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To the Editor: Dr McDonald and colleagues¹ and Dr Leape² discussed the recent Institute of Medicine (IOM) report about medical errors.³ I am concerned, however, that deaths due to errors may mean different things to different people.

Specifically, I question some of the scenarios that Leape notes as examples of errors leading to death. He cites 3 examples: a stroke in a patient with atrial flutter, a patient with a ruptured bowel who was not taken to surgery, and a patient with hypoxemic brain damage due to hemorrhagic shock from splenic rupture. These are not what I think of when I think of errors in the hospital. All of these examples strike me as evidence that medicine is still an art. These are examples of medical judgments that were, in retrospect, wrong. Physicians make dozens or hundreds of such judgments every day, and some of these are sometimes incorrect. Without . . . [Full Text of this Article]

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