We could cut 180,000 preventable hospital deaths a year. Here’s exactly why we haven’t

Anders Pederson died trying to save his sister.

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From the time Kelly was a toddler, Anders was her protector. When she was just 15 months old, a serious illness damaged her kidneys. Doctors warned the family that one day she might need a transplant. Decades later, when Kelly turned 30 and her kidneys began to fail, Anders didn’t hesitate, he immediately volunteered to donate one of his.

The surgery was successful.

The next morning, Anders visited Kelly and told her donating his kidney had been the best day of his life. But hours later, he began experiencing severe pain and vomiting. His pain medication was changed, and warning signs went unnoticed. When his mother returned to check on him, Anders’ hand was cold, his lips were blue, and he wasn’t breathing.

Anders fell into a coma and died nine days later. The family was initially told his heart had simply stopped. Only after pushing for answers did they learn the truth: a cascade of preventable failures, inadequate monitoring and medication management, had taken the life of a healthy young man who had just saved his sister.

Stories like Anders’ are not rare tragedies. They are symptoms of a systemic failure. And the most maddening part? We already know exactly how to prevent them.

The number hiding in plain sight

For more than two decades, patient safety experts have warned that preventable medical harm is one of the most urgent public health crises in America. Research suggests medical errors contribute to roughly 250,000 deaths each year in the United States, placing them behind only heart disease and cancer as a cause of death. Globally, the toll may reach 3 million deaths annually.

But here is what rarely gets stated plainly: if every hospital in this country implemented all of the evidence-based practices that researchers and clinicians have already identified and validated, we could reduce that death toll from approximately 200,000 a year to as few as 20,000, a 90% reduction. Not through new drugs or breakthrough science. Through

protocols that exist today, posted on our website, available to any hospital administrator who cares to look.

That is not an aspirational goal. It is a quantifiable, achievable outcome that we are choosing, collectively, not to pursue.

In 1999, the Institute of Medicine’s landmark report To Err Is Human shocked the nation by estimating that 44,000 to 98,000 Americans were dying each year from preventable medical errors. That report was meant to ignite transformation. It promised accountability, transparency, and systemic change. By 2011, an OIG report showed we were losing 200,000 patients a year. Twenty-five years after that first alarm, families like the Pedersons are still paying the price.

Why the aviation comparison misses the point

When people talk about patient safety, they inevitably reach for the aviation analogy. Airlines transformed their safety culture; why can’t hospitals? It’s a fair comparison as far as it goes, but understanding why it breaks down reveals the real problem.

First, when a plane goes down, it dominates the news cycle for days. Medical errors kill the equivalent of two fully-loaded passenger jets every single day in America, and it barely registers. The absence of a single catastrophic, visible event means there is no public outrage, no pressure campaign, no congressional hearing.

Second, when a plane crashes, the pilots die too. That brutal alignment of incentives — skin in the game — drove aviation to make safety non-negotiable. When a patient dies from a preventable error, the doctors and nurses go home. That is not a criticism of healthcare workers, most of whom entered the profession to heal people. It is a structural reality: the system does not force those who design and deliver care to bear the consequences of its failures in the same visceral way.

Third, passengers can choose not to fly. That market pressure gave airlines a powerful financial incentive to fix safety problems fast. Patients who need hospital care have no such choice. They come because they must, which means hospitals face no equivalent consumer penalty for unsafe outcomes.

The lesson from aviation is not simply that bold safety goals work, though they do. The lesson is that healthcare lacks the self-correcting mechanisms that forced aviation to change. Which means those mechanisms have to be built deliberately, from the outside in.

What actually works: the CHOC model

We know this can be done because we have done it.

When I was asked to chair the quality committee at Children’s Hospital of Orange County, we brought in all 20 of the evidence-based practices the Patient Safety Movement Foundation had identified; standardized protocols for the specific, known causes of preventable harm: failure to rescue, medication errors, hospital-acquired infections, sepsis, communication breakdowns, venous thromboembolisms, falls, and diagnostic errors. The result: zero preventable deaths for more than