Surgical adverse events in the US

After all these years, why has patient safety not improved? In late 1999, the US Institute of Medicine’s report “To Err is Human: Building a Safer Health System” galvanized the nascent patient safety movement into action with its assertion that as many as 98 000 Americans died annually from medical error.1 That alarming statistic was derived from the 1991 Harvard Medical Practice Study, a randomized chart review undertaken to create an evidence base for the controversy then raging around litigation against medical malpractice.2 That study found that 3.7% of patients in a sample of hospital admissions in New York state had experienced serious adverse events, more than one fourth of which the researchers considered legally compensable. Overall, 48% of the events were associated with surgical procedures. A related study in Colorado and Utah a few years later showed similar percentages of surgical error, whereas a targeted follow-up study found that surgery accounted for two thirds of adverse events in hospitals in the same two states.3 …