Wednesday, June 06, 2012

Medical bleg

Can anyone help me to find the total deaths attributed to iatrogenesis in a single, recent year in the UK (preferably 2011)?

Google seems to be remarkably unhelpful, since the first few pages of results give figures for the US, or scenarios for particular conditions—such as CJD or AIDS—or are from highly suspect sources, such as chiropractic websites.

The most common figure that I can find is astonishingly high—can it really be true that doctors kill some 52,000 people a year by being utterly crap?

Oh, and if anyone thinks that I want these figures in order to launch a sustained attack on the medical profession then let me assure you that nothing could be closer to the truth.

So, anyone...?

24 comments:

Xopher said...

It might also be interesting to find total compensation paid out by the NHS for medical 'mishaps'.

brain-4-hire said...

Try using Google Scholar e.g
http://bit.ly/KNR8qT

Simon Jester said...

This may be relevant:

http://www.whatdotheyknow.com/request/statistics_on_iatrogenic_deaths

This shows "236 male deaths
and 226 females deaths where the underlying cause was a complication of medical and surgical care, in England and Wales, for 2009".

Simon Jester said...

It also points out that "ONS do not have a National Statistics definition for iatrogenic deaths", so it looks as though the relevant figures aren't being recorded.

lilith said...

Of course the figures are not recorded. They rarely report adverse drug reactions either.

Chuckles said...

Here perhaps?

http://www.sin-medicalmistakes.org/Letters4.html

Anecdotal reports worldwide suggest that every time the medicos go on strike, the mortality rate drops anywhere from 18-50%

Ryan said...

Not that much here... https://www.evidence.nhs.uk/search?q=Iatrogenesis&rf=False

much easier to blame bad health on fags booze and burgers

Anonymous said...

Found this: http://tinyurl.com/6m64me4 - its from 2009, and links to an article on The Spectator, which doesn't seem to exist any more...

Lord Blagger said...

There is NHS research where they estimate the number of deaths where the NHS contributes to the death. The number is 20-80,000 a year.

Now my first reaction to this is that it can't be correct. However, when you have a GP killing 215 (and probably over 600) without detection, it isn't quite as far fetched. Likewise with one hospital killing over 100 from just one cause.

The major issues are under reporting. Either deliberately, or because they just plain didn't realize. I've seen reports of a sub 10% reporting level.

http://www.dailymail.co.uk/news/article-1106074/Deaths-hospital-blunders-soar-60-years-NHS-staff-abandon-quality-care-chase-targets.html

Official records show that 3,645 died as a result of outbreaks of infections, botched operations and other mistakes in 2007/08. That was up from 2,275 two years before.

The problem here is under reporting. The reported figure is the lower limit.

http://www.publications.parliament.uk/pa/cm200809/cmselect/cmhealth/151/15106.htm

However, as the NPSA itself acknowledges, there is very significant under-reporting of safety incidents (as is discussed further below). So figures for reported incidents are not a reliable indicator of how many incidents actually take place in the NHS.

http://www.telegraph.co.uk/health/3287571/Nine-out-of-ten-preventable-deaths-in-the-NHS-are-not-reported.html

Of the estimated 72,000 annual deaths in the NHS, just 3,200 are recorded by the National Patient Safety Agency, MPs were told.
The Commons Health Select Committee heard evidence from experts in its first evidence session on its investigation into patient safety.
The NPSA runs a system where all NHS staff can report incidents or near misses so patterns can be spotted and the wider health community warned.

So with a 10% reporting level, 3,200 known cases. 32,000 estimated and in the 20-80K range.

http://www.guardian.co.uk/society/2012/apr/09/nhs-blunders-babies-brain-damage

NHS Litigation Authority sets aside £235.4m to settle 60 cases in which hospital staff failed to spot hypoglycaemia in newborns

Just one example. Multiply by 10. 600 the likely estimate.

the a&e charge nurse said...

'Oh, and if anyone thinks that I want these figures in order to launch a sustained attack on the medical profession then let me assure you that nothing could be closer to the truth' - will there be a comparative element to the analysis (e.g adverse events in NHS vs other health systems).

Mind you any comparison might not be easy because, following on from this freedom of information request, it appears the ONS 'do not have a National Statistics definition for iatrogenic deaths'.
http://www.whatdotheyknow.com/request/statistics_on_iatrogenic_deaths

The causes most closely fitting this concept are 'complications of medical and surgical care', ICD 10 codes Y40-Y84. Table 5.19, from the annual 'Mortality Statistics' publication shows that there were 236 male deaths and 226 females deaths where the underlying cause was a complication of
medical and surgical care, in England and Wales, for 2009.

ONS only hold mortality data for England and Wales, you will need to contact the Northern Ireland Statistics and Research Agency (www.nisra.gov.uk)
And National Records of Scotland
(www.gro-scotland.gov.uk) to obtain statistics for the rest of the UK.

Anonymous said...

