Medical errors and consequent adverse events in critically ill surgical patients in a tertiary care teaching hospital in Delhi.
BACKGROUND
Medical errors and adverse events (AE), though common worldwide, have never been studied in India. We believe that though common these are under reported.


OBJECTIVE
The aim of this study was to study medical errors and consequent AE in patients presenting with trauma and bowel perforation peritonitis.


METHODS
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.


RESULTS
There were 500 (85%) 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%) and 183 (31.2%) patients, respectively. Consequences were as follows: disability - 157 (85%), increased hospital stay and/or increased visits in the OPD - 28 (15.3%) and both-101 (55.2%) patients. Disabilities were: death - 62 (40%), temporary disability - 90 (58%) and permanent disability - 05 (3.1%) patients. AE in 133 (71.8%) 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%) patients. System and operative errors were the commonest, 84.3% and 82.7%, respectively. One hundred and sixty-seven (90%) patients had multiple errors.


CONCLUSIONS
The study proves that medical errors and AE are a serious problem in our set-up and calls for immediate system improvement.
Kumar
Sunil
S
Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, Shahdara, Delhi-110 095, India.
Chaudhary
Sujata
S