'India records 5.2 million medical injuries a year' -Kounteya Sinha

LONDON: India is recording a whopping 5.2 million injuries each year due to medical errors and adverse events.

Of these, the biggest sources are mishaps from medications, hospital-acquired infections and blood clots that develop in legs from being immobilized in the hospital.

Similarly, approximately 3 million years of healthy life are lost in India each year due to these injuries.

A landmark report by an Indian doctor from Harvard School of Public Health has concluded that more than 43 million people are injured worldwide each year due to unsafe medical care.

These injuries result in the loss of nearly 23 million years of healthy life (DALYs).

The findings for the first time tries to quantify the global burden of unsafe medical care across a range of adverse health events.

Premature death was the biggest driver of DALYs lost - 78.6% of all adverse events in high-income countries and 80.7% in low- and middle-income countries.

However, disability was more common than death itself, the study found.

The researchers also found that a large majority - about two-thirds - of injuries and harm occur in low- and middle-income countries like India.

For every 100 hospitalizations, there were approximately 14.2 adverse events in high-income countries and 12.7 in low- and middle-income countries.

The number of DALYs lost was more than twice as high in low- and middle-income countries (15.5 million) as it was in high-income countries (7.2 million).

The most common adverse events in high-income countries were adverse drug events (incidence rate 5%). The most common adverse events in low- and middle-income countries were blood clots in veins (incidence rate 3%).

"This is the first attempt to quantify the human suffering that results from unsafe care," said lead author Ashish Jha, professor of health policy and management at HSPH. "We find that millions of people around the world are hurt, disabled and sometimes even die as a result of medical errors".

Speaking to TOI, Dr Jha said "unfortunately, our data from India is among the poorest - there have been very few studies done on this topic and so we are making estimations based on a global average for low and middle income countries, with only a few data inputs from India itself".

HSPH researchers, along with colleagues at the Patient Safety Programme of the World Health Organization (WHO) and the RTI International in Durham used data from more than 4,000 articles that have been published over the previous few decades that focused on adverse events in hospitals, as well as from epidemiologic studies commissioned by WHO aimed at estimating how much these events harmed patients.

They examined seven different adverse outcomes that can occur while patients are hospitalized - injuries due to medications, catheter-related urinary tract infections, catheter-related blood stream infections, hospital-acquired pneumonia, blood clots in veins, falls and bedsores.

WHO has earlier said that over seven million people across the globe suffer from preventable surgical injuries every year, a million of them even dying during or immediately after the surgery.

The UN body quantified the number of surgeries taking place every year globally - 234 million. It said surgeries had become common, with one in every 25 people undergoing it at any given time. China conducted the highest number of surgeries followed by Russia and India. In developing countries, the death rate was nearly 10% for a major surgery. Mortality from general anaesthesia affected one in 150 patients while infections were reported in 3% of surgeries with the mortality rate being .5%. Nearly 50% of the adverse effects of surgery were preventable.

The authors noted that, taken together, the seven types of adverse impacts examined in the study rank as the 20th leading cause of morbidity and mortality for the world's population. However, they added, there are many other types of adverse events not examined in this study - such as the use of infected needles, tainted blood products, or counterfeit drugs - that would likely raise the estimates of DALYs lost substantially.

"When patients are sick, we find that they are too often injured from the care that is meant to heal them," said Dr Jha.

Britain's NHS has put in place a list of 25 'never events' - incidents that can cause severe harm or death and that should never happen because we already have guidance and tools to prevent them.

In 2011 to 2012, 326 never events were reported to strategic health authorities.