In the six years that I have been writing this blog the article that has been consistently viewed the most, year after year, is the one published on September 29, 2008: How often does Medical Malpractice Happen in Canada?
Therefore, I thought it might be useful to take another look at the issue to see if the statics have changed or if there is any new information to shed some light on the question.
The American experience
In 1999 the Institute of Medicine in the United States published To Err is Human: Building a Safer Healthcare System. This landmark report investigated patient safety in American hospitals. The authors concluded that between 44,000 to 98,000 preventable deaths happened every year in hospitals across the United States because of medical errors.
The shocking numbers were a wake-up call to Americans. However, subsequent studies found that medical errors and their fatal consequences may be even more prevalent than suggested in the Institute of Medicine Report.
For example, the journal Health Affairs published a report in 2011 indicating that adverse events (medical mistakes or errors) happen in up to 1/3 of all hospital admissions, a figure 10 times greater than previous estimates.
In 2012 Wolters Kluwer Health reported that almost 1/3 of Americans had a family member or friend that had experienced a medical error.
The Canadian experience
In 2004 the Canadian Medical Association published “The Canadian Adverse Events Study: The Incidence of Adverse Events in Hospital Patients in Canada”. Despite our public belief (hope?) that the Canadian health care system is somehow better or more efficient than the United States the CMA report confirmed that medical errors were just as prevalent in Canada as in the United States.
The Canadian Adverse Events Study concluded:
7.5% of patients admitted to acute care hospitals experienced an adverse event.
Approximately 24,000 Canadian patients die every year as a result of adverse events in hospitals. Keep in mind this figure does not include deaths that happen as a result of medical negligence that occurs outside the hospital setting.
Here in Canada the Canadian Institute for Health Information has reported that more than 5 million Canadians (approximately 1/4) of all Canadian adults have reported that they, or a family member, had experienced a “preventable adverse event” in other words, a medical error.
Health Care Quarterly published a study in 2009 that 1 in 6 Canadians (about 4.2 million people) reported that they had experienced a medical error in the previous two years.
A report published in 2012 called attention to the "epidemic" of fatal medical errors in Canada stating between 38,000 to 43,000 deaths happen every year in Canada as a result of failed health care. According to the authors of the report, the actual number of deaths across the country is likely much higher because of high rates of non-reporting.
The Canadian Adverse Events Study found that 37% of adverse events were “highly” preventable and almost 1/4 of adverse events (24%) were due to medication errors.
The economic cost of medical errors across Canada is hard to comprehend. A study published by the Canadian and Patient Safety Institute in 2012 estimated that the economic cost of preventable medical errors between 2009 and 2010 (one year) was $397,000,000.00.
Again it is important to point out that this estimate represents only a small fraction of the entire cost of medical errors across Canada because the report did not include costs incurred after discharge from hospital. The long term cost of caring for a disabled person or a severely injured child can amount to tens of thousands or even hundreds of thousands of dollars per year.
Many errors, few claims
Despite the thousands of medical errors that occur across Canada every year only a comparatively few medical malpractice lawsuits are filed in Canada every year.
Why don’t Canadians file medical malpractice claims?
There are any number of reasons why there are comparatively few medical malpractice lawsuits filed in Canada every year. I explored some of these reasons in my previous article.
Maybe Canadians are less litigious than Americans. Sometimes medical errors don't cause significant (or any) injury. The National Post explored this question in an article published last year.
I believe the main reason Canada has so few medical malpractice lawsuits is the fact that most patients simply do not know that they may have been the victim of medical malpractice.
Given that there are no national standards requiring the disclosure of medical errors to patients, many potential victims of medical malpractice are never told there was an error made in their care that may have caused or contributed to their injuries.
The Canadian Patient Safety Institute created a committee to draft national guidelines for the disclosure of adverse events. The draft national guidelines were provided to national and provincial health care organizations in 2007 with a request for their feedback.
CPSI published the results of their consultation in 2008. While 81% of the organizations surveyed stated that their organization had a policy for disclosure of adverse events, more than half (53%) said that the organization did not offer training regarding the disclosure of adverse events to patients and family members.
Until there are mandatory rules requiring disclosure of adverse events to Canadians I expect many victims of medical errors are going to suffer without knowing the reason for their injuries, without being provided the opportunity to find out what happened to them, and without being provided an opportunity to seek appropriate compensation.