Report of Deaths From Medical Errors Called 'Exaggerated'
July 5, 2000 (Washington) -- The hair-raising report that caused President Clinton to propose an unprecedented effort to reduce the death toll from medical errors was "exaggerated," according to an article in today's issue of the Journal of the American Medical Association.
The widely publicized analysis, issued last year by the Institute of Medicine (IOM), an affiliate of the National Academy of Sciences,said that as many as 98,000 Americans die annually because of medical mistakes.
"The number that's out there, I can say with very strong conviction, is wrong. Further, I can say it has no scientific basis," says Clement McDonald, MD, who wrote the JAMA piece. Clement is director of the Regenstrief Institute, a not-for-profit research center with ties to the Indiana University School of Medicine.
McDonald says the IOM researchers misinterpreted data from two landmark studies on medical errors -- one was done at Harvard, and one that looked at information gathered about residents of Colorado and Utah. The studies, which were based on reviews of medical records, estimated the deaths from medical errors at 98,000 and 44,000 a year, respectively, according to the IOM. McDonald calls that conclusion "inaccurate and misleading."
"If I were a press agent, I would want those big numbers, because I know they would get me attention," McDonald tells WebMD.
He says the patients in both studies were an extremely sick group, and thus faced a high risk of dying anyway. What's needed, he says, is to compare these patients to a similar group of patients who weren't exposed to medical errors. In that case, McDonald estimates, the rate of deaths actually attributable to medical error would be just 1% or 2%.
That's the number that needs to be taken into account, McDonald says. "It's not right to design a program to fix a problem that we've exaggerated and we don't know the size of," he tells WebMD.
Those who wrote the IOM report dispute the notion that the number of deaths due to medical errors has been inflated.
"McDonald is, unfortunately, I think, looking for reasons to poo-poo and ignore the hard evidence that's right in front of him," Lonnie Bristow, MD, tells WebMD. Bristow, a member of the committee that developed the IOM report, is also a past president of the American Medical Association.
Bristow says the sickest people were excluded from the studies that the IOM used to form its views, though he admits it would be difficult to perform companion studies of similar patients who were not exposed to medical errors. He also says such errors don't result simply from gross negligence, but that they are the result of poorly designed systems that desperately need to be fixed.