First, do no harm

Medical care: a high risk activity?

A report released by the Institute of Medicine of the National Academy of Sciences in the USA estimates that between 44,000 and 98,000 Americans die from medical errors each year – more than the number who die from motor vehicle accidents. According to Dr Kenneth Kizer, former head of the Veterans Administration, it is not surprising that errors occur, given the complexity of health care. ‘What is surprising’, he said, ‘is that health care has lagged so far behind other high-risk activities in risk reduction’.

The authors of a commentary in The Lancet noted that errors in the execution of an act (slips of action or lapses of memory) are more likely to occur when people are tired, stressed, distracted or in unfamiliar surroundings – ‘almost a caricature of medical life’, they wrote.