Report of Deaths From Medical Errors Called 'Exaggerated'
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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.
"The point of the [IOM] report is: Let's look at the processes by which we provide services to people, care to people, and clean them up -- get rid of the things that are potentially harmful," Bristow says. Further, since the Harvard study contained more than 30,000 case records, it's not clear that a study involving another population would yield different results.
When the type of detailed, long-term studies of patients that McDonald suggests are performed, "error and injury rates are almost invariably much higher than indicated by the large record-review studies," Lucian Leape, MD, of the Harvard School of Public Health and another IOM committee member, writes in a companion article in JAMA.
The IOM report, released in November 1999, triggered a national debate on ways to make the medical system safer for patients. President Clinton endorsed the document's key goal of reducing medical errors by 50% over a five-year period, partly by urging the creation of a nationwide mandatory medical-error reporting system.