A New, Evidence-based Estimate of Patient Harms Associated with Hospital Care

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'''A New, Evidence-based Estimate of Patient Harms Associated with Hospital Care''' is a 2013 report produced by John T. James, Ph.D., that estimates the number of incidences of patient harm or death [[Iatrogenesis|caused by modern hospital care]] in the [[US]]. Overall, the report found that, between 2008 and 2011, "a lower limit of 210,000 deaths per year was associated with preventable harm in hospitals" but "the true number of premature deaths associated with preventable harm to patients was estimated at more than 400,000 per year". Further, "[s]erious harm seems to be 10- to 20-fold more common than lethal harm."<ref>James, John T. [http://journals.lww.com/journalpatientsafety/Fulltext/2013/09000/A_New,_Evidence_based_Estimate_of_Patient_Harms.2.aspx "A new, evidence-based estimate of patient harms associated with hospital care."] Journal of patient safety 9.3 (2013): 122-128.</ref> Altogether, this would make medical accidents the third leading cause of death in the US, after heart disease and [[cancer]]. (The [[CDC]]'s estimates currently place accidents at fourth.<ref>http://www.cdc.gov/nchs/fastats/leading-causes-of-death.htm</ref>)

The study itself appears valid, and evidence that further and ongoing medical reform must be done. The report gained significant media attention,<ref>http://www.forbes.com/sites/leahbinder/2013/09/23/stunning-news-on-preventable-deaths-in-hospitals/</ref> not least because it disparaged the medical profession. However, the report has been used by all too many people opposed to "[[allopathic]]" medicine as evidence that allopathic medicine is bad, and [[False dichotomy|you should prefer whatever it is that they're pushing]].<ref name=ABH>http://www.abetterwaytohealth.com/acupuncture-scientific-evidence</ref><ref>http://www.infowars.com/foundation-of-medical-reality-explodes/</ref>

There are several problems with this view.

==Types of Reporting==
It is important to understand which statistics for patient harm are being utilized. A number of hospitals have been moving towards open reporting of events with the potential for patient harm. This often includes events that don't actually reach the patient or cause them harm.<ref>[http://www.bidmc.org/Quality-and-Safety/EffortstoImproveQualityofCare/prevHarm.aspx Beth Israel Medical Center &mdash; Eliminating Preventable Harm at BIDMC]</ref> It can be anything from a scale that is not well labeled leading to the possibility of dosage errors, medication errors in transcriptions caught by pharmacists,<ref>[http://qualitysafety.bmj.com/content/18/1/22.short Medication errors: the impact of prescribing and transcribing errors on preventable harm in hospitalised patients]</ref> to serious safety events leading to harm or death.  They use open evidence-based approaches to identify, find and correct the cause for future patients. Often publishing research and quality improvement that show positive results for other facilities to emulate in order to improve patient care.<ref>http://www.ncbi.nlm.nih.gov/pubmed/23860193 A new, evidence-based estimate of patient harms associated with hospital care</ref>

This system does not exist for alternative treatments. Harm is generally shown in news articles and lawsuits with little interest in building a similar systems. Alternative medical practitioners often disparage critics and those looking to shine a light on their practices.

==Allopathic vs human error==
All but one of the Predictable Adverse Events (PAEs) looked for are human errors. Equipment that was not sterilized properly. A surgeon's carelessness. Miscommunication between doctor and nurse. Lack of patient compliance. If anything, the study shows that we imperfect humans make the error, not the "allopathic" system behind it. Even if we assume that [[Naturopathy|"naturopathic" medicine]] worked and we switched to an entirely naturopathic system, we'd see the same kind of issues.

There are some studies in effect for naturopathic treatments which show the same types of human error.<ref>[http://www.newscientist.com/article/dn22247-acupuncture-treatment-is-not-as-safe-as-advertised.html#.VY2rvFI5BBk Acupuncture treatment is not as safe as advertised]</ref> This includes improperly placed needles going deeper than intended, puncturing major organs that needed to be surgically removed,<ref>[http://www.theguardian.com/science/2010/oct/18/dozens-killed-acupuncture-needles Dozens killed by incorrectly placed acupuncture needles: Professor of complementary medicine calls for adequate training for all acupuncture practitioners after survey reveals punctured hearts and lungs among causes of death over past 45 years] by Ian Sample (Monday 18 October 2010 12.21 EDT) ''The Guardian''</ref> needles accidentally being left in patients, and infections caused by reusing needles without sterilizing them.<ref>[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361796/ An outbreak of post-acupuncture cutaneous infection due to Mycobacterium abscessus - 40 people affected]</ref>

==Scale==
Even some [[acupuncture]] proponents admit "more people use hospitals than acupuncture in the U.S.", though they argue "that doesn’t come close to touching the difference in death rate."<ref name=ABH />

The problem here is that, unlike hospital deaths, which are increasingly well-reported, deaths from acupuncture or [[herbal medicine]] or [[faith healing]] or almost any alternative medicine have effectively ''no'' reporting system. It's entirely possible that alternative medicines kill at higher rates than allopathic medicines. Little is known due to the lack of regulation on [[supplements]] and treatments until regulators start looking into incidences of people being hospitalized at legitimate medical centers.

==External links==
*[http://skepticalscalpel.blogspot.com/2013/09/medical-errors-and-deaths-is-problem.html?m=0 Medical errors and deaths: Is the problem getting worse?] Skeptical Scalpel

==References==
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{{DEFAULTSORT:New Evidence based Estimate of Patient harms Associated with Hospital Care}}
[[Category:Arguments against evidence-based medicine]]
[[Category:Documents]]

Categories: Arguments against evidence-based medicine, Documents