Did you know that the third most common cause of death in the U.S. is medical errors? That’s what research published in the British Medical Journal  yesterday says.

The study authors estimate at least 251,000 deaths a year from medical errors. That’s more than twice as much as the deaths from firearms, motor vehicles and suicide put together.

And the number is most likely underestimated. Many deaths from medical errors are never noted, as death certificates typically do not attribute the cause of death to a mistake, but rather to a billable diagnosis, such as “coronary artery disease” or “pneumonia.” That number  also doesn’t even include the error-related deaths in out-patient surgery centers, nursing homes, or other healthcare facilities. It also doesn’t include the deaths that happen at home, not long after leaving the hospital.

Want an example of what we’re talking about? The study authors tell the story of a young woman who recovered well after transplant surgery.  Not long afterwards, she wasn’t feeling well and was readmitted to the hospital. One test, which involved inserting a needle into the sac that covers the heart, showed no problem. She was sent home, but just a few days later was back in the hospital with an abdominal hemorrhage and died. It turned out that when the doctor put the needle into the heart sac, the needle nicked the liver, causing a sort of balloon or aneurysm, which ruptured and killed her.

Medical errors can include everything from giving you the wrong drug to removing the wrong leg. The study authors say that while human error is inevitable, we need to  better measure the problem so we can design safer systems that will reduce the  incidence and consequences of these mistakes.

Hospitals and health systems have been working on improving the medical error problem for decades. Back in 1999, the Institute of Medicine released a report that showed that medical errors were already more deadly than breast cancer, car crashes or AIDS. Now the estimate is far higher, based on studies released since that report.

The British Medical Journal study says we need to have a place on death certificates where physicians can indicate that a medical error contributed to death. They also suggest that everyone involved in health care needs to make preventing medical errors a top priority.

In the meantime, what can you do? 

• Before you have surgery, an invasive test or a major procedure, make sure it is absolutely necessary. Ask about the alternatives. Discuss what the possible side effects or problems from the test might be and how you will be monitored to be sure those issues don’t occur afterwards.

• Read your consent form (before a surgery or major procedure) and take the time to ask questions. Make sure the procedure or surgery is accurately stated in the consent.

• Before you go home from the hospital, insist on a careful review of each medication you should be taking and how much, and when, and why. Often, drugs and dosages change after you’ve been in the hospital. If anything doesn’t make sense to you, insist on talking with your physician. A recent analysis by Kaiser Health News showed that medication mistakes can slip past pharmacists and home health nurses and are a major patient safety issue.

• Keep an up-to-date list of your current medications, recent surgeries and any major procedures, and any unusual but normal-for-you lab results, and put them in a conspicuous place (like your refrigerator) in case you have to call 911. Also put this information on your smart phone, and in your purse or wallet.

• If you visit the emergency room, urgent care center, rehabilitation center, nursing home, or another type of clinic, or even just see a new medical specialist, bring that list of medications, recent healthcare treatments and key health data with you. Offer that list to the clinicians right away; don’t wait for them to ask.

And last, but not least, assume nothing.  If something seems off,  wrong, or just unusual, or if you just have a feeling about something, ASK.