A groundbreaking and deeply unsettling nationwide study has exposed the U.S. states where patients face the highest risk of surgical errors, botched procedures, and preventable complications—and the findings have sparked serious alarm in both medical and legal circles.
The research, published this week in the New England Journal of Medicine and summarized by The Wall Street Journal, analyzed over 12.4 million surgical records from 2019 to 2024. The results are not just eye-opening—they’re terrifying.
The states topping the list for highest rates of surgical errors were Mississippi, Alabama, West Virginia, and Oklahoma. Researchers measured malpractice payouts, post-op complications, unplanned readmissions, and patient death rates within 30 days of surgery to rank each state. According to data obtained via FOIA requests and hospital records, patients in these states were up to four times more likely to experience a major surgical error compared to those in top-performing regions like Massachusetts and Minnesota.
Lead researcher Dr. Lila Freeman told The New York Times: “This isn’t about bad luck. This is systemic. We’re seeing clusters of poor training, lax regulations, and serious understaffing that are putting patients in jeopardy.”
One of the most damning revelations was that in certain low-performing hospitals, checklist protocols—designed to prevent surgical tools being left inside patients—were either skipped or performed incorrectly. A whistleblower nurse from a hospital in Jackson, Mississippi told ProPublica, “I saw scalpels, gauze, even tubing left behind. Surgeons rushing. No double-checks. I reported it. Nothing changed.”
Her story has since gone viral after being shared on X by More Perfect Union, sparking national outrage. The post has over 8.2 million views and counting.
TikTok creator @NurseReacts, a licensed RN in Illinois, broke down the report in a widely shared video: “This isn’t just about where you live. It’s about whether you’ll survive a basic appendectomy. Read the hospital data before you go under.”
Another key finding from the study was the lack of board-certified surgeons in many high-risk regions. In rural areas of Alabama and West Virginia, up to 37% of general surgeons were found to be operating without up-to-date credentials, according to verification logs accessed by BuzzFeed News.
In one shocking example, a patient in Tulsa, Oklahoma went in for gallbladder removal and woke up missing part of his colon. A malpractice suit filed last year, now unsealed and reviewed by NBC News, reveals that the surgeon “mistook an organ during a power outage” and failed to alert the patient post-surgery. The man only found out after a second hospital visit for internal bleeding.
States with the lowest error rates—Massachusetts, Minnesota, Washington, and California—tended to have strict surgical oversight, hospital transparency laws, and higher minimum staffing requirements. They also had greater patient access to real-time online surgical ratings and disciplinary histories, features missing from most medical boards in low-ranked states.
A Reddit thread on r/AskDocs is now flooded with users posting stories of botched surgeries and sharing recommendations for how to request a hospital’s “surgical outcome data”—a little-known right in many states.
President of the American College of Surgeons, Dr. Miguel Barrera, told CNN: “These findings are damning. We’re talking about life-and-death failures. It’s no longer just about malpractice—it’s about accountability, transparency, and the absolute need for federal oversight.”
Some states have begun scrambling to respond. Mississippi’s Department of Health issued a press release stating it is “reviewing licensing and safety protocols immediately.” West Virginia’s governor has called for an “emergency task force” to audit all operating rooms in the state, according to West Virginia Public Broadcasting.
Legal analysts are already forecasting a surge in malpractice suits. Prominent medical attorney Kate Munson told Axios, “This study gives plaintiffs a data-driven foundation. Expect a litigation wave in states with bad numbers and no action.”
Patients’ rights groups are also mobilizing. Advocacy org Patient Safe America is circulating a petition—already signed by over 250,000 people—demanding Congress pass a “National Surgical Safety Bill” to enforce baseline standards across all 50 states. The link was posted on Instagram by founder Dr. Jenna Lee with the caption: “A zip code should not determine whether you die on the operating table.”
The study also found a disturbing trend among marginalized patients. Black, Indigenous, and low-income patients were significantly more likely to be operated on by surgeons with poor track records in states ranked at the bottom. “There is a brutal racial and economic overlay here,” said sociologist Dr. Imani Waters in a segment for MSNBC. “The data is telling us that inequality literally cuts deeper in some states.”
As news of the study spreads, patients are flooding Google searches with terms like “safest hospitals in my state” and “how to check my surgeon’s rating.” Traffic to hospital review sites like Healthgrades and RateMDs surged 280% overnight, according to data shared with Vox.
Meanwhile, families of victims who died during routine procedures are using this moment to speak out. Mary Ellen Raines, whose daughter died from a “preventable nicked artery” in a West Virginia hospital, told CBS News, “Now we know it wasn’t an accident. It was a broken system. And we’re not staying quiet anymore.”
