How Pharmaceuticals Came To Be The 4th Leading Cause Of Death In America

[marshall]

157. I can guess at the conclusion, but basically I think the writer doesn't close the gap

Nothing in the story directly ties her death to any specific drug as the leading cause of her death or a contributing factor. Since the story itself is fiction it would have been more illustrative in my opinion to tie it back irrefutably. That is what I was looking for but didn't find. That is what I mean by muddled, because no direct link is identified, although one can assume at the very least that her health was compromised and it was ultimately the strain of the surgery that killed her. In that case I would say the surgery was the leading cause of her death, with the repeated misdiagnoses and side effects from misprescribed drugs being a contributing factor.

And in the research I did dig back to JAMA and find the original 1998 article, which only examines people who are admitted to a hospital for one identifiable time. And there is no mention of the controversy that immediately followed in JAMA about the validity of the interpretation of the data. All generally agreed that a problem was identified, but disagreed about the crunching of the numbers, as in this passage by Dr. Gary Kravitz from Minnesota:

"The results of the meta-analysis by Lazarou et al deserve a reality check. Lumping together voluminous mounds of archaic data with more recent data from a nonrepresentative sample of hospitalized patients and then extrapolating to the entire US patient population can lead to egregious errors. Many minor ADRs go unreported, as suggested by Bates, but I doubt this is true of deaths due to ADRs. It is not possible to sweep that many bodies under the rug. The problem of serious ADRs should not be compounded with erroneous estimates of their mortality. The study by Lazarou et al grossly overestimates the magnitude of this problem."