In my very limited experience, those responsible do not declare when this takes place. My Father died of liver failure recently, his death was certainly accelerated by him being submitted to A&E and being assessed without an awareness of his cancer, unfortunately their diagnosis was poor (the words of my Fathers GP, not mine) and they proceeded to pump him with a fluid in a bid to reduce the liquid in his lungs. He declined rapidly after this treatment and he was dead within 5 days of his submission. His death certificate notes the cause of death as liver failure, with absolutely no mention to the procedure that took place some days earlier (and admitted by the GP to be a certain factor in his sudden death).
I wish you success.

Lord Blagger said...

http://www.telegraph.co.uk/health/9316982/NHS-compensation-to-misdiagnosed-patients-rises-to-98-million.html

Compensation paid to people whose illnesses were not spotted or were detected too late soared from £56 million in 2009-10 to more than £98 million in 2010-11.
Nearly one in ten of the 1,204 successful cases brought against NHS trusts last year related to health staff failing to diagnose cancer, figures released by the NHS Litigation Authority (NHSLA) in response to a Freedom of Information request show.

Lord Blagger said...

The most common figure that I can find is astonishingly high—can it really be true that doctors kill some 52,000 people a year by being utterly crap?

===========

Have you a link for the figure?

The whole area has been one of my interests for a while.

Why do you think its crap? I suspect that its this argument. If true, its horrific. It can't be true, because we haven't been told.

However, it is true.

1. Underreporting. Less than 10% reported.

Contrast this with pilots where there is an active anonymous reporting of errors. Why? Pilots are killed by their mistakes. Doctors kill other people.

2. No incentive to report.

The critical issue here is the structure of the NHS. It is insurer, supplier and regulator. That means a huge conflict of interest. After all, if you start reporting, you will have to start paying out compensation.

Those three legs need to be split.

3. Extrapolate. OK - has some known risks. Look at the cases you know about.

http://news.bbc.co.uk/1/hi/health/7037657.stm

90 Patients known about - from one cause c-dificile. Is that hospital going to be an isolated case? I very much doubt it. 1,121 hospitals in the UK. Do the maths. Now think about other causes of avoidable deaths.

the a&e charge nurse said...

'Why do you think its crap?' - crap?
Compared to what - other doctors or pilots?

Brilliant viewing here
http://www.risky-business.com/talk-89-just-a-routine-operation.html

Lord Blagger said...

It's crap for lots of reasons.

1. Those injured should be told.
2. Relatives of those killed should be told.
3. If it's negligence they should be compensated. Rather than now, bugger off and suffer. ie. The NHS's current attitude is the victim pays.
4. Compared to other countries.

Contrast this

The woman went in for surgery at a hospital in the town of Sankt Johann during June due to vascular problems, however, the wrong leg was marked in the planning for the procedure.

A 91-year-old Austrian woman had the wrong leg amputated
She had the correct limb amputated during a second procedure several days later.
The error, which the doctors did not realise had been made until after the surgery, was attributed to human error and a lack of safety measures.
Both doctors involved, the operating surgeon, who has over 25 years experience, and a second doctor, have been suspended and charged with bodily injury caused by negligence.


Read more: http://www.metro.co.uk/news/843887-austrian-doctors-charged-for-amputating-the-wrong-leg#ixzz1x90W5V3v

With the NHS

http://news.bbc.co.uk/1/hi/health/7037657.stm

90 Deaths. No prosecutions.

Simon Jester said...

Not reading earlier comments, A&E?

the a&e charge nurse said...

Yea, missed it, Simon - sorry for the duplication.

the a&e charge nurse said...

Current list of NHS 'never events'
http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_132352.pdf

Lord Blagger said...

Interesting.

1. I had a friend intubated in the stomach and they did monitor his O2 levels, but did nothing as he turned blue. Brain dead, died 3 days later.

2. The colleague I sit next to stopped medical staff injecting an over dose of chemotherapy in his daughter. 3 months later, another patient's father did the same where they mixed up the drugs between patients.

BrianSJ said...

See if you can get hold of what the Medical Defence Union sends its doctor members. Wonderful case stories of e.g. wrong leg removed, successfully defended.

the a&e charge nurse said...

MDU cases here - I think you need a membership number to browse all details.
http://www.the-mdu.com/section_gps_and_primary_care_professionals/topnav_case_histories_2/index.asp

Anonymous said...

http://www.medicalprotection.org/uk/education-publications/casereports

Anonymous said...

btw Lord Blagger.

The most common figure that I can find is astonishingly high—can it really be true that doctors kill some 52,000 people a year by being utterly crap?

Most of these people were going to die very soon anyway. Doctors' mistakes may have hastened their death, but it is a bit OTT to say that doctors killed every single one of them.

Chuckles said...

http://www.dailymail.co.uk/news/article-2161869/Top-doctors-chilling-claim-The-NHS-kills-130-000-elderly-patients-year.html

Petr Skrabanek's books may be useful as well

https://bradtaylor.wordpress.com/2009/06/05/petr-skrabanek-books/