To err is human

Dr KK Aggarwal
Padma Shri and Dr B C Roy National Awardee
President, Heart Care Foundation of India 

Bad people in a good system or good people in a bad system

In US alone, over 98,000 people die in any given year from medical errors that occur in hospitals. That’s more than deaths from motor vehicle accidents, breast cancer, or AIDS, three causes that receive far more public attention. Also more people die annually from medication errors than from workplace injuries.

Two large studies, one conducted in Colorado and Utah and the other in New York, found that adverse events occurred in 2.9 and 3.7% of hospitalizations, respectively. In Colorado and Utah hospitals, 6.6% of adverse events led to death, as compared with 13.6% in New York hospitals. In both of these studies, over half of these adverse events resulted from medical errors and could have been prevented.

When extrapolated to the over 33.6 million (3.3 crores) admissions to U.S. hospitals in 1997 (population 26.7 crores) , the results of the study in Colorado and Utah imply that at least 44,000 Americans die each year as a result of medical errors. This translates to about 12% people getting admitted in a year.

The results of the New York Study suggest the number may be as high as 98,000. Even when using the lower estimate, deaths due to medical errors exceed the number attributable to the 8th-leading cause of death. More people die in a given year as a result of medical errors than from motor vehicle accidents (43,458), breast cancer (42,297) or AIDS (16,516).

To Err is Human: medical errors   
In India, the number will be much larger. If we apply the US statistics, then for a population of 117 crores the expected number of admissions will be 13.94 crores and the number of medical errors will be 42 lakhs (3%). With 10% of these leading to deaths, the number of deaths in India due to medical errors will be 4.2 lakhs annually. This would mean 1150 deaths per day.

India has about 9.5 million (95 lakhs) deaths a year or 26000 deaths a day. In total, 4.4% deaths could be attributed to medical errors or adverse events. (0.3% of admissions)

With only a few hundred electronic channels in the country there will be enough breaking stories every minute if the media translates every mistake as negligence, which actually is not. The channels do not project the 96% of people surviving because of medical treatments.

To Err is Human. No fingers should be pointed at caring health care professionals who make honest mistakes. Of course one needs to reduce medical errors and improve patient safety through the design of a safer health system.

To err is human asserts that the problem is not bad people in health care; it is just that good people are working in bad systems that need to be made safer.

The aim should be to raise the level of patient safety. Patients themselves can influence the quality of care that they receive once they check into the hospital.

The action is required at all levels, federal, state, and local health policy makers and regulators, health professional licensing officials, hospital administrators, medical educators and students, health caregivers, health journalists, patient advocates–as well as patients themselves.