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Medical Mistakes Study Old News at Harvard

"There was an immediate public reaction," Berwick said. "It was covered on network TV, and on the front page of all major newspapers."

Since the report was released two weeks ago, Berwick has appeared on the Today Show and on several other news programs, just as other committee members have.

One local case in particular spread interest in identifying problems with medical errors and helped spark studies like this one, he said.

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In 1995, Betsy Lehman, a Boston Globe reporter, underwent chemotherapy for breast cancer at the Dana Farber Cancer Institute.

During one treatment session, Lehman was given too much of the chemicals being used to treat her tumor, and died as a result.

Her death was covered in the Globe and other local media, but Berwick says the kind of error that killed Lehman case isn't unusual.

But the question of blame sometimes makes people reluctant to report or take responsibility for such errors. Berwick says that most errors, in fact, are not directly caused by human mistakes but by breakdowns in administrative or communications systems.

"The most important thing is to understand that most errors are not caused by bad people," Berwick said.

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