Some 45 percent of specialists reported that a medical error had occurred in their practice in the past six months, according to a national survey. Researchers sent out the brief, anonymous survey to 2,500 members of the American Academy of Otolaryngology (head and neck surgery), of which they received 466 responses. About 37 percent of the reported errors, which affected both children and adults, caused major harm or injury. Four percent of the errors were fatal.

The otolaryngologist who led the survey pointed out that he had first-hand experience with medical errors. He described a near-miss in which a patient was about to receive a cochlear implant, and, upon closer inspection of the CT scan and an MRI, realized that the person had no auditory nerves on either side. This meant that a major device would have been surgically implanted in a child's head when there was no possibility of benefit. The error? The initial scan was not looked at carefully.

The reported errors were classified into the following categories:

• Technical errors during procedures (19 percent): 56 percent of these caused major injury or harm
• Medication errors (14 percent): these included dosage mistakes and giving medications that were contraindicated or to which the patient was allergic
• Testing errors (10 percent): such as physicians ordering incorrect tests, not reviewing tests or not acting on the results, and lab errors like lost specimens and errors in labeling and interpretation of results
• Surgical planning errors (10 percent): these included scheduling mistakes, failing to ensure that all preoperative studies were complete and judgment errors, such as undertaking surgery when it was risky

It was noted that younger physicians were more likely than physicians over age 50 to report errors (approximately 60 versus 40 percent). Other errors reported in the survey included:

• Equipment errors: equipment not available or improperly assembled, equipment failure (9.4 percent)
• Errors in post-operative care (8.5 percent)
• Wrong site surgery: wrong patient, wrong organ, or wrong side (6 percent)
• Drug errors during surgery (4 percent)
• Communication errors (4 percent)

Researchers say that the number of doctors reporting medical errors--45 percent--is an underestimate. They suggest that doctors, who are likely not trained to recognize errors, may recall serious errors but overlook minor ones.

Laryngoscope August 2004;114(8):1322-1335

EurekAlert August 3, 2004