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Back in 1999, a group of researchers with the Institute of Medicine published an estimate of the number of deaths caused by medical errors each year, pegging the figure at around 98,000. Since then, the media and other groups have latched onto the figure, seldom challenging its accuracy.

A recent study sets out to upend the previous estimate, figuring that between 210,000 and 440,000 die each year due to preventable errors in hospitals. The study, which appears in the Journal of Patient Safety, marks a substantial upward revision in the number of deaths caused by medical mistakes each year, highlighting just how serious such hospital errors can be.

According to an article in the Scientific American, if the numbers are indeed accurate that would make medical errors the third leading cause of death in the United States. Many people would be stunned to know that botched medical treatment is nipping at the heels of heart disease and cancer in terms of which category is responsible for killing the most Americans each year.

The new figures were discovered by John James, a NASA researcher who runs a patient advocacy organization known as Patient Safety America. James began work on the issue after his teenage son died from what James claims was negligent care from a hospital. James based his findings on four recent studies which explored the frequency of adverse medical events in hospitals. The studies found that adverse events occur in as many as 21 percent of all cases, with nearly 1.4 percent of such events proving fatal.

Taking this number and applying it to the millions of hospitalizations that occur every year led James to conclude that a minimum of 210,000 people die from preventable hospital errors each year. The number could be more than doubled due to a variety of factors that lead to the underreporting of such preventable deaths. The nonprofit research organization ProPublica reviewed James’ numbers and also had three experts in patient safety review the study and all of them concluded that James’ methods were credible and appeared to be accurate.

You might be surprised that arriving at a definite number is so hard in the first place. The trouble is that no official count has ever been done to determine the number of hospital patients who experience preventable harm each year. Instead, researchers are left with estimates and are then forced to extrapolate out across the country, leading to imperfect information. It’s important that more accurate numbers are found. Patient safety advocates say that fully measuring the problem is critical to bringing awareness to the issue. Before the problem can be tackled, the medical community must first get a sense of how big it actually is.

Though we may not know precisely how many innocent patients suffer from preventable medical errors each year, we do know that early estimates were likely dramatically underestimated. Patient safety experts say that it is clear that the media and public health officials need to stop citing the 98,000 figure and instead start grappling with the idea that many times more people are dying from preventable medical mistakes every year in American hospitals.

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