iatrogenesis.
Any idea what that is?
It’s defined in the Merriam – Webster Dictionary as the “inadvertent and preventable induction of disease or complications by the medical treatment or procedures of a physician or surgeon.”
We’ve talked a lot about it in past posts – it’s another term for medical malpractice and it’s the third leading killer in America.
So is it something new?
Nope.
Contemporary medical scholars have been writing about it for years.
Here is an excerpt from a paper published in 1955 by Dr. David P. Barr entitled Hazards of Modern Diagnosis and Therapy—the Price to Pay: “Therapeutic preparations are confusingly numerous and varied. In the lists of 1953, more than 140,000 medicaments (have never seen the word)were available to practitioners, and 14,000 new preparations were added during the year… In a medical service of a great hospital, over a period when approximately 1,000 patients were admitted, more than 50 major toxic reactions and accidents [>5%] consequent to diagnostic or therapeutic measures were encountered.”[1]
In 1964, a Yale physician, Dr. E. M. Shimmel wrote about the dangers of hospital care in a major paper titled The Hazards of Hospitalization in which he reported that 20% of patients admitted to a university hospital suffered one or more iatrogenic incidents and that 20% of those incidents were serious or fatal.[2]
Then in 1981, Dr. Knight Steel, et al. from Boston University Medical Center sounded another disturbing alarm. In a five-month prospective study, they reported, “We found that 36% of 815 consecutive patients on a general medical service of a university hospital had an iatrogenic illness. In 9% of all persons admitted, the incident was considered major in that it threatened life or produced considerable disability. In 2% [15 patients] of the 815 patients, the iatrogenic illness was believed to contribute to the death of the patient.” “Major toxic reactions” greater than the 5% previously reported by Dr. Barr was now found to be as high as 9%. The authors pointed out the inertia of the system with a total lack of progress since Drs. Barr and Schimmel had reported the same problem respectively 28 and 17 years earlier.[3]
A 1997 study found that there were close to 199,000 reported deaths related to the side effects of well-prescribed drugs in non-hospitalized patients.[4]
A 1998 article entitled Time to Act on Drug Safety, written by a team of U.S. epidemiologists, reported, “Discovering new dangers of drugs after marketing is common. Overall, 51% of approved drugs have serious adverse effects not detected prior to approval.”
In 1999, a team from Boston University and Stanford estimated conservatively that 16,500 deaths occurred singly among patients with rheumatoid arthritis or osteoarthritis every year in the United States just from the use of non-steroidal anti-inflammatory drugs (NSAID).[5] If these deaths from gastrointestinal toxic effects caused by NSAID were tabulated separately in the National Vital Statistics reports, it would constitute the 15th most common cause of death in the United States.
In 2007, the Institute of Medicine reported that 400,000 preventable drug-related injuries occurred each year in hospitals only. Another 800,000 occurred in long-term care settings, and roughly 530,000 occurred just among Medicare patients in outpatient clinics.
What can be done to protect patients from medical malpractice and iatrogenesis?
It’s complicated but more needs to be done to take the profit out of medical errors, to police drug manufacturers, and to better train doctors… but more on that in a future column.
If you or a loved one is ever the victim of a defective drug, the improper prescription of a drug therapy, over-exposure to medical radiation, a hospital-acquired infection, a fall while in the hospital, a preventable blood clot, or a misdiagnosis, call a qualified Connecticut medical malpractice lawyer. A knowledgeable malpractice attorney can help to ensure that your rights are protected.
RisCassi & Davis has handled hundreds of defective drug and medical malpractice cases over our nearly 60 years serving the people of Connecticut.
What’s more, our Connecticut medical malpractice lawyers have received local and national recognition for our handling of these cases.
We have a great team of legal experts dedicated to medical malpractice in Connecticut. Please contact us if we can help you. The consultation is free and there is no obligation of any kind. And – there is no fee or other costs unless we are successful on your behalf.
[1]David P. Barr. Hazards of modern diagnosis and therapy: the price we pay. Journal of the American Medical Association 1955; 159: 1452-1456.
[2]E. M. Schimmel. The hazards of hospitalization. Annals of Internal Medicine 1964; 60: 100-110.
[3]Knight Steel, P. M. Gertman, C. Crescenzi, J. Anderson. Iatrogenic illness on a general medical service at a university hospital. New England Journal of Medicine 1981; 304: 638-642.
[4]Jeffrey A. Johnson, J. Lyle Bootman. Drug-related morbidity and mortality and the economic impact of pharmaceutical care. American Journal of Health-System Pharmacy 1997; 54 (5): 554-558.
[5]M. M. Wolfe, D. .R. Lichtenstein, G. Singh. Gastrointestinal toxicity of nonsteroidal anti-inflammatory drugs. New England Journal of Medicine 1999; 340: 1888-1899.