Individuals do make lethal mistakes, but the main reason for preventable medical mistakes is a health care system inadequate to the complexities of 21st-century medicine
A few months ago, I cared for an older patient that I will call Mr. Jones. He lived alone and one afternoon, after a neighbor found him disoriented, was brought into the emergency department. Diagnosed with pneumonia, he was admitted and started on standard guidelines-based antibiotics. By next morning, he had taken a turn for the worse and was sent to the intensive care unit where he struggled and eventually died 72 hours later. Troubled by the death of a seemingly healthy man, I spoke to his daughter who lived in California. She mentioned he had been admitted to another hospital two months prior, also for pneumonia. The lab at that hospital told me his pneumonia had been caused by an unusual bacterium susceptible to only a few antibiotics—none of which we had used. And days later, when our lab confirmed that Mr. Jones’ current pneumonia was caused by the same bacteria, I knew his death had been wholly preventable. Despite our best efforts, we all missed it.
A recent report in the British Medical Journal (BMJ)estimates that 250,000 Americans die each year due to medical errors. This reportsparked a firestorm. Skeptics carefully documented why that number might be wrong. While other estimates have put the number of deaths from medical errors at 100,000 , many in the medical community believe the number of cases is much smaller. The truth depends largely on the most important question of all: what is a medical error?