Category Archives: Iatrogenic death

How Many Die From Medical Mistakes in U.S. Hospitals?


“For the wisdom of this world is foolishness with God.  For it is written, ‘He catches the wise in their own craftiness’. (1 Corinthians 3:19)

It seems that every time researchers estimate how often a medical mistake contributes to a hospital patient’s death, the numbers come out worse.

In 1999, the Institute of Medicine published the famous “To Err Is Human” report, which dropped a bombshell on the medical community by reporting that up to 98,000 people a year die because of mistakes in hospitals. The number was initially disputed, but is now widely accepted by doctors and hospital officials — and quoted ubiquitously in the media.

In 2010, the Office of Inspector General for Health and Human Services said that bad hospital care contributed to the deaths of 180,000 patients in Medicare alone in a given year.

Now comes a study in the current issue of the Journal of Patient Safety that says the numbers may be much higher — between 210,000 and 440,000 patients each year who go to the hospital for care suffer some type of preventable harm that contributes to their death, the study says.

That would make medical errors the third-leading cause of death in America, behind heart disease, which is the first, and cancer, which is second.

The new estimates were developed by John T. James, a toxicologist at NASA’s space center in Houston who runs an advocacy organization called Patient Safety America. James has also written a book about the death of his 19-year-old son after what James maintains was negligent hospital care.

Asked about the higher estimates, a spokesman for the American Hospital Association said the group has more confidence in the IOM’s estimate of 98,000 deaths. ProPublica asked three prominent patient safety researchers to review James’ study, however, and all said his methods and findings were credible.

What’s the right number? Nobody knows for sure. There’s never been an actual count of how many patients experience preventable harm. So we’re left with approximations, which are imperfect in part because of inaccuracies in medical records and the reluctance of some providers to report mistakes.

Patient safety experts say measuring the problem is nonetheless important because estimates bring awareness and research dollars to a major public health problem that persists despite decades of improvement efforts.

“We need to get a sense of the magnitude of this,” James said in an interview.

James based his estimates on the findings of four recent studies that identified preventable harm suffered by patients – known as “adverse events” in the medical vernacular – using use a screening method called the Global Trigger Tool, which guides reviewers through medical records, searching for signs of infection, injury or error. Medical records flagged during the initial screening are reviewed by a doctor, who determines the extent of the harm.

In the four studies, which examined records of more than 4,200 patients hospitalized between 2002 and 2008, researchers found serious adverse events in as many as 21 percent of cases reviewed and rates of lethal adverse events as high as 1.4 percent of cases.

By combining the findings and extrapolating across 34 million hospitalizations in 2007, James concluded that preventable errors contribute to the deaths of 210,000 hospital patients annually.

That is the baseline. The actual number more than doubles, James reasoned, because the trigger tool doesn’t catch errors in which treatment should have been provided but wasn’t, because it’s known that medical records are missing some evidence of harm, and because diagnostic errors aren’t captured.

An estimate of 440,000 deaths from care in hospitals “is roughly one-sixth of all deaths that occur in the United States each year,” James wrote in his study. He also cited other research that’s shown hospital reporting systems and peer-review capture only a fraction of patient harm or negligent care.

“Perhaps it is time for a national patient bill of rights for hospitalized patients,” James wrote. “All evidence points to the need for much more patient involvement in identifying harmful events and participating in rigorous follow-up investigations to identify root causes.”

Dr. Lucian Leape, a Harvard pediatrician who is referred to the “father of patient safety,” was on the committee that wrote the “To Err Is Human” report. He told ProPublica that he has confidence in the four studies and the estimate by James.

Members of the Institute of Medicine committee knew at the time that their estimate of medical errors was low, he said. “It was based on a rather crude method compared to what we do now,” Leape said. Plus, medicine has become much more complex in recent decades, which leads to more mistakes, he said.

Dr. David Classen, one of the leading developers of the Global Trigger Tool, said the James study is a sound use of the tool and a “great contribution.” He said it’s important to update the numbers from the “To Err Is Human” report because in addition to the obvious suffering, preventable harm leads to enormous financial costs.

