How Many Die From Medical Mistakes in U.S. Hospitals?


MEDICAL ERRORS (1)Note: This is being republished, with permission, under a Creative Commons license. See the original ProPublica page and comments.

by Marshall Allen ProPublica, Sep. 19, 2013, 10:03 Charles Ornstein and Lena Groeger, ProPublicaby Dan Nguyen, Charles Ornstein and Tracy Weber, ProPublica by Robin Fields, Al Shaw and Jennifer LaFleur, ProPublica



















Dr. David Classen, one of the leading developers of the Global Trigger Tool, said the James study is a sound use of the tool and a “great contribution.” He said it's important to update the numbers from the “To Err Is Human” report because in addition to the obvious suffering, preventable harm leads to enormous financial costs.








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  1. Andrew Wagner says

    This conversation always reminds me of the Aviation Safety Reporting System–a system sponsored by the FAA to allow voluntary, confidential reporting of near miss and close-call incidents in civil and commercial aviation. They go so far as to have NASA run the system, simply because NASA has no enforcement powers, which guarantees that the aircrew involved will not be punished for reporting incidents.
    Modelling this type of system in healthcare would go a long-way toward reducing these tragic numbers.


  2. Frank says

    This high number is hog wash. When people are very ill and are using more medical care than ever to stay alive, for instance dyalisis, blood transfusions, ventilators. When something goes wrong with this complex care or not quite as planned, the death is still a result of there underlying illness.

  3. Robert says

    Frank: I don’t believe it’s hog wash at all. These reviews take into account comorbidities and other conditions that make patient survivability a challenge to begin with. Having worked in hospitals for over 20 years and having seen cases where healthy individuals come in and end up dying during the course of their stay or are “treated and released” and die shortly thereafter, I can tell you that the numbers presented are probably fairly close to accurate (RCAs of those particular cases pointed to medical errors–not the patients’ conditions). You seem to overlook the fact that not all of those deaths are people who are coming in near the end of their life and require considerable medical care to stay alive (even in those instances, it doesn’t justify medical error that results in an unexpected or unanticipated death). Many are relatively healthy individuals, who are coming in for treatment that many thousands of others receive–without error–and live to talk about it.

  4. CS says

    Having worked at two different hospitals with two different perspectives I think Frank and Robert could both be right. I would rather my family go to the hospital that doesn’t excuse errors away as a known side-effect, within reasonable care, or as complications of a life-saving effort. Hospitals have a long way to go towards transparency well beyond current reported measures.

  5. John Hunter says

    I wish these reports would provide some detail on what these really mean. Is it 250,000 people that were completely healthy coming in for a physical and they die when they would have been healthy if the medical system didn’t exist? I doubt it. Is it 2,000 completely healthy people and 248,000 people that were under intensive medical care for years keeping them alive and now we slipped up and they died? Probably not, again, but my guess is it is closer to the second.

    Preventing errors is obviously important. And in health care it is very important, of course. But just because you use data doesn’t mean it isn’t misleading. Medical errors leading to death is just too big an operational definition to be very meaningful in my opinion. For these numbers to provide much insight I really think they need to be segmented more:

    – perfectly health person that was going to be perfectly healthy for decades but were killed by medical error.
    – person that needed life saving care of they were going to die that month and we routinely should be able to provide the very easy care to make them perfectly healthy again but they were killed.


    – person that was extremely sick with many problems for years and was saved with medical care over and over again. Complex care was needed and much of it was done well but in the very challenging situation there was a mistake and that mistake is the proximate cause of death.

    We should be working on making everything better and eliminating medical errors that cause damage and death. But there are huge differences between a medical error conditions that caused death and to me those differences are so huge lumping them together is hardly useful.

    1. Mark Graban says

      Great question. Some of these numbers are very unknowable numbers. But we must try to improve anyway.

      I guess there is a difference between a preventable medical error that kills a 50-ish woman and robs 20 to 40 years of her life (the Louise Batz story) or an error that steals the life of a young child versus an error that kills a 90-year old who is ill already.

      I know you’re not suggesting that errors are acceptable or more acceptable in the ill and elderly.

      The broken processes and systems that potentially harm us all can be the improved processes that better protect us all.

      A recent email from a personal friend from elementary school:

      “My mom is [at a hospital in my hometown], and there have been several instances where they would have done things wrong if she didn’t tell them.

      The latest is that transport came to take her for an x-ray. She asked why and said she didn’t want to go unless she knew why.

      They asked the nurse, and she deleted the order. My mom asked why there was an order for an x-ray. They said it was an error.

      They also did a CT Scan for a possible blood clot in her lung. My mom said to the tech, “Oh, I didn’t know a CT scan could show a blood clot.” The tech said, “Oh, this is for a blood clot? The kind I was going to do wouldn’t show that. A different kind of CT is needed. She then confirmed with the doctor and did the kind that can detect a clot.”

      Those might not have been errors that would have killed her, but it doesn’t give one much confidence in our chaotic, overburdened, screwed up hospitals.

  6. John Hunter says

    Right, l think the thing I am getting at is there is a big difference between making a mistake while you are in a complex situation where any of 30 bad decisions in a pressure situation could result in death (and where doing nothing results in death) versus a situation where there is no risk of death until you do an absolutely idiotic thing that turns my visit to get a physical into death.

    Everything should be constantly improved and made safer with mistake-proofing thinking… And healthcare needs this more than most everything due to the dangers and consequences involved.

    When there are headlines like 100,000 deaths due to medical error every year that reads to me like John was walking along the street and boom a medical error/piano dropped on his head. But I don’t believe that is true. I bet it is true that are lots of deaths due to just unforgivable errors – someone is given a drug which was indicated in numerous sensible ways would kill them due an allergy but they were given it anyway and died. But I don’t trust how much of the deaths attributed to error are really 20% error, 19% cancer, 18% diabetes, 17% cardio-vascular disease, 16% long term high level use of powerful drugs ravaging the body, 10% car accident (which also someone else might say is 5% error, 30% cancer, 25%…). The error is still bad, and the system needs to be improved to reduce the frequency and consequences of errors. But I just don’t know how to take the error to death data without much more explanation.

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