The Institute of Medicine Report on Medical Errors

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Abstract
Brennan (April 13 issue)1 misrepresents several of the important messages of the Institute of Medicine (IOM) report entitled “To Err is Human.”2 He implies that the studies used by the IOM exaggerated the extent of preventable medical injuries because “neither study . . . involved judgments by the physicians reviewing medical records about whether the injuries were caused by errors.” This is not so. In the same issue of the Journal that contained the report of the results of the 1984 Harvard Medical Practice Study3 is a companion paper on the nature of adverse events in hospitalized patients.4 It states that, “in addition, the reviewers were asked to indicate whether each adverse event could have been caused by a reasonably avoidable error, defined as a mistake in performance or thought.”4 The study conducted in Colorado and Utah in 1992, which was cited in the IOM report, used similar methods.5