Dr. Marty Makary, a surgeon at The Johns Hopkins Hospital whose book “Unaccountable” calls for greater transparency in health care, said the James estimate shows that eliminating medical errors must become a national priority. He said it’s also important to increase the awareness of the potential of unintended consequences when doctors perform procedure and tests. The risk of harm needs to be factored into conversations with patients, he said.

Leape, Classen and Makary all said it’s time to stop citing the 98,000 number.

Still, hospital association spokesman Akin Demehin said the group is sticking with the Institute of Medicine’s estimate. Demehin said the IOM figure is based on a larger sampling of medical charts and that there’s no consensus the Global Trigger Tool can be used to make a nationwide estimate. He said the tool is better suited for use in individual hospitals.

The AHA is not attempting to come up with its own estimate, Demehin said.

Dr. David Mayer, the vice president of quality and safety at Maryland-based MedStar Health, said people can make arguments about how many patient deaths are hastened by poor hospital care, but that’s not really the point. All the estimates, even on the low end, expose a crisis, he said.

“Way too many people are being harmed by unintentional medical error,” Mayer said, “and it needs to be corrected.”

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Teshuvah Road

Evil Angels of Death: The Doctors


Motives: Part 2

Certain doctors actually exploit their position for the express purpose of murder, such as those who kill for the following reasons:

  1. Experimentation: People become doctors because they’re innately curious about the human body and the only way to experiment with it without being discovered is to kill the victims. H. H. Holmes is a good example, and if Jack the Ripper was a physician, as some suspect, this may have motivated him, too. Obviously, Joseph Mengele had this motive, although he did not have to find ways to cover it up. He was free to experiment all he wanted on creatures that were considered less than human.
  2. Financial profit: Some doctors participate in schemes to defraud insurance companies by killing people and sharing in the death benefits. Dr. Morris Bolber organized a partnership for this type of crime in Philadelphia in the 1930s. It is estimated that he and his partners killed around fifty people before they were stopped.
  3. Bloodlust: For some, committing a violent death is as exciting as a sexual encounter. They want the heightened feeling that comes from the excitement that results from killing or watching others react to a death. Michael Swango, for example, described a major fatal accident as an ultimate fantasy and also admitted how much he loved coming out of the ER with an erection, knowing he was about to tell parents that their child is dead.
  4. Dr. Frank Sweeney
    Dr. Frank Sweeney

    Dr. Francis E. Sweeney was the prime suspect and man who super cop Eliot Ness believed was guilty in a series of thirteen Depression-era murders in Cleveland. Still officially unsolved, the killer was believed to have medical knowledge and, almost uniquely in serial killer history, killed men and women equally by expert decapitation. Sweeney, a brilliant but twisted surgeon, taunted Ness for years about not having sufficient evidence to convict him.

  5. Visionary purposes: Mengele believed that his experiments with people were a way to put science into the service of the Nazi goal of evolving a superior human race. He had a mission to kill.
  6. Punishment and power: Dr. Thomas Neill Cream poisoned four women in part for sadistic pleasure and in part to be their judge and executioner for their immoral behavior. Going to medical school in Canada, he was forced to marry a woman he’d aborted, so he left for England. Then he returned to Canada and that’s where he killed a chambermaid who came to him for an abortion. He moved to Chicago where another woman fell victim to his abortion methods. He then killed a man while “treating” his epilepsy because he coveted the man’s wife. For that he went to prison for ten years. (Although he claimed as he was hung years later that he was Jack the Ripper, he was in fact behind bars in 1888.) Going to London in 1891, he poisoned four prostitutes with strychnine. Identified and arrested, he was hanged in 1892.
  7. Dr.Harold Shipman
    Dr.Harold Shipman

