DEATH BY MEDICINE
Each year approximately 2.2 million US hospital patients experience adverse drug reactions (ADRs) to prescribed medications... Approximately 7.5 million unnecessary medical and surgical procedures are performed annually in the US, while approximately 8.9 million Americans are hospitalized unnecessarily.
Deaths induced inadvertently by a physician or surgeon or by medical treatment or diagnostic procedures [aka 'Iatrogenesis'] in the US annually is 783,936. By comparison, approximately 699,697 Americans died of heart disease in 2001, while 553,251 died of cancer.
US health care spending reached $1.6 trillion in 2003, representing 14% of the nation's gross national product. Considering this enormous expenditure, we should have the best medicine in the world. We should be preventing and reversing disease, and doing minimal harm. Careful and objective review, however, shows we are doing the opposite. Because of the extraordinarily narrow, technologically driven context in which contemporary medicine examines the human condition, we are completely missing the larger picture.
As few as 5% and no more than 20% of iatrogenic acts are ever reported. This implies that if medical errors were completely and accurately reported, we would have an annual iatrogenic death toll much higher than 783,936. In 1994, Leape [a Harvard University researcher] said his figure of 180,000 medical mistakes resulting in death annually was equivalent to three jumbo-jet crashes every two days. Our considerably higher figure is equivalent to six jumbo jets are falling out of the sky each day.
Our estimated 10-year total of 7.8 million iatrogenic deaths is more than all the casualties from all the wars fought by the US throughout its entire history.
A 2003 study found that nearly half of medical school faculty who serve on institutional review boards to advise on clinical trial research also serve as consultants to the pharmaceutical industry.
In June 2002, the New England Journal of Medicine announced that it would accept journalists who accept money from drug companies because it was too difficult to find ones who have no ties..... In l981 the drug industry “gave” $292 million to colleges and universities for research. By l991, this figure had risen to $2.1 billion.
Leape focused on the “Harvard Medical Practice Study” published in 1991........ Why Leape chose to use the much lower figure of 4% injury for his analysis remains in question. Using instead the average of the rates found in the three studies he cites (36%, 20%, and 4%) would have produced a 20% medical error rate. The number of iatrogenic deaths using an average rate of injury and his 14% fatality rate would be 1,189,576.
In 1995, a JAMA report noted, "Over a million patients are injured in US hospitals each year, and approximately 280,000 die annually as a result of these injuries.... An October 2003 JAMA study from the US government's Agency for Healthcare Research and Quality (AHRQ) documented 32,000 mostly surgery-related deaths costing $9 billion and accounting for 2.4 million extra hospital days in 2000.
An analysis by Wald and Shojania found that only 1.5% of all adverse events result in an incident report.
A 2002 study shows that 20% of hospital medications for patients had dosage errors. Nearly 40% of these errors were considered potentially harmful to the patient. In a typical 300-patient hospital, the number of errors per day was 40.
In a New England Journal of Medicine study, an alarming one in four patients suffered observable side effects from the more than 3.34 billion prescription drugs filled in 2002.
According to William Agger, MD, director of microbiology and chief of infectious disease at Gundersen Lutheran Medical Center in La Crosse, WI, 30 million pounds of antibiotics are used in America each year. Of this amount, 25 million pounds are used in animal husbandry, and 23 million pounds are used to try to prevent disease and the stress of shipping, as well as to promote growth. Only 2 million pounds are given for specific animal infections.... In the US, over 3 million pounds of antibiotics are used every year on humans. With a population of 284 million Americans, this amount is enough to give every man, woman, and child 10 teaspoons of pure antibiotics per year.
In 1989, German biostatistician Ulrich Abel, PhD, wrote a monograph entitled “Chemotherapy of Advanced Epithelial Cancer.” Abel presented a comprehensive analysis of clinical trials and publications representing over 3,000 articles examining the value of chemotherapy on advanced epithelial cancer. Epithelial cancer is the type of cancer with which we are most familiar, arising from epithelium found in the lining of body organs such as the breast, prostate, lung, stomach, and bowel. From these sites, cancer usually infiltrates adjacent tissue and spreads to the bone, liver, lung, or brain. With his exhaustive review, Abel concluded.... “Many oncologists take it for granted that response to therapy prolongs survival, an opinion which is based on a fallacy and which is not supported by clinical studies.”
In 1974, 2.4 million unnecessary surgeries were performed, resulting in 11,900 deaths at a cost of $3.9 billion. In 2001, 7.5 million unnecessary surgical procedures were performed, resulting in 37,136 deaths at a cost of $122 billion (using 1974 dollars).
In 1978, the US Office of Technology Assessment (OTA) reported: “Only 10-20% of all procedures currently used in medical practice have been shown to be efficacious by controlled trial." In 1995, the OTA compared medical technology in eight countries (Australia, Canada, France, Germany, the Netherlands, Sweden, the UK, and the US ) and again noted that few medical procedures in the US have been subjected to clinical trial. It also reported that US infant mortality was high and life expectancy low compared to other developed countries.
In 1983, 809,000 cesarean sections (21% of live births) were performed in the US, making it the nation's most common obstetric-gynecologic (OB/GYN) surgical procedure. In 2001, cesarean section is still the most common OB/GYN surgical procedure. Approximately 4 million births occur annually, with 24% (960,000) delivered by cesarean section. In the Netherlands, only 8% of births are delivered by cesarean section.