Medical error is the third leading cause of death in the US after heart disease and cancer, experts have said.
While accurate data on deaths associated with medical error is lacking, recent estimates suggest a range of 210,000 to 400,000 deaths a year among hospital patients in the US.
Using studies from 1999 onwards - and extrapolating to the total number of US hospital admissions in 2013 - the researchers calculated a mean rate of death from medical error of 251,454 a year.
Comparing their estimate to the annual list of the most common causes of death in the US, compiled by the Centers for Disease Control and Prevention (CDC), suggests that medical error is the third most common cause of death in the US.
"Although we cannot eliminate human error, we can better measure the problem to design safer systems mitigating its frequency, visibility, and consequences," the researchers said in the article published in the journal The BMJ.
Death certificates in the US have no facility for acknowledging medical error, lamented the researchers Martin Makary and Michael Daniel from Johns Hopkins University School of Medicine in Baltimore.
Currently, death certification in the US relies on assigning an International Classification of Disease (ICD) code to the cause of death - so causes of death not associated with an ICD code, such as human and system factors, are not captured.
The researchers suggested three strategies to reduce death from medical care - making errors more visible when they occur so their effects can be intercepted, having remedies at hand to rescue patients, and making errors less frequent by following principles that take human limitations into account.
For instance, instead of simply requiring cause of death, they suggest that death certificates could contain an extra field asking whether a preventable complication stemming from the patient's medical care contributed to the death.
Another strategy would be for hospitals to carry out a rapid and efficient independent investigation into deaths to determine the potential contribution of error.
Measuring the consequences of medical care on patient outcomes "is an important prerequisite to creating a culture of learning from our mistakes, thereby advancing the science of safety and moving us closer towards creating learning health systems," the researchers noted.
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