What she is struggling to communicate is a reference to an Institute of Medicine (IOM) study from 1999 that made the claim that 98,000 Americans (often rounded to an even 100,000) are KILLED every year by medical errors. This study was based on retrospective data, subsequently used for predictive purposes, from 1984. (Hence the AIDS reference in Kliff's article). That's a long time ago, right? We need to delve deeper into the data on that IOM report on a subsequent post. In any event, Ms Kliff has composed a structurally awkward post parceled into seven numbered sections. Section 2 is titled: "Bed sores are huge source of harm in the health care system". Hey, I'm as anti-bedsores as anyone but I fail to see the relevance of bringing up bed sores in the the context of a piece ostensibly about patients dying from medical errors. Kliff begins the section discussing wrong site surgeries and transitions to :
But they aren't what cause the most harm in American health care. It's the less stunning, more quotidian mistakes that are the biggest killers. Take, for example, bed sores.
A 2006 government survey found that more than half a million Americans are hospitalized annually for bed sores that are the result of other care they have received. 58,000 of those patients die in the hospital during that admission.
Does this mean that pressure ulcers killed all those patients? No — these are typically frail, elderly patients battling other conditions ranging from pneumonia to dementia. But did bed sores mean some of these patients died who otherwise wouldn't have? Experts say that's almost certainly the case.
After the bed sore non-sequitor, Kliff makes some valid points about physician transparency and the difficulty of identifying errors when they occur. She also assails the "fee for service" model as a source for disincentivization to correct mistakes and prevent them from happening again. Finally she assures her readers that this post is the first in a year long series investigating fatal medical errors. She then affixes a form for readers to fill out if they or their loved ones have been the victim of a medical error. This form asks "Type of Harm" (and the participant is to check all that apply). Choices include: "Infection", "Surgical Injury", "Bedsores", "Fall", "Medication error", "Blood Clot", "Device (ortho or cardiac).
Ms Kliff has committed a very common error here, creating a false equivalence between the concept of known complications related to procedures or disease processes and true negligence/malpractice. Surgical injury, of course, is my personal favorite listing. I love the use of the pejorative word "injury" rather than "complication" or "unexpected outcome". So now surgical site infections, post op pneumonia, hernia recurrences, duct of Luschka leaks, anastomotic dehiscences, and other surgical complications are re-defined as "injuries" suffered as a result of "medical errors". Certainly many bad surgical outcomes are the result of incompetence or negligence. Most are not. Most are simply known complications of a well described procedure. Mixing up the two is tantamount to journalistic malpractice.
It will be interesting to read Ms Kliff's follow up articles on this important topic.....