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To the Editor: In their Controversies article about medical errors, Leape and colleagues¹ praise the safety record of anesthesiology: "Everyone . . . agrees that the current practice of anesthesia provides an outstanding example of how a high level of safety can be achieved in health care. Anesthesia is the only system in health care that begins to approach the vaunted ‘six sigma' level of perfection that other industries strive for. Mortality from elective anesthesia has declined 10-fold in the past several decades as the result of a concerted effort to improve safety." Similarly, the Institute of Medicine (IOM) report To Err Is Human: Building a Safer Health System stated: "Studies . . . indicate that, today, anesthesia mortality rates are about one death per 200,000-300,000 anesthetics administered, compared with two deaths per 10,000 anesthetics in the early 1980s."²

The improvement has actually been considerably less than those reports suggest. . . . [Full Text of this Article]

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