The Alarming Truth About Unreported Medical Errors

When someone goes to the hospital, they expect to receive high-quality, safe care that will help them recover from their illness or injury. Unfortunately, the reality is that medical errors are far more common than most people realize, and the true scale of the problem is being severely underreported.

As reported by PBS earlier this month, a recent study published in the health policy journal Health Affairs found that roughly one out of every three people encounter an "adverse event" - such as a hospital-acquired infection or a complication from the wrong medication - when they are admitted to a hospital. Even more disturbing, the study found that about 90% of all hospital mistakes go unreported.

This is a theme that medical malpractice lawyer, Sean Domnick, Shareholder at Rafferty Domnick Cunningham & Yaffa, has seen develop not recently but over the past decades.

“That 90% of hospital errors go unreported should be a national scandal on the front of every newspaper. How are we supposed to make intelligent, informed choices about our options when we need medical care if we can’t trust the medical mistakes are being accurately reported?”

Indeed, this is not a new problem. In 1999, a landmark report by the Institute of Medicine estimated that as many as 98,000 Americans may die each year from hospital mistakes. Since then, numerous studies have continued to highlight the growing issue of medical errors, but progress in addressing the problem has been painfully slow.

The same report indicates that healthcare providers are often reluctant to report errors due to a culture of fear, lack of feedback, and poor understanding of what constitutes a medical error.

"Fear of consequences is the most reported barrier" to reporting medical errors, found a systematic review of 30 studies on this topic. Providers worry about facing disciplinary action, lawsuits, or damage to their professional reputation if they admit to making a mistake. This fear is pervasive across different healthcare settings and management styles, and even the option to report errors anonymously does not seem to eliminate this barrier.

Another significant reason for underreporting is the lack of feedback from hospital administration. When healthcare providers report errors, they often do not receive sufficient information about the actions taken to address the issue or the measures implemented to prevent similar errors in the future. This absence of transparency and follow-up can discourage them from reporting subsequent mistakes.

The culture and climate within a healthcare organization also play a vital role. Research indicates that when hospital leaders primarily blame individuals for errors instead of tackling systemic issues, the reporting of medical errors tends to decline. In contrast, environments that emphasize teamwork, psychological safety, and proactive error prevention programs typically experience higher rates of error reporting.

Perhaps most troublingly, many healthcare providers simply lack a clear understanding of what constitutes a medical error and the importance of reporting them. This knowledge gap means that numerous mistakes likely go unrecognized and unreported.

The consequences of this underreporting are severe. By failing to accurately track and analyze medical errors, hospitals and the healthcare system as a whole are missing critical opportunities to learn from mistakes and implement effective solutions to improve patient safety.

"We can't develop safer healthcare without identifying and analyzing medical errors when they happen," wrote the authors of a Harvard Health article. They called for the creation of a national database of medical errors to facilitate quality improvement and prevention research.

Domnick believes that this national database would be “a significant step forward in recognizing and memorializing the totality of medical errors in the nation. We should be aiming at having at least 90% of medical errors properly reported and recorded, not the abysmal inverse that exists today.”

Encouragingly, some healthcare institutions are starting to recognize the importance of openly addressing medical errors. The Harvard article's author, a physician, described how their own institution has embraced a culture of error reporting, with an easy-to-use online system that colleagues use to document everything from mislabeled lab samples to patient falls.

"Worried that these types of reports reflect more mistakes being made than normal? Think again: as the data supports, the vast majority of medical mistakes simply go unreported," the author wrote, "The true number of medical errors, both fatal and non-fatal, is unknown. What we do know is that healthcare delivery cannot improve if these are not examined."

By shining a light on medical errors and creating an environment where providers feel safe to report them, healthcare organizations can take the first step towards meaningful progress. As the author's personal experience illustrates, owning up to mistakes and using them as learning opportunities can lead to valuable improvements in patient safety.

"If we don't own our errors, we are destined to repeat them," the author concluded. "In medicine, honesty is truly the best policy."

The stakes are high and getting higher by the day. 

Estimates from a UCSF Ambulatory Safety Center for Innovation article suggest that medical errors may be the third leading cause of death in the United States, behind only heart disease and cancer. While the exact numbers are difficult to pin down due to underreporting, the scale of the problem is undeniable.

It's time for the healthcare industry to confront this crisis head-on. By fostering a culture of transparency, accountability, and continuous learning, hospitals and providers can start to chip away at the silent epidemic of medical errors. Patients deserve nothing less than the highest standard of safe, quality care - and it's up to the healthcare system to deliver.