"Iatrogenic", from the Greek Iatros meaning "physician" and -genic, meaning "induced by" - together "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 published 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 (L. Leape -1997). 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.
Starfield1, L. Leape2
Iatrogenic Death, or Preventable Medical Errors, now accounts for 251,000 deaths a year, making it the #3 cause of death in America - more deaths than respiratory disease, accidents, stroke, Alzheimer’s, Diabetes... Reported in the British Medical Journal (BMJ) May 3, 2016
| JAMA July 26, 2000;284(4):483-51
| Unnecessary surgery
| Drug errors in hospitals
| Others errors in hospitals
| Infections in hospitals
| Negative effects of properly prescribed drugs
| TOTAL DEATHS
National Patient Safety Foundation Oct. 9, 19972
| TOTAL DEATHS
Martin Makary, a professor of surgery at the Johns Hopkins University School of Medicine who led the research, said in an interview that the category includes everything from bad doctors to more systemic issues such as communication breakdowns when patients are handed off from one department to another.
“It boils down to people dying from the care that they receive rather than the disease for which they are seeking care,” Makary said.
7 Most Deadly Surgeries JAMA Surgery (April 27, 2016)
In an analysis of 421,476 patient records from a national database of hospital inpatients, researchers discovered that a mere seven procedures accounted for approximately 80 percent of all admissions, deaths, complications and inpatient costs related to emergency surgeries. The sample included only adults who underwent a procedure within two days of admission from 2008 to 2011.
The seven dangerous and costly procedures are mostly related to the organs of the digestive system:
50% of Surgeries have Drug Error at Top U.S. Hospital (Anesthesioology October, 2015)
- Removing part of the colon,
- Small-bowel resection,
- Removing the gallbladder,
- Operations related to peptic ulcer disease,
- Removing abdominal adhesions,
- Other operations to open the abdomen.
Researchers at Massachusetts General Hospital found that 124 of the 277 operations they watched in 2013-2014 included at least one medication error or drug-related incident that harmed a patient. Among the most frequently observed errors were mistakes in labeling, incorrect dosages and medications that should have been given but were not.
More than one-third of the observed errors injured patients, including three life-threatening mistakes, according to the study.
The error rate is much higher than what has been previously reported but in line with rates found in inpatient wards and outpatient clinics, researchers said. There have been a few studies about medication errors in the operating room but they relied mostly on self-reported data, which typically underrepresent true rates.
The medications most frequently associated with errors were propofol, a commonly used sedative in the operating room; fentanyl, a powerful pain medication; and phenylephrine, a medication given to increase blood pressure in patients with very low blood pressure.
On average, about 10 medications were given during an operation. The study found that some kind of error was made in about 1 in 20 medications, which equates to every other operation.
"Boy, we still have a lot of work to do," said Tejal Gandhi, president and chief executive of the National Patient Safety Foundation. "If it happens at MGH, it can happen anywhere."
Are you reassured?