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Lucian L. Leape, MD

JAMA. 1994;272(23):1851-1857.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

FOR YEARS, medical and nursing students have been taught Florence Nightingale's dictum—first, do no harm.¹ Yet evidence from a number of sources, reported over several decades, indicates that a substantial number of patients suffer treatment-caused injuries while in the hospital.^2-6

In 1964 Schimmel² reported that 20% of patients admitted to a university hospital medical service suffered iatrogenic injury and that 20% of those injuries were serious or fatal. Steel et al³ found that 36% of patients admitted to a university medical service in a teaching hospital suffered an iatrogenic event, of which 25% were serious or life threatening. More than half of the injuries were related to use of medication.³ In 1991 Bedell et al⁴ reported the results of an analysis of cardiac arrests at a teaching hospital. They found that 64% were preventable. Again, inappropriate use of drugs was the leading cause of . . . [Full Text PDF of this Article]

Author Affiliations
From the Department of Health Policy and Management, Harvard School of Public Health, Boston, Mass.

Footnotes
Reprint requests to Department of Health Policy and Management, Harvard School of Public Health, 677 Huntington Ave, Boston, MA 02115 (Dr Leape).

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