You have a greater chance of dying of medical errors than of stroke, Alzheimer's, diabetes, the flu, pneumonia, or car crashes. That's according to a new analysis from researchers at the Johns Hopkins University School of Medicine in Baltimore.

They looked at research going back to 1999 and calculated that an estimated 251,454 Americans a year die from medical errors in hospitals—things such preventable infections, drug errors, mistaken diagnoses, and poor communication, especially upon discharge. In fact, medical errors account for more deaths than all other causes of death except for heart disease and cancer, according to this analysis.

And that likely underestimates the problem, say the study authors, Martin Makary, M.D., and Michael Daniel, M.D. "We believe this understates the true incidence of death due to medical error because the studies cited rely on errors extractable in documented health records and include only inpatient deaths," they wrote in their paper, which was published on May 3 by the BMJ.

In fact, previous research suggests that as many as 440,000 Americans a year die from medical errors in hospitals.

Part of the problem in establishing firm numbers, Makary and Daniel write, is that the Centers for Disease and Control and Prevention does not require that death certificates record medical errors. Currently, death certificates rely on assigning an International Classification of Disease (ICD) code to the cause of death—so deaths not associated with an ICD code, such as human and system errors, are not captured.

Makary and Daniel believe that preventing deadly errors in hospitals requires a multipronged approach, starting with greater accountability among hospitals to record and respond to medical errors. For example, they believe that hospitals should investigate all deaths to see if errors were a contributing factor.

Lisa McGiffert, the director of Consumer Report's Safe Patient Project, agrees that the CDC should require death certificates to include medical errors. "That would give us the data we need to really understand the scope of the problem, and also force hospitals to acknowledge how common and serious the situation is—and take steps to correct it, too."

Leading Causes of Death in the U.S.

Listed here are the top causes of death in the U.S. for 2015 based on data from the Centers for Disease Control and Prevention and the estimated number of deaths from medical errors in the new BMJ study.

• Heart disease: 614,348

• Cancer: 591,699

• Medical errors: 251,454
  

• Chronic lower respiratory diseases: 147,101

• Accidents (unintentional injuries): 136,053

• Stroke (cerebrovascular diseases): 133,103

• Alzheimer's disease: 93,541

• Diabetes: 76,488

• Influenza and pneumonia: 55,227

• Kidney diseases: 48,146

• Suicide: 42,773

• Firearms: 33,636

• Motor vehicles: 32,675
  

3 Tip For Staying Safe in the Hospital

One way to avoid medical errors is to avoid dangerous hospitals. Consumer Reports' hospital Ratings can help you do that by comparing hospitals across the country on infections, readmissions, and other measures of patients safety.

And Lisa McGiffert, of our Safe Patient Project, recommends these three steps as the most important to do to stay safe in the hospital and prevent medical errors:

1. Insist on clean hands: Ask everyone who walks into your room whether they’ve washed their hands (and if they’re doing it at your sink, ask them to scrub for 40 to 60 seconds). Simply rubbing on alcohol-based hand sanitizer is not enough to destroy certain bacteria, such as the dangerous C. diff. Read our report, "How Your Hospital Can Make You Sick."

2. Have a friend or family member with you. Hospitals are often chaotic places. Having someone else on hand can help you catch mistakes, ask questions, and keep notes. The most important times to have a companion on hand for hospital safety are on weekends and holidays, when staff is reduced, and when shifts change, which is when errors often happen. Having a companion with you can also ensure that the staff sees you as a real person, and treats you with respect.

3. Keep a record. Keep a pad and pen within arm’s reach so that you or your companion can write down when doctors see you, which drugs you receive and when, and any questions you have. If you spot something that seems unusual or that seems to jeopardize hospital safety—such as a medication you don’t recognize—write that down or take a picture of it with your phone. You can also use your phone to record your thoughts or your conversations with nurses and doctors. “Just explain that you are recording so you can remember later,” McGiffert says. “Hospital staff should have no reason to object.”

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