About 6 weeks ago, I wrote a post called “Overestimating the effect of medical errors can be detrimental.” I cited a few examples of blind acceptance of the massively flawed BMJ paper “Medical error — the third leading cause of death in the US” by Makary and Daniel.

In my post, I wrote that without critical analysis naïve journalists had accepted as facts that 251,000 deaths were caused by medical errors — now the third leading cause of death in the US.

Unfortunately I underestimated the severity of the problem. Here are some examples of the continuing misinterpretation of “Medical error — the third leading cause of death in the US.” Notice how uncritically the numbers are reported.

A website called Public Source stated, “Heart disease is the culprit in one in every four deaths. Cancer took more than 591,000 lives in 2014. According to researchers at Johns Hopkins University, the next leading cause of death is medical errors.”

From NBC News Washington, “A recent study found medical errors cause up to 250,000 deaths each year in this country.”

Health Leaders Media: “We’ve all heard harrowing stories about medical errors. They are the third leading cause of death in the U.S., estimated to be responsible for more than 250,000 deaths per year.”

Dallas-Fort Worth Healthcare Daily: “…research by surgeons at Baltimore’s Johns Hopkins School of Medicine, proclaims that medical errors kill more Americans than anything except heart disease and cancer. That study, published in May in The BMJ medical journal, argued that more than 250,000 Americans die from medical error each year.”

The Seattle Times: “Medical errors are the third leading cause of death in the U.S. — exceeded only by heart disease and cancer — according to a recent analysis by surgeons at Johns Hopkins Medicine in Baltimore. More than 250,000 Americans die from medical mistakes each year, the authors estimated…”

I could cite many more such examples.

Two of the most egregious misuses of the misleading data in the BMJ paper are as follows:

During a speech in Albany, New York, the sheriff of Milwaukee (Wisconsin) County, David Clark, said he didn’t like outsiders criticizing the police adding, “That would be akin to me trying to transform the medical community after a botched surgery when I know nothing about the medical community. I’m not educated in it, I’m not trained in it. By the way, did you know that doctors kill about 250,000 people a year in botched surgeries?”

Politifact Wisconsin took Mr. Clark to task about his statement, pointing out that the paper was not about botched surgeries and was merely an estimate.

The second misuse of the estimate is one I predicted in my previous post — that the BMJ paper would embolden anti-vaccine advocates and “natural healers” who see mainstream medicine as evil incarnate.

In the Huffington Post, alternative medicine advocate John Weeks wrote, “Then came the whap to all of our faces of the British Medical Journal article reminder that medicine, in the USA, is the nation’s third most powerful cause of death.” [That’s a direct quote.]

Weeks followed this with another piece asking why the Makary study had not been published in an US journal. He said Makary emailed him this: NEJM said not relevant to practicing docs. JAMA said pass. So we went to next highest impact journal [in] medicine.”

Weeks surmised that the US journals rejected the paper because it was critical of mainstream medicine soWhat else should be expected of an industry gone so awry?”

I thought I had seen the worst of these stories until CNN published another misinterpretation of data on August 10.

Snipped CNN

Not long after the screen shot went viral on Twitter, the following correction appeared: “An earlier version of this article misstated the estimated number of Americans who die each year from surgical errors. It is 200,000.”

However, this is yet another misreading. Those patients died with complications, not all of which were due to surgical errors nor were they all preventable.

And some people wonder why I am so critical of studies like Makary’s.


Skeptical Scalpel is a retired surgeon and was a surgical department chairman and residency program director for many years. He is board-certified in general surgery and a surgical sub-specialty and has re-certified in both several times. For the last six years, he has been blogging at SkepticalScalpel.blogspot.com and tweeting as @SkepticScalpel. His blog has had more than 2,500,000 page views, and he has over 15,500 followers on Twitter.