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edical errors — including incorrect medications, surgical mishaps, and wrong diagnoses — kill more than 250,000 Americans every year, according to a new study, making them the third-leading cause of death in the country.

But nobody’s keeping good track of that number — and that needs to change, according to an article published Tuesday in the BMJ.

“There’s vast underrecognition, underpreparation, and underfunding of the problem of medical care gone awry, even though it has a significant impact on public health,” said Dr. Martin Makary, professor of health policy and management at Johns Hopkins University School of Medicine and lead author on the paper.

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This paper builds upon a recent study that found that more than 210,000 deaths per year occur due to medical errors. When adjusting for 2013 hospital admission rates, Makary and his colleague found that the present number is more likely 251,454 deaths per year — surpassing the CDC’s stated third-leading cause of death, respiratory disease, which kills close to 150,000 people per year. The leading cause of death in the US is heart disease, followed by cancer.

The American Hospital Association has historically quibbled with similar figures for hospital deaths due to medical errors, putting the true number nearer the 98,000 estimated by the Institute of Medicine. In an email to STAT, the association affirmed that the IOM report is “based on sound scientific analysis.”

Currently, deaths are categorized based on insurance billing codes, which sometimes miss the true cause of death. The paper includes the case of a woman who had a potentially unnecessary invasive test and died because a needle grazed her liver. But since CPR was attempted and failed, the woman’s cause of death was “cardiovascular,” mischaracterizing the real reason she died.

“People don’t just die of billing codes,” Makary said.

Makary said that one way to improve the situation is to change the culture of hospitals so that people can more freely talk about and address mistakes, a step that some hospitals are already taking.

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  • I want to follow up on a comment from Dr. Makary “change the culture of hospitals so that people can more freely talk about and address mistakes, a step that some hospitals are already taking”. I find it difficult to believe that this culture in hospitals still exists in 2016 and how far we have not come/evolved. When I was a DOP/Admin of Pharmacy at a Large Teaching Hospital, we moved to a Non-punitive environment in 1996. We were working on an ADE project with Don Berwick and IHI and I had experience in Med Error Prevention since the 1980’s and worked with ISMP during their inception. We deal with peoples lives everyday and need to have them involved in their care also, which is why we also developed a Patient Safety video, in English and Spanish in 2002. We focused on a number of areas to help us manage their care.

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