Medical errors in neurosurgery.
BACKGROUND
Medical errors cause nearly 100,000 deaths per year and cost billions of dollars annually. In order to rationally develop and institute programs to mitigate errors, the relative frequency and costs of different errors must be documented. This analysis will permit the judicious allocation of scarce healthcare resources to address the most costly errors as they are identified.


METHODS
Here, we provide a systematic review of the neurosurgical literature describing medical errors at the departmental level. Eligible articles were identified from the PubMed database, and restricted to reports of recognizable errors across neurosurgical practices. We limited this analysis to cross-sectional studies of errors in order to better match systems-level concerns, rather than reviewing the literature for individually selected errors like wrong-sided or wrong-level surgery.


RESULTS
Only a small number of articles met these criteria, highlighting the paucity of data on this topic. From these studies, errors were documented in anywhere from 12% to 88.7% of cases. These errors had many sources, of which only 23.7-27.8% were technical, related to the execution of the surgery itself, highlighting the importance of systems-level approaches to protecting patients and reducing errors.


CONCLUSIONS
Overall, the magnitude of medical errors in neurosurgery and the lack of focused research emphasize the need for prospective categorization of morbidity with judicious attribution. Ultimately, we must raise awareness of the impact of medical errors in neurosurgery, reduce the occurrence of medical errors, and mitigate their detrimental effects.
Department of Neurological Surgery, University of California at San Francisco, San Francisco, CA, USA.
John D
JD
Rolston
Department of Neurological Surgery, University of California at San Francisco, San Francisco, CA, USA.
Corinna C
CC
Zygourakis
Department of Neurological Surgery, University of California at San Francisco, San Francisco, CA, USA.
Seunggu J
SJ
Han
Division of Hospital Medicine, University of California at San Francisco, San Francisco, CA, USA.
Catherine Y
CY
Lau
Department of Neurological Surgery, University of California at San Francisco, San Francisco, CA, USA.
Mitchel S
MS
Berger
Department of Neurological Surgery, Northwestern University, Chicago, IL, USA.
Andrew T
AT
Parsa
Adverse events; medical error; neