Medical errors are now the third leading cause of death in the United States, trailing only heart disease and cancer, according to a study in BMJ.

Martin Makary, MD, and Michael Daniel from the Johns Hopkins University School of Medicine in Baltimore, found that medical errors accounted for more than 251,000 deaths in the US in 2013, compared with 611,000 deaths from heart disease and 585,000 deaths from cancer.

The CDC has compiled an annual list of the most common causes of death in the United States. However, the list is based on death certificates, which rely on International Classification of Disease (ICD) codes to identify the cause of death, and ICD codes do not take into account human and system factors.

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The investigators sought to analyze the scientific literature regarding medical errors that contributed to U.S. deaths and compare those findings with the causes listed by the CDC.

Medical error was defined in the report as an “unintended act (either of omission or commission) or one that does not achieve its intended outcome, the failure of a planned action to be completed as intended (an error of execution), the use of a wrong plan to achieve an aim (an error of planning), or a deviation from the process of care that may or may not cause harm to the patient.”

Using research reported since a 1999 study from the Institute of Medicine found an incidence of 44,000 to 98,000 deaths occurring annually due to medical errors, and extrapolating to the total number of US hospital admissions in 2013, Makary and Daniel found a mean rate of death from medical errors of 251,454 per year. “Comparing our estimate to CDC rankings suggests that medical error is the third most common cause of death in the U.S.,” the researchers stated.

“While many errors are non-consequential, an error can end the life of someone with a long life expectancy or accelerate an imminent death,” the investigators commented. “To achieve more reliable healthcare systems, the science of improving safety should benefit from sharing data nationally and internationalluy, in the same way as clinicians share research and innovation about coronary artery disease, melanoma, and influenza. Sound scientific methods, beginning with an assessment of the problem, are critical to approaching any health threat to patients. The problem of medical error should not be exempt from this scientific approach. More appropriate recognition of the role of medical error in patient death could heighten awareness and guide both collaborations and capital investments in research and prevention.”


  1. Makary MA, Daniel M. Medical error—the third leading cause of death in the US. BMJ. 2016;353:i2139; doi: 10.1136/bmj.i2139. Epub ahead of print May 3, 2016.