Medical Accidents

Abstract

Abstract Medical, or iatrogenic, injury is by no means an insignificant phenomenon. A 1964 study reported that 20% of patients admitted to the medical wards of a teaching hospital over an 8-month period experienced one or more untoward episodes.1 A 1981 report in the New England Journal of Medicine reported a 36% rate of iatrogenic injury (defined as “any illness that resulted from a diagnostic procedure or from any form of therapy” as well as “harmful occurrences ... that were not natural consequences of the patient’s diseases”) among 815 consecutive patients on a general medical service of a university hospital; of these, 9% were reported to have suffered “major complications.”.A Department of Health, Education and Welfare (DHEW) study based on records from two hospitals placed the incidence of iatrogenic injury at 7.5%.3 Two large-scale independent studies of hospital records-one undertaken in California in the mid-1970s4 and the recent Harvard Medical Practice Study of New York hospitals5-yielded similar findings, indicating that approximately 4% of all hospitalizations result in adverse events from medical treatment and one-quarter of these incidents involve substandard care.6 In other words, negligent adverse events were found to occur in 1% of all discharges.7 As a result, the Harvard study concluded that in New York State in 1984 nearly 99,000 patients suffered disabling injuries, of which more than 13,000 resulted in death.8 Extrapolated to the U.S. population as a whole, this suggests that of 40 million patients hospitalized every year, 1.5 million suffer some kind of disabling injury, that 180,000 of these patients die as a result of medical treatment, and that over half of these deaths are due to negligence.9 The number of deaths from medical injury thus appears to exceed mortalities associated with both motor vehicle accidents (about 40,000 per year) and workplace accidents (6,000 per year)..