The number comes from a 2000 study published in the Journal of the American Medical Association. While the number is not entirely rectally derived, “medical malpractice” is not an accurate term for it, nor one that the study’s authors used. Rather, the authors were looking at “the combined effect of errors and adverse effects that occur because of iatrogenic damage not associated with recognizable error…” (“Iatrogenic” means caused by medical examination or treatment.)
So these are not (all) malpractice, per se. But they are considered preventable deaths, if we change what we’re doing. Even infections in hospitals are considered, by nurses and doctors, a failure of something we’re doing, although realistically we may not be able to prevent every single infection.
The numbers quoted in the study break down to deaths per year due to:
12,000 – unnecessary surgery
7,000 – medication errors in hospitals
20,000 – other errors in hospitals
80,000 – infections in hospitals
106,000 – non-error, negative effects of drugs
These numbers were gathered from the following sources:
Leape L. Unnecessary surgery. Annu Rev Public Health. 1992;13:363-383.
Phillips D, Christenfeld N, Glynn L. Increase in US medication-error deaths between
1983 and 1993. Lancet. 1998;351:643-644.
Lazarou J, Pomeranz B, Corey P. Incidence of adverse drug reactions in hospitalized
patients. JAMA. 1998;279:1200-1205
Errors are not always malpractice. Malpractice is “Improper, unskilled, or negligent treatment of a patient by a physician, dentist, nurse, pharmacist, or other health care professional.” Medical Malpractice legal definition of Medical Malpractice
Furthermore, to be considered malpractice, four criteria must be met.
(1) a duty of care was owed by the physician - that is, if a doctor offers you advice at a dinner party, but is not your doctor, there is no duty of care, so there can be no malpractice
(2) the physician violated the applicable standard of care - that is, they did not do something that is accepted as standard of care, or they did do something that is not considered standard of care. So if I follow all the current guidelines for wound care of your pressure ulcer and it becomes infected anyway, that’s not malpractice. That’s just life sucking (for both of us.)
** (3) the person suffered a compensable injury -** close calls don’t count. Death, clearly, does.
(4) the injury was caused in fact and proximately caused by the substandard conduct. - This is where things get murky in the real world, because people are complicated and often many factors contribute to a bad outcome. But it’s up to the plaintiff to prove - if I’m using old wound care guidelines and at the same time you’re not changing the dressing every day like I told you to, it’s up to you to prove that my not following the standard of care caused the problem, and not your failure to follow instructions.
So some of those deaths in that huge number are malpractice, and some are not. Some are errors without being malpractice. And the largest portion of them aren’t errors *or *malpractice, but adverse drug events.