Death by Medicine -2
Gary Null PhD, Carolyn Dean MD ND, Martin Feldman MD, Debora Rasio MD
November 2003

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ABSTRACT
A definitive review and close reading of medical peer-review journals, and government health statistics shows that American medicine frequently causes more harm than good. The number of people having in-hospital, adverse drug reactions (ADR) to prescribed medicine is 2.2 million.¹ Dr. Richard Besser, of the CDC, in 1995, said the number of unnecessary antibiotics prescribed annually for viral infections was 20 million. Dr. Besser, in 2003, now refers to tens of millions of unnecessary antibiotics.^{2, 2a} The number of unnecessary medical and surgical procedures performed annually is 7.5 million.³ The number of people exposed to unnecessary hospitalization annually is 8.9 million.⁴  The total number of iatrogenic deaths shown in the following table is 783,936. It is evident that the American medical system is the leading cause of death and injury in the United States. The 2001 heart disease annual death rate is 699,697; the annual cancer death rate, 553,251.⁵

TABLES AND FIGURES (see Section on Statistical Tables and Figures, below, for exposition)

ANNUAL PHYSICAL AND ECONOMIC COST OF MEDICAL INTERVENTION

We could have an even higher death rate by using Dr. Lucien Leape’s 1997 medical and drug error rate of 3 million. ¹⁴ Multiplied by the fatality rate of 14% (that Leape used in 1994⁾¹⁶ we arrive at an annual death rate of 420,000 for drug errors and medical errors combined. If we put this number in place of Lazorou’s 106,000 drug errors and the Institute of Medicine’s (IOM) 98,000 medical errors (which may have a drug error overlap with Lazorou¹s study), we could add another 216,000 deaths making a total of 999,936 deaths annually.

ANNUAL UNNECESSARY MEDICAL EVENTS STATISTICS

The enumerating of unnecessary medical events is very important in our analysis. Any medical procedure that is invasive and not necessary must be considered as part of the larger iatrogenic picture. Unfortunately, cause and effect go unmonitored. The figures on unnecessary events represent people (“patients”) who are thrust into a dangerous healthcare system. They are helpless victims. Each one of these 16.4 million lives is being affected in a way that could have a fatal consequence. Simply entering a hospital could result in the following:

1. In 16.4 million people, 2.1% chance of a serious adverse drug reaction,1 (186,000)

2. In 16.4 million people, 5-6% chance of acquiring a nosocomial infection,9 (489,500)

3. In16.4 million people, 4-36% chance of having an iatrogenic injury in hospital (medical error and adverse drug reactions),16 (1.78 million)

4. In 16.4 million people, 17% chance of a procedure error,40 (1.3 million)

All the statistics above represent a one-year time span. Imagine the numbers over a ten-year period. Working with the most conservative figures from our statistics we project the following 10-year death rates.

TEN-YEAR DEATH RATES FOR MEDICAL INTERVENTION

Our projected statistic of 7.8 million iatrogenic deaths is more than all the casualties from wars that America has fought in its entire history. 

Our projected figures for unnecessary medical events occurring over a 10-year period are also dramatic.

TEN-YEAR STATISTICS FOR UNNECESSARY INTERVENTION

These projected figures show that a total of 164 million people, approximately 56% of the population of the United States, have been treated unnecessarily by the medical industry – in other words, nearly 50,000 people per day.

We have added, cumulatively, figures from 13 references of annual iatrogenic deaths. However, there is invariably some degree of overlap and double counting that can occur in gathering non-finite statistics. Death numbers don’t come with names and birth dates to prevent duplication On the other hand, there are many missing statistics. As we will show, only about 5 to 20% of iatrogenic incidents are even recorded. ^{(16,24,25,33,34)} And, our outpatient iatrogenic statistics ⁽¹¹²⁾ only include drug-related events and not surgical cases, diagnostic errors, or therapeutic mishaps.

We have also been conservative in our inclusion of statistics that were not reported in peer review journals or by government institutions. For example, on July 23, 2002, The Chicago Tribune analyzed records from patient databases, court cases, 5,810 hospitals, as well as 75 federal and state agencies and found 103,000 cases of death due to hospital infections, 75% of which were preventable.⁽¹⁵²⁾ We do not include this figure but report the lower Weinstein figure of 88,000. ⁽⁹⁾ Another figure that we withheld, for lack of proper peer review was The National Committee for Quality Assurance, September 2003 report which found that at least 57,000 people die annually from lack of proper care for commons diseases such as high blood pressure, diabetes, or heart disease. ⁽¹⁵³⁾

Overlapping of statistics in Death by Medicine may occur with the Institute of Medicine (IOM) ⁽⁶⁾ paper that designates "medical error" as including drugs, surgery, and unnecessary procedures. Since we have also included other statistics on adverse drug reactions, surgery and, unnecessary procedures, perhaps a much as 50% of the IOM number could be redundant. However, even taking away half the 98,000 IOM number still leaves us with iatrogenic events as the number one killer at 738,000 annual deaths.

Even greater numbers of iatrogenic deaths will eventually come to light when all facets of health care delivery are measured. Most iatrogenic statistics are derived from hospital-based studies. However, health care is no longer typically relegated to hospitals. Today, health care is shared by hospitals, outpatient clinics, transitional care, long-term care, rehabilitative care, home care, and private practitioners offices. In the current climate of reducing health-care costs, the number of hospitals and the length of patient stays are being slashed. These measures will increase the number of patients shunted into outpatient, home care, and long-term care and the iatrogenic morbidity and mortality will also increase.

© 2003 Gary Null & Associates, Inc. (GNA)
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