New estimates put the number of preventable deaths attributable to medical errors between 210,000 to upwards of 440,000 per year, findings from a meta-analysis of four studies published between 2008 and 2011 indicate.

This is much higher than a previous Institute of Medicine report which estimated as many as 98,000 such deaths take place in U.S. hospitals each year. Released in 2000, the ground breaking IOM report “To Err is Human: Building a Safer Health System,” focused national attention on the problem of medical errors. However, estimates were based on data from 1984, now more than three decades old.

So John T. James, PhD, of Patient Safety America, performed a literature review and identified four studies that relied on the Global Trigger Tool, which flag specific evidence in medical records such as medication stop orders or abnormal laboratory results, that potentially point to adverse events that may have harmed a patient.

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Based on a weighted average from the four studies, and taking into account limitations in search capability and incompleteness of medical records, James estimated the true number of premature deaths associated with preventable harm to patients is more than 400,000 per year. This would make medical errors the third leading cause of death in the United States, after cancer and heart disease.

James, a NASA toxicologist by day, has personal reasons for wanting to bring the problem to light. His 19-year-old son died after what he contends was negligent hospital care.

“In a sense, it does not matter whether the deaths of 100,000, 200,000 or 400,000 Americans each year are associated with [preventable adverse events] in hospitals. Any of the estimates demands assertive action on the part of providers, legislators and people who will one day become patients,” James concluded.


  1. James JT. J Patient Saf. 2013; 9(3):122-128.