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6 Medical Error Definitions You Should Be Aware Of
Oct 15, 2021
Medical errors are an unfortunately common event in the medical industry. Stakeholders have taken significant steps to improve patient safety by promoting accountability among healthcare workers.
These measures necessitate clear definitions and understanding of what constitutes a medical error to prevent undue liability and punishment. The consensus is that medical errors result from multiple factors, some of which are beyond medical practitioners' control. Discussed below are six medical errors definitions you should know.
1. Active Errors
Active errors occur when a person interacts directly at a point of contact as part of a larger system. In simple terms, these errors happen when a frontline health worker such as a clinician is dealing with a patient on behalf of the hospital.
A surgeon operating on the wrong leg is a classic example of an active error.
2. Adverse Event
Adverse events arise from issues with a medical procedure instead of the patient's underlying medical condition. Healthcare workers are liable if they fail to follow the acceptable or recommended practice at the individual or system level. In such a case, the error could have been prevented.
However, not all adverse events can be prevented. Faults with the healthcare system can result in adverse events for which medical practitioners are not liable. An example of adverse events is physical disability caused by a poorly conducted surgery or medical intervention.
3. Latent Error
Issues with faulty system design, faulty installation, or inefficient organizational structure result in latent errors. These errors do not cause harm by themselves, and they often go unnoticed until people get involved.
Latent errors are essentially accidents that are about to happen. The combination of human errors with latent errors is the primary cause of medical errors. An example is a poorly organized patient system that can lead to misdiagnosis or wrong medical intervention.
4. Negligence
Negligence occurs when healthcare providers offer substandard medical care. Typically, there is a set standard in healthcare delivery that qualified clinicians and nurses should provide for all patients under the same circumstances.
For example, it is negligence if a surgeon damages a nerve after confusing it with an artery. All surgeons are expected to know and differentiate between specific arteries and nerves before operating on a patient.
A negligent adverse event is a common subcategory of negligence used to determine legal liability among medical practitioners who conduct substandard medical management.
5. Never Event
Some medical errors should never exist, and they fall under never events. These mishaps are often atypical yet preventable blunders, such as performing surgery on the wrong part of the patient.
The National Quality Forum developed the never event list in 2002 to keep track of errors that could lead to identifiable serious issues such as death or disability. Seven subcategories constitute the list.
An example of a never event is when a person pretending to be a health care professional performed an invasive medical procedure.
6. Near Miss
Near miss describes events in which the potentially fatal outcomes are averted through some form of intervention. Near miss events are similar to adverse events in all ways except the outcome.
An example is when an artery punctured accidentally due to negligence is fixed without leading to dire patient outcomes.
The medical industry has a growing need for accountability because of the number of medical errors. Accordingly, you should know the elements that constitute a medical error, as the definition is so broad. These six medical error definitions are vital in establishing liability or lack thereof among affected individuals.
At Spiga & Associates, we defend licensed healthcare professionals against their professional boards in California. Contact us if you have any issues relating to medical errors or malpractice.
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You see him or her on your television, in your professional journals, and on your home page . . . the “Poster Child.” The Physician existing on the fringe of the profession, who gets arrested for overwriting prescriptions for Schedule II substances . Their example is easy to dismiss. The average M.D. engaged in legitimate practice seemingly has nothing to worry about. This fate befalls the slacker, the greedy, the foolhardy. Don't be so sure, any M.D. who prescribes Schedule II substances as a regular part of their practice is only one adverse patient outcome away from California Medical Board and possibly criminal investigation. For example, Surgeons and Physicians practicing in Emergency Medicine, Oncology, and Pain Management, routinely write hundreds, if not thousands of prescriptions for Schedule II substances. There is no way for a Physician to control the patient’s use of controlled substances, yet a dangerous and influential myth is being propagated that a physician is a fortune teller and can predict which patients will misuse the substances provided. Further complicating the issue is the difficult ethical landscape navigated by Physicians dealing with patients presenting legitimate symptoms demanding treatment with Schedule II and III substances, but who are nevertheless, drug dependent. Long term pain management patients are at particular risk of overdose due to their high tolerances leading to increasing dosages and the difficulty in weaning them off the substances they have become dependent upon. Should a patient die or suffer an adverse outcome that is somehow connected to a prescription for a schedule II substance, a criminal and California Medical Board investigation is sure to follow. Oftentimes the investigation will be spearheaded by investigators for the California Department of Consumer Affairs working in conjunction with local law enforcement but who also work on behalf of the Medical Board of California. These investigators are sworn peace officers and have the power to arrest and working with the Attorney General or local District Attorney also have the ability to bring criminal charges against a Physician. These investigations start out invisibly with scrutiny of CURES II reports detailing a Physician’s prescription history. All patients receiving scheduled substances will be given particular attention. Soon after, the physician will receive a request for patient records, followed by a letter of investigation from a California Department of Consumer Affairs Investigator indicating that a complaint has been made and requesting an interview. They do not inform the Physician of his or her right to counsel or whether the Physician even has the right to refuse the interview. Nor do they inform him or her of their right to review the complaint. Believe it or not, one of the common mistakes Physicians make in dealing with these investigations is not taking it seriously. They will delay responding or not respond at all. Often Physicians confident in their prescribing practices will have a false sense of confidence going in to such an interview and will wing it without consulting consul. Those Physicians learn the error of that approach through hard experience. If you are facing such an inquiry. Take it very seriously, Your medical license is your most important asset. If you have an adverse patient outcome that has come to the attention of your Hospital Administration, The Medical Board of California or local law enforcement, call Spiga and Associates immediately. Because of our 25 years of experience in both Criminal and Administrative defense we are uniquely qualified to defend you and your medical license.
WHAT DO YOU DO WHEN AN INVESTIGATOR ACTING ON BEHALF OF THE CALIFORNIA MEDICAL BOARD CALLS YOU DEMANDING AN INTERVIEW?
Doctors, Dentists, Veterinarians, Nurses and all California Licensees in the healthcare profession are unfortunately rarely aware of their right to inspect and copy their entire central file maintained by their licensing agencies. Under Business and Professions’ Code § 800 (3)(c)(1) the licensee has a right to inspect his central file and the Licensing Board must specifically disclose to the licensee any: “personal information that could be considered detrimental, disparaging or threatening to a licensee’s reputation, rights, benefits, privileges or qualifications or be used by the Board to make a determination that would affects a licensee’s rights, benefits, privileges or qualifications.” The reason most licensees do not know about this right is the various Licensing Boards and their investigators do not tell licensees that they have the right to see the complaints against them (minus the identities of informants and patients etc . . ) and any negative item in their file. A licensee has no more important right than this. Whether you are facing a Board investigation as a Doctor , Dentis t , Nurse , Veterinarian, Chiropractor , Psychologist etc . . . one of the first things your lawyer should do is request a copy of your central file. Knowledge is power. Once you see the administrative agencies information, it is like getting a copy of their playbook. There is no better way to prepare yourself for an interview than to inform yourself of the basis of their investigation. Your answers can be more precise and you can more easily avoid a perjury trap. Like a surgeon’s scalpel, these statutes are a good lawyer’s tools. This is but one tool. There are many more. Like any specialized tool they can be useful but not optimum in the hands of an inexperienced layman. If you are under investigation call Spiga and Associates where an experienced medical and nursing license defense attorney is standing by.
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