BMJ Study Finds 1 in 3 Patients Harmed by Surgical Medical Errors

A 2024 study published in the British Medical Journal (BMJ) on surgical safety has revealed that more than one-third of patients experience complications during or following surgery, with a significant proportion linked to preventable medical errors. Despite advances in patient care, the findings underscore ongoing concerns about the safety of hospital procedures and the widespread impact of medical errors on patient outcomes.¹

The study analyzed over 1,000 surgical admissions across 11 hospitals in Massachusetts in 2018. Researchers found that 38 percent of the patients experienced some form of adverse event, with nearly half of these being classified as major, life-threatening, or fatal. Additionally, 25 percent of all patients encountered potentially preventable surgery complications, with 10 percent experiencing events that were definitively or probably preventable.²

The study emphasized that many of these complications stem from issues within surgical procedures themselves, with 49 percent of adverse events directly linked to the surgery. The remaining incidents were largely attributed to adverse drug reactions (27 percent), healthcare-associated infections (12 percent), and problems arising from patient care (11 percent), such as falls or pressure ulcers. The researchers pointed out that medical errors also occur outside of the operating room, with many incidents happening in general care units, where nearly half (48.8 percent) of the adverse events were recorded.³

Notably, the findings align with earlier research dating back to the 1980s, such as the Harvard Medical Practice Study, which first highlighted the prevalence of medical errors in hospitals. In response to earlier reports like 2000 To Err is Human, published by the National Academies of Sciences Institute of Medicine, hospitals implemented several protocols to improve safety, including surgical checklists and electronic health records. However, this latest study suggests that, despite these improvements, the problem remains widespread.⁴

David Bates, MD, a professor of health policy and management at Harvard’s T.H. Chan School of Public Health, who is a researcher on the study said:

We’re trying to figure out, have things changed? Have they gotten better? It’s clear that the problem has not gone away. If anything, it’s even bigger than it was.⁵

Persistent Issues in Surgical Patient Safety

A key concern raised by the researcher is the role of medical personnel in these incidents. Attending physicians were involved in nearly 90 percent of the adverse events, followed by nurses (58.9 percent) and medical residents (49.5 percent). This highlights the collaborative nature of surgery, where multiple providers interact with patients across various stages of care. The study suggests that addressing errors requires systemic improvements in training, staffing, and communication, both in the operating room and throughout the hospital.⁶

While technological advancements such as electronic health records and surgical safety checklists have been introduced, the study found that these innovations have not fully addressed the underlying problems. Antoine Duclos, MD, PhD, lead researcher on the Massachusetts study, noted that the frequency of adverse events in surgery points to the need for a more comprehensive reassessment of how medical care is structured. Factors such as physician burnout, staff shortages, and inadequate monitoring systems maybe contributing to the persistence of preventable errors.⁷

Further complicating the issue is the significant proportion of medical errors occur outside of the operating room, in settings like the general care unit (48.8 percent of cases) and intensive care units (13 percent). This finding highlights the importance of improving overall patient care beyond the surgical procedure itself. The study’s authors suggest that hospitals need to focus on better coordination among providers, including nurses, surgeons, and other medical staff, to ensure safer outcomes across all stages of care.⁸

Tips for Patients to Minimize Surgical Risks

The study also highlights the importance of patient involvement in reducing surgical risks. David Bates, MD suggests that patients can take proactive steps to help lower their risk of complications. “It’s useful, for example, to know what medications you’re taking and to keep track of what the dosages are,” he said. He also recommended that patients bring a family member or friend with them to the hospital if undergoing surgery, as they can assist in ensuring better communication and provide support during post-operative recovery.

Dr. Bates added:

Often, people who are in the hospital are not that mentally alert. They’re not their usual self or in pain. And so having someone else, either a friend or a loved one, there can be really helpful.⁹

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