DRUG IATROGENESIS (DOCTOR CAUSED DEATH)

Prescription drugs constitute the major treatment modality of scientific medicine. With the discovery
of the “germ theory,” medical scientists convinced the public that infectious organisms were the cause
of illness. Finding the “cure” for these infections proved much harder than anyone imagined. >From the
beginning, chemical drugs promised much more than they delivered. But far beyond not working, the
drugs also caused incalculable side effects. The drugs themselves, even when properly prescribed,
have side effects that can be fatal, as Lazarou's study(1) showed. But human error can make the situation
even worse.  

Medication Errors
A survey of a 1992 national pharmacy database found a total of 429,827 medication errors from 1,081
hospitals. Medication errors occurred in 5.22% of patients admitted to these hospitals each year. The
authors concluded that at least 90,895 patients annually were harmed by medication errors in the US
as a whole.(37) A 2002 study shows that 20% of hospital medications for patients had dosage errors.
Nearly 40% of these errors were considered potentially harmful to the patient. In a typical 300-patient
hospital, the number of errors per day was 40.(38) Problems involving patients' medications were even
higher the following year. The error rate intercepted by pharmacists in this study was 24%, making the
potential minimum number of patients harmed by prescription drugs 417,908.(39) Recent Adverse
Drug Reactions
 
More-recent studies on adverse drug reactions show that the figures from 1994 published in Lazarou's
1998 JAMA article may be increasing. A 2003 study followed 400 patients after discharge from a tertiary
care hospital setting (requiring highly specialized skills, technology, or support services). Seventy-six patients
(19%) had adverse events. Adverse drug events were the most common, at 66% of all events. The next most
common event was procedure-related injuries, at 17%.(40) In a New England Journal of Medicine study, an
alarming one in four patients suffered observable side effects from the more than 3.34 billion prescription
drugs filled in 2002.(41) One of the doctors who produced the study was interviewed by Reuters and
commented, "With these 10-minute appointments, it's hard for the doctor to get into whether the symptoms
are bothering the patients."(42) William Tierney, who editorialized on the New England Journal study, said
“… given the increasing number of powerful drugs available to care for the aging population, the problem
will only get worse.” The drugs with the worst record of side effects were selective serotonin reuptake inhibitors
( SSRIs), nonsteroidal anti-inflammatory drugs (NSAIDs), and calcium-channel blockers. Reuters also reported
that prior research has suggested that nearly 5% of hospital admissions (over 1 million per year) are the result
of drug side effects. But most of the cases are not documented as such. The study found that one of the reasons
for this failure is that in nearly two-thirds of the cases, doctors could not diagnose drug side effects or the side
effects persisted because the doctor failed to heed the warning signs. (cont)