    Relief for inner conflicts: Dr. Harold Shipman was convicted in England of 15 counts of murder in 2001. In court, he displayed indifference to the suffering he’d caused many families and contempt for the prosecution, which is indicative of sociopathy. However, according to Dr. Chris Missen, head of forensic psychology at Anglia Polytechnic University, Shipman actually had a secret self that was awash in monumental self-pity. He had watched his mother die when he was seventeen, which he may have interpreted as rejection and abandonment. He wanted the jury to believe that he had an impulse control problem, but in truth, he had been highly organized in the way he altered medical records and adopted the pretense of making proper arrangements. He’d even typed up a will for his last victim and forged her signature. “What might have been perceived as a deep inner hypersensitivity,” says Missen, “may have been no more than a swollen ego, in danger of imploding at the least pinprick.” Shipman could not handle potential rejection from women the age his mother would have been had she lived, so his older female patients brought out his inner conflicts. That means that what may have become suicidal despair in others turned into a homicidal rage in Shipman. He killed patients to keep from killing himself. If the estimates that his victims number nearly 300 are correct, then he killed an average of one patient a month since his medical career began.

The question can be asked whether it’s the position of power that shapes them into killers or whether they’re just sociopaths who managed to become doctors. A close look at one of the most flagrant offenders in American history may offer some clues.

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Prominent Cancer Doctor Prescribed Unnecessary Chemo, Killing Healthy Patients


Prominent Cancer Doctor Prescribed Unnecessary Chemo, Killing Healthy Patients

Imagine a well-renowned oncologist gives you the life-rending news that you have cancer. You then undergo rounds of sickening, body-rending chemotherapy only to much later learn it was all a con designed to make money prescribing unnecessary medical treatment.

This is precisely what prominent Michigan cancer specialist Dr. Farid Fata pled guilty to recently in a case a U.S. Attorney called “the most egregious” example of healthcare fraud her office had ever witnessed. The Detroit Free Press’ Tresa Baldas reported on the story:

“It is my choice,” Fata said on Tuesday [9/16] of his surprise guilty plea, which included rattling off the names of numerous drugs he prescribed for his patients over the years. In each admission, he uttered these words:

“I knew that it was medically unnecessary.”

Fata, 49, a married father of three, pleaded guilty to 13 counts of health care fraud, two counts of money laundering and one count of conspiracy to pay and receive kickbacks. He faces sentencing in February before U.S. District Judge Paul Borman.

… Fata of Oakland Township was charged with running a $35-million Medicare fraud scheme that involved billing the government for medically unnecessary oncology and hematology treatments. The government says Fata ran the scheme from 2009 [when the Lebanon native was naturalized] to the present, through his medical businesses, including Michigan Hematology Oncology Centers, with offices in Clarkston, Bloomfield Hills, Lapeer, Sterling Heights, Troy and Oak Park.

It wasn’t just chemotherapy, either. As Time’s Kate Pickert reported, “In even more egregious cases, investigators say Fata falsified cancer diagnoses in order to justify — and receive payment for — positron emission tomography (PET) scans, which include radiation.”

It should be emphasized here that Fata was prescribing poison, as this is essentially what chemotherapy is, which is why it not only destroys cancer cells but healthy ones in the process. And as Inquisitor.com wrote, listing several destroyed, formerly healthy victims:

I lost my sister and her children lost a mother,” said Cindy Burt. “There’s just no justice for that.”

White Lake resident Karen Baldwin said her husband, Harrison, was treated for a diagnosis of brain cancer.

… Dave Kroff was also put through years of unnecessary chemotherapy by Fata. Kroff says that the chemo suppressed his immune system so badly that he lost both of his legs.

… Multiple civil suits have already been filed, according to Click On Detroit. For example, Donna Virkus, the daughter of one of Fata’s patients, says that her 78-year-old father, Donald, was referred to Fata by a concerned physician to rule out esophageal cancer.

“It’s unbelievable. I can’t believe we put our trust into a doctor that was supposed to take care of him and ended up killing him,” Virkus said.

Donna’s father never had the cancer, a review of Donald’s medical files showed. Yet, the prestigious cancer doctor ordered two years of chemo. The civil suit alleges that Donald developed a blood-related cancer as an effect of the chemotherapy treatments. Donald later died.

Additionally, there’s an immigration angle to the story. As Pickert wrote, “The criminal complaint also outlines accusations that [the newly naturalized] Fata arranged for foreign doctors, who might have been unlicensed to practice medicine in the U.S., to treat patients in his multiple clinic locations.”

