Mishaps in the management of stroke: a review of 214 complaints to a medical responsibility board.
BACKGROUND
This is the first survey of formal complaints to a Medical Responsibility Board (MRB) in the literature concerning stroke management and the disciplinary actions to which the complaints lead.


METHODS
All available complaints submitted to the Swedish MRB during a 5-year period that concerned stroke management (n = 214) were reviewed. We compiled information on the plaintiffs, the health care staff the complaints were directed against, the area of stroke management involved and the disciplinary actions taken by the MRB.


RESULTS
Only 1% of all complaints to the MRB concerned stroke. Three quarters of these complaints were directed against physicians and one fifth against nurses. 23 complaints (11%) resulted in a warning or an admonition. Nearly all disciplinary actions against physicians (12 of 13) concerned misdiagnoses, of subarachnoid hemorrhage in particular. The most common reason for a nurse receiving a warning or an admonition was negligent handling of drugs.


CONCLUSIONS
The survey has identified two areas in which educational programs to improve patient safety seem essential. The small number of formal complaints and disciplinary actions suggest that other, blameless procedures have a greater potential than MRB actions to reduce mishaps in routine stroke care.
Johansson
Asa
A
Medicine, Department of Public Health and Clinical Medicine, University Hospital, Northern Branch, Umeå, Sweden.
Lagerstedt
Katarina
K
Asplund
Kjell
K
D003951:Diagnostic Errors; D004647:Employee Discipline; D005260:Female; D006801:Humans; D008297:Male; D008318:Malpractice; D008508:Medication Errors; D009726:Nurses; D009732:Nursing Care; D010820:Physicians; D011369:Professional-Patient Relations; D020521:Stroke / Q000175:diagnosis* / Q000188:drug therapy*; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis; D013548:Sweden