnecessary deaths, 106,000, were due to the negative effects of properly prescribed drugs, making them the fourth leading cause of death in America.

On a strictly monetary basis, depending on which published study you use, this adds up to $58.5 to $100 billion in extra costs! Walter Cronkite, well-known news anchor, painted a dismal picture: “America’s healthcare system is neither healthy, caring, nor a system.”  (1990) 


No wonder some have also dubbed this 20th century disease Acquired Iatrogenic Death Syndrome (AIDS) 

 

Iatrogenic Death

JAMA July 26, 2000;284(4):483-5

 
Unnecessary surgery
12,000 
Drug errors in hospitals
7,000
Others errors in hospitals
20,000
Negative effects of properly prescribed drugs
106,000
TOTAL
225,000
Cost $100 billion

Iatrogenic Death

National Patient Safety Foundation Oct. 9, 1997 

 
TOTAL 420,000
Cost $200 billion

    

In 2003 a independent review of government-approved medicine (Death by Medicine - Authors: Gary Null PhD, Carolyn Dean MD ND, Martin Feldman MD, Debora Rasio MD, Dorothy Smith PhD) compared thousands of published, peer-reviewed scientific studies.  The numbers generated were higher than those cited in the JAMA article, but the conclusion was the same: there is something dreadfully wrong with American medicine. Too often it does more harm than good. Compelling evidence from this study unveiled astounding statistics on the 783,936 iatrogenic deaths per year that have resulted from conventional medicine at the staggering cost of $282 billion. Depending on which of the above studies one finds more credible, it still adds up to between two and six jumbo jets falling out of the sky each and every day! This phenomena is not limited to the U.S. Similar percentages were seen in Britain, Canada, and Australia.

  Annual Physical and Economic Cost of Medical Intervention

 Condition Deaths  Cost
Author
 Adverse Drug Reactions
106,000
$12 billion
Lazarou(1) Suh(2)
 Medical error
98,000
$2 billion
IOM(3)
 Bedsores 115,000
$55 billion
Xakellis(4) Barezak(5)
Infection
88,000
$5 billion
Weinstein(6) MMWR(7)
Malnutrition
108,800
  -----
Nurses Coalition(8)
Outpatients
199,000
$77 billion
Starfield(9) Weingart(10)
Unnecessary Procedures
37,136
$122 billion
HCUP(11)
Surgery-related
32,000
$9 billion
AHRQ(12)
TOTAL
783,936
$282 billion
 

 

Worse drug offenders
The leading causes of adverse drug reactions are: antibiotics (17%), cardiovascular drugs (17%), chemotherapy (15%), and analgesics and anti-inflammatory agents (15%).
 
Antibiotics
Dr. Richard Besser, of the Center for Disease Control and Prevention (CDC), in 2003, said the number of unnecessary antibiotics prescribed annually for viral infections was in the tens of millions. The CDC posts this public awareness on its website: “Are you aware that colds, flu, and most sore throats and bronchitis are caused by viruses? Did you know that antibiotics do not help fight viruses? It’s true. Plus, taking antibiotics when you have a virus may do more harm than good. Taking antibiotics when they are not needed increases your risk of getting an infection later that resists antibiotic treatment.” 
 
References
(1) Lazarou J, Pomeranz B, Corey P. Incidence of adverse drug reactions in hospitalized patients. JAMA. 1998;279:1200-1205.
(2) Suh DC, Woodall BS, Shin SK, Hermes-De Santis ER. Clinical and economic impact of adverse drug reactions in hospitalized patients. Ann Pharmacother. 2000 Dec;34(12):1373-9.
(3) Thomas et al., 2000; Thomas et al., 1999. Institute of Medicine.
(4) Xakellis, G.C., R. Frantz and A. Lewis, Cost of Pressure Ulcer Prevention in Long Term Care, JAGS, 43 - 5, May 1995.)
(5) Barczak, C.A., R.I. Barnett, E.J. Childs, L.M. Bosley, "Fourth National Pressure Ulcer Prevalence Survey", Advances in Wound Care, 10- 4, Jul/Aug 1997
(6) Weinstein RA. Nosocomial Infection Update. Special Issue. Emerging Infectious Diseases. Vol 4 No. 3, July Sept 1998.
(7) Forth Decennial International Conference on Nosocomial and Healthcare-Associated Infections, Morbidity and Mortality Weekly Report (MMWR), February 25, 2000, Vol. 49, No. 7, p. 138.
(8) Greene Burger S, Kayser-Jones J, Prince Bell J. Malnutrition and Dehydration in Nursing Homes:Key Issues in Prevention and Treatment. National Citizens' Coalition for Nursing Home Reform. June 2000. http://www.cmwf.org/programs/elders/burger_mal_386.asp
(9) Starfield B. Is US health really the best in the world? JAMA. 2000 Jul 26;284(4):483-5. Starfield B. Deficiencies in US medical care. JAMA. 2000 Nov 1;284(17):2184-5.
(10) Weingart SN, McL Wilson R, Gibberd RW, Harrison B. Epidemiology of medical error. West J Med. 2000 Jun;172(6):390-3.
(11) Calculations detailed in Unnecessary Surgery section, from two sources: (13) http://hcup.ahrq.gov/HCUPnet.asp and (71) US Congressional House Subcommittee Oversight Investigation. Cost and Quality of Health Care: Unnecessary Surgery. Washington, DC: Government Printing Office, 1976
(12)  Zhan C, Miller M. Excess Length of Stay, Charges, and Mortality Attributable to Medical Injuries During Hospitalization. JAMA. 2003;290:1868-1874.
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