Medical errors! The very term sounds ominous — and it should. After all, when patients visit a hospital or go to a doctor's office, they don't always expect to be cured, but they certainly don't expect to be hurt.

It is important to note that this is not a new issue. However, it wasn't until 1999 that the public got exposed to the magnitude of the problem with the famous report that estimated that 44,000 to 98,000 persons die each year in the United States because of medical errors in hospitals, thus exceeding deaths due to motor vehicle accidents, breast cancer or AIDS separately.

But first, let's define some terms. A medical error is the failure of a planned action to be completed as intended (i.e., error of execution) or the use of a wrong plan to achieve an aim (i.e., error of planning). Some medical errors result in adverse events. An adverse event is an injury caused by medical management rather than the underlying condition of the patient.

There was a surprisingly rapid and strong response to the report by the media, the public, the president, key lawmakers, and especially researchers. Within weeks, congress held hearings, then-President Clinton held a Rose garden ceremony to appoint a task force and patient safety became the buzzwords in health care.

The 44,000-98,000 numbers represent a failure rate of 2.9%-3.7%. Compare that to other industries: Even a 1% failure rate is not tolerated, because that would equate to two unsafe landings at O'Hare airport every day, 16,000 pieces of lost mail every hour, and 32,000 bank checks directed from the wrong bank account every hour!

So nearly 10 years later, how is our patient safety situation? Not so good, according to recent reports. The estimates suggest that 1.5 million injuries were associated with medical errors in the U.S in 2008. These medical errors added a whopping $19.5 billion to our health care bill in that same year. The following list summarizes the top 10 most expensive types of errors, the number of errors, the cost per error, and the total cost:

  1. Pressure ulcers — 374,964 errors, $10,288 per error and $3.858 billion total.
     
  2. Postoperative infections — 252,695 errors, $14,548 per error, $3.676 billion total.
     
  3. Mechanical complication of a device, implant or graft — 60,380 errors, $18,771 per error, $1.133 billion total.
     
  4. Postlaminectomy syndrome — 113,823 errors, $9,863 per error, $1.123 billion total.
     
  5. Hemorrhage complicating a procedure — 78,216 errors, $12,272 per error, $960 million total.
     
  6. Infection following infusion, injection, transfusion, vaccination — 8,855 errors, $78,083 per error, $691 million total.
     
  7. Pneumothorax — 25,559 errors, $24,132 per error, $617 million total.
     
  8. Infection due to central venous catheter — 7,062 errors, $83,365 per error, $589 million total.
     
  9. Other complications of internal (biological) (synthetic) prosthetic device, implant and graft — 26,783 errors, $17,233 per error and $462 million total.
     
  10. Ventral hernia without mention of obstruction or gangrene — 53,810 errors, $8,178 per error and $440 million total.

Obviously, we still have a long way to go!