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A study by researchers at Johns Hopkins Medicine says medical errors should rank as the third leading cause of death in the United States — and highlights how shortcomings in tracking vital statistics may hinder research and keep the problem out of the public eye. The authors, led by Johns Hopkins surgeon Dr. Martin Makary, call for changes in death certificates to better tabulate fatal lapses in care. In an open letter, they urge the Centers for Disease Control and Prevention to immediately add medical errors to its annual list reporting the top causes of death. (Allen and Pierce, 5/3)

If medical error were considered a disease, a new study has found, it would be the third leading cause of death in the United States, behind only heart disease and cancer. Medical error is not reported as a cause of death on death certificates, and the Centers for Disease Control and Prevention has no “medical error” category in its annual report on deaths and mortality. But in this study, researchers defined medical error as any health care intervention that causes a preventable death. (Bakalar, 5/3)

Martin Makary, a professor of surgery at the Johns Hopkins University School of Medicine who led the research, said in an interview that the category includes everything from bad doctors to more systemic issues such as communication breakdowns when patients are handed off from one department to another. "It boils down to people dying from the care that they receive rather than the disease for which they are seeking care," Makary said. (Cha, 5/3)

Fatal medical errors include cases in which patients received medications they were allergic to and instances in which patients died of preventable infections, among many other possibilities. Doctors and nurses are not necessarily involved, experts said — sometimes a faulty computer program may be to blame. “Medical care has become really complex,” said Dr. David Classen, an associate professor of medicine at the University of Utah who was not involved in the study. “It's no longer one single physician taking care of a single person at a hospital. It's these huge groups of people now, and mistakes get made.” (Netburn, 5/3)

The study gives an example of exactly how limited the death certificates are when it comes to recording medical errors. One example involved a patient who had a successful organ transplant and seemed healthy, but had to go back to the hospital for a non-specific complaint. During tests to determine what was wrong, a doctor accidentally cut her liver and hadn't realized it. The hospital sent her home, but she returned with internal bleeding and went into cardiac arrest and later died. It was the cut that led to her death, but her death certificate only listed a cardiovascular issue as the cause. (Christensen and Cohen, 5/3)

This paper builds upon a recent study that found that more than 210,000 deaths per year occur due to medical errors. When adjusting for 2013 hospital admission rates, Makary and his colleague found that the present number is more likely 251,454 deaths per year — surpassing the CDC’s stated third-leading cause of death, respiratory disease, which kills close to 150,000 people per year. The leading cause of death in the US is heart disease, followed by cancer. (Swetlitz, 5/3)

For the study, Makary and his colleagues evaluated four separate studies that analyzed medical death rate data from 2000 to 2008, including one by the U.S. Department of Health and Human Services' Office of the Inspector General and the Agency for Healthcare Research and Quality. Based on 2013 data on hospitalization rates, they found that of 35,416,020 hospitalizations, 251,454 deaths stemmed from a medical error. They said that adds up to 9.5 percent of all deaths a year in the U.S. (Marcus, 5/4)