The annual list of most common causes of death in the United States is a vital part of our country’s health statistics and research priorities each year. Recently, Martin Makary, a professor of surgery at Johns Hopkins, stated that the 3rd leading cause of death in the US is medical mistakes. However, this is being underreported due to a major limitation on death certificates because they rely on assigning an International Classification of Disease (IDC) code to the cause of death. According to Makary, causes of death not associated with an IDC code are not captured. This means that any form of medical malpractice, hospital negligence, or employee incompetence that results in patient harm or death are not recorded.
The definition and role of an error can be complex. However, there are many ways to define a medical error in order to focus on preventable lethal events and find potential for improvement. Medical errors can be defined as:
• An unintended act or an act that does not achieve its intended outcome.
• The failure of a planned action to be completed as intended.
• The use of a wrong plan to achieve an aim.
• A deviation from the process of care that may or may not cause harm to the patient.
While many of these errors are non-consequential, an error can also end someone’s life. Death due to medical error can be defined as death due to:
• An error in judgment, skill, or coordination of care.
• A diagnostic error.
• A system defect resulting in death or a failure to rescue a patient from death.
• A preventable adverse event.
According to Makary’s study, medical mistakes kill at least 250,000 Americans a year. This number suggests that medical error is the third most common cause of death in the United States, trailing only heart disease and cancer. Unfortunately, none of these deaths are recorded as what they truly are: medical errors. And although we cannot eliminate human error, we can better measure the problem in order to achieve more reliable healthcare systems. Sharing data nationally and internationally would benefit the science of improving safety, much like sharing research on a disease. Recognition of the problem of medical error in patient death could increase awareness and create a new focus on investments in research and prevention.
Although many hospitals and healthcare providers blame the legal system for underreporting, pursuing legal action is most times the only way to hold a hospital or provider accountable for their mistakes leading to the death of a loved one. Not only should medical care providers be required to truthfully report causes of death, but this report should be required to be shared with the patient’s family in the event of a death from a medical mistake. The current philosophy of the medical care community that patients do not have a right to know what happened to their loved ones in the hospital needs to change to a system of honesty. There is a right to know the truth held by patients that doctors and hospitals often forget in the name of protecting their reputations and liability to the detriment of future patients.