Medical errors and consequent adverse events in critically ill surgical patients in a tertiary care teaching hospital in Delhi

• Main Authors: Kumar Sunil, Chaudhary Sujata
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2009-01-01
• Series: Journal of Emergencies, Trauma and Shock
• Subjects: Adverse events; medical errors; peritonitis; trauma
• Online Access: http://www.onlinejets.org/article.asp?issn=0974-2700;year=2009;volume=2;issue=2;spage=80;epage=84;aulast=Kumar

<b>Background: </b> Medical errors and adverse events (AE), though common worldwide, have never been studied in India. We believe that though common these are under reported. Aim: The aim of this study was to study medical errors and consequent AE in patients presenting with trauma and bowel perforation peritonitis. <b>Methods:</b> Five hundred and eighty-six consecutive patients with trauma or peritonitis, presenting to surgery emergency of UCMS-GTBH, were prospectively studied using review form (RF) 1 and 2. AE was defined as an outcome not expected to be part of the illness. RF 1 was filled for all and indicated if AE was present or not. RF2 was filled when RF 1 indicated presence of AE; it further confirmed the occurrence of AE and pointed to the type of medical error and resultant disability. All results were expressed as percentage. <b>Results:</b> There were 500 (85&#x0025;) males. Mean age of the patients was 31 years. There were 332 patients with peritonitis and 254 with trauma. AE and its consequences were present in 185 (31.5&#x0025;) and 183 (31.2&#x0025;) patients, respectively. Consequences were as follows: disability - 157 (85&#x0025;), increased hospital stay and/or increased visits in the OPD - 28 (15.3&#x0025;) and both-101 (55.2&#x0025;) patients. Disabilities were: death - 62 (40&#x0025;), temporary disability - 90 (58&#x0025;) and permanent disability - 05 (3.1&#x0025;) patients. AE in 133 (71.8&#x0025;) patients was definitely (level of confidence 6) due to error in healthcare management. All AE were considered preventable. Error of omission accounted for AE in 122 (65.9&#x0025;) patients. System and operative errors were the commonest, 84.3&#x0025; and 82.7&#x0025;, respectively. One hundred and sixty-seven (90&#x0025;) patients had multiple errors. <b>Conclusions:</b> The study proves that medical errors and AE are a serious problem in our set-up and calls for immediate system improvement.