Submitted by Dr. Gary G. Kohls MD

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By Maria Panagioti, et al – July 17, 2019 (Excerpted article: 480 words)

Full article, including author affiliations and references at: https://www.bmj.com/content/366/bmj.l4185

Objective 

To systematically quantify the prevalence, severity, and nature of preventable patient harm across a range of medical settings globally.

Introduction

Patient harm during healthcare is a leading cause of morbidity and mortality internationally.

The World Health Organization defines patient harm as “an incident that results in harm to a patient such as impairment of structure or function of the body and/or any deleterious effect arising therefrom or associated with plans or actions taken during the provision of healthcare, rather than an underlying disease or injury, and may be physical, social or psychological (eg, disease, injury, suffering, disability and death).” 

The health burden and patient experiencing healthcare-related patient harm has been reported to be comparable to chronic diseases such as multiple sclerosis and cervical cancer in developed countries, and tuberculosis and malaria in developing countries.

Harmful patient incidents are a major financial burden for healthcare systems across the globe.

It is estimated that 10-15% of healthcare expenditures are consumed by the direct sequelae of healthcare-related patient harm.

Early detection and prevention of patient harm in healthcare is an international policy priority.

In principle, zero harm would be the ideal goal. However, this goal is not feasible because some harms cannot be avoided in clinical practice.

For example, some adverse drug reactions which occur in the absence of any error in the prescription process and without the possibility of detection are less likely to be preventable.

Key sources of preventable patient harm could include the actions of healthcare professionals (errors of omission or commission), healthcare system failures, or involve a combination of errors made by individuals, system failures, and patient characteristics.

Key types of preventable harm were

  1. drug-related,
  2. diagnostic errors,
  3. medical procedure-related, and
  4. healthcare-acquired infections.

The excess length of hospital stays attributable to medical errors is estimated to be 2.4 million hospital days, which accounts for $9.3 billion excess charges in the US.

Another important finding is that preventable patient harm appears to be a serious concern in advanced medical specialties including intensive care and surgical units.

Patients treated in these specialties were more likely to experience preventable patient harm compared with patients treated in general hospitals. Surgical harm is a sizeable part of the overall in-hospital harm, but our estimates are higher than anticipated.

Conclusion

Our findings affirm that preventable patient harm is a serious problem across medical care settings. Priority areas are the mitigation of major sources of preventable patient harm (such as drug incidents) and greater focus on advanced medical specialties. It is equally imperative to build evidence across specialties such as primary care and psychiatry, vulnerable patient groups, future studies are critical for reducing patient harm in medical care settings.

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Appendix

Table of Annual Iatrogenic Deaths in The United States (235 words)

From: https://www.ourcivilisation.com/medicine/usamed/deaths.htm

(Deaths induced inadvertently by a physician or surgeon or by medical treatments or diagnostic procedures)

Adverse Drug Reactions 106,000 Deaths

Medical Error 98,000 Deaths

Bedsores 115,000 Deaths

Infection 88,000 Deaths

Malnutrition 108,800 Deaths

Outpatient Deaths 199,000 Deaths

Unnecessary Procedures 37,136 Deaths

Surgery-related 32,000 Deaths

TOTAL 783,936 Deaths

Annual Unnecessary Medical Events

The enumerating of unnecessary medical events is very important in our analysis. Any medical procedure that is invasive and not necessary must be considered as part of the larger iatrogenic picture.

Unfortunately, cause and effect go unmonitored. The figures on unnecessary events represent people (“patients”) who are thrust into a dangerous health care system. They are helpless victims.

Each one of these 16.4 million lives is being affected in a way that could have a fatal consequence. Simply entering a hospital could result in the following (out of 16.4 million people):

2.1% chance of a serious adverse drug reaction (186,000).

5% to 6% chance of acquiring a nosocomial [hospital] infection (489,500).

4% to 36% chance of having an iatrogenic injury in hospital (medical error and adverse drug reactions) (1.78 million).

17% chance of a procedure error (1.3 million).

All the statistics above represent a one-year time span. Imagine the numbers over a 10-year period. Working with the most conservative figures from our statistics we project the following 10-year death rates.

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Dr Gary Kohls is a retired rural family physician from Duluth, Minnesota who has written a weekly column for the Reader Weekly, Duluth’s alternative newsweekly magazine since his retirement in 2008. His column, titled Duty to Warn is re-published around the world.

 

Dr Kohls practiced holistic mental health care in Duluth for the last decade of his family practice career prior to his retirement in 2008, primarily helping patients who had become addicted to cocktails of psychiatric drugs to safely go through the complex withdrawal process. His column often deals with various unappreciated health issues, including those caused by Big Pharma’s over-drugging, Big Vaccine’s over-vaccinating, Big Medicine’s over-screening, over-diagnosing and over-treating agendas and Big Food’s malnourishing food industry. Those four sociopathic entities can combine to even more adversely affect the physical, mental, spiritual and economic health of the recipients of the vaccines, drugs, medical treatments and the eaters of the tasty and ubiquitous “FrankenFoods” – particularly when they are consumed in combinations, doses and potencies that have never been tested for safety or long-term effectiveness.

 

Dr Kohls’ Duty to Warn columns are archived at: http://duluthreader.com/search?search_term=Duty+to+Warn&p=2;

http://www.globalresearch.ca/author/gary-g-kohls;

http://freepress.org/geographic-scope/national; https://www.lewrockwell.com/author/gary-g-kohls/; and https://www.transcend.org/tms/search/?q=gary+kohls+articles