Making the case even more tragic is that Fata’s scam could have been stopped early on, as a chemotherapy nurse named Angela Swantek blew the whistle on the doctor in 2010. Finding his practices so shocking that she left his office after only an hour and a half of employment, Swantek warned Michigan authorities that Fata was prescribing chemotherapy incorrectly — at toxic levels. Yet despite giving the state the doctor “on a silver platter,” as she put it, the authorities dismissed her complaint, saying they discovered no evidence of malpractice.

Of course, Swantek did find herself up against Fata’s seeming impressive reputation. As ZoomInfo.com records, “Dr. Fata was voted by his peers to be one of the ‘Top Doc’s’ in Hematology and Oncology in 2006, 2007, 2008 and 2009 by Hour Detroit Magazine. He has received numerous awards including: ‘Outstanding First Year Resident,’ ‘Intern of the Year,’ and multiple clinical research awards.” And how could Fata’s image be so different from the reality?

Perhaps because of another scam: the fraudulent granting of medical awards and accolades.

As ABC News wrote in 2012 about just one of the medical-award organizations it scrutinized, “Their database of ‘Top Physicians’ includes doctors with serious criminal and disciplinary records.” And this is no surprise — doctor awards can essentially be bought. As an example, ABC reports that “a couple of hundred” physicians have paid to be at TopDocs.com and that “the cost to buy a spot on the website ranges anywhere from $1,500 to $10,000, in addition to an annual fee of $1,600.” And relevant to Fata’s selection as a “Top Doc” by his peers, “A hospital employee from a large urban hospital who wishes to remain anonymous told ABC News that a senior hospital administrator sent an email offering a $300 American Express gift card to the first 100 doctors who nominated their peers for a top doctor award,” wrote ABC.

And the effects of this fraud are obvious, as patients often choose doctors based on honors and awards. Unfortunately for Fata’s patients, however, the only thing their “Top Doc” was top at was lying and making money — and killing.

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iatro 77

Killing patients for hospital beds


  • A group of doctors allegedly altered oxygen levels for patients
  • Police: The doctors also administered lethal doses of medication
  • Seven other health care professionals have been charged in the case

A Brazilian doctor appeared in court for allegedly killing seven patients to free up hospital beds in the southeast city of Curitiba.

Virginia Helena Soares de Souza recruited a group of doctors to help administer lethal doses of anesthetics, sedatives and painkillers, according to authorities.

In addition, the group allegedly altered oxygen levels for patients, leading to deaths by asphyxiation, police said.

Seven other health care professionals have been charged in the case.

Prosecutors allege de Souza pulled the plug on victims against the wishes of patients and their families, and in so doing broke the law. She did that to free up beds in the ICU and clear up the “clutter” the patients were causing, according to police.

De Souza was arrested in February, but was later released until trial. Her court appearance Wednesday is part of mandated monthly appearances to avoid going back to jail.

Investigators say between 2006 and 2013, de Souza ordered medical professionals working under her at an intensive care unit to alter medication and oxygen levels.

In an interview with CNN affiliate TV Globo, Mario Lobato, the doctor tasked by the health ministry to investigate the case, said the number of deaths could be much higher.

He said his team is analyzing medical charts of more than 1,700 patients and interviewing more doctors.

During the seven years the incidents occurred, in cases where de Souza did not prescribe the drugs herself, she ordered other doctors to change mechanical ventilation devices, according to authorities. She allowed them access to medical records to issue prescriptions in her name, police said.

De Souza has pleaded not guilty.

Her lawyer, Elias Mattar Assad, said she will prove that her orders in the ICU were backed and justified by medical literature. Lobato, however, said some of the patients were awake and conscious moments before the drugs were administered.

CNN affiliate TV Record reported that the investigation began a year ago. In telephone recordings made with the consent of the justice department, de Souza ordered other medical doctors and employees to shut down some ventilation devices.

Euthanasia is considered a crime in Brazil.

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Get Ready!  It’s coming to every hospital in every country around the world!

iatro 77