Cases of patients mistakenly operated on the wrong leg, administered double the permissible dosage of medicines or not given adequate care could be more common — and have far more serious consequences — than one thinks. A new study published in the BMJ (formerly the British Medical Journal) on Wednesday said that if medical error were a disease, it would be the third largest killer in the US.
There hasn’t been an equivalent study for India, but a Harvard University study in 2013 estimated that 52 lakh injuries occur across India each year (out of the 430 lakh globally) due to medical errors and adverse events. The new BMJ study, conducted by a Johns Hopkins University team, for the first time measures the contribution of medical errors (estimated at 2.51 lakh annually as against 6.11 lakh deaths due to heart disease and 5.85 lakh deaths due to cancer) to deaths in the US.
Medical errors are rarely black or white decisions. “A nurse in an ICU would literally have a split second to decide which injection to give a suddenly serious patient. If a patient turns serious at 3am, she is faced with a situation in which she has three similar sounding and similar looking injections to choose from,” said Dr Nikhil Datar, a gynaecologist and health activist, who set up the Patient Safety Alliance in Mumbai five years ago to promote a healthy dialogue between patients and doctors on unintended medical errors.
There are many such interfaces in the medical world daily. Dr Datar quotes World Health Organization’s statistics that estimated one in 10 hospital admissions leads to an adverse event and one in 300 admissions in death. WHO’s European data shows that medical errors and health-care related adverse events occur in 8% to 12% of hospitalizations.
The biggest contributors to medical errors are mishaps from medications, hospital-acquired infections and blood clots that develop in legs from being immobilized in the hospital. “Approximately 3 million years of healthy life are lost in India each year due to these injuries,” said the 2013 Harvard study.
But Dr Datar gives another point of view. “In the last five years, I have realized that people don’t want to talk about medical errors. There hasn’t been any increase in the awareness about patient safety but there has been a manifold increase in blaming doctors and the healthcare system,” he said.
The BMJ study, meanwhile, said death certificates in the US have no facility for acknowledging medical error. “Death certificates could contain an extra field asking whether a preventable complication stemming from the patient’s medical care contributed to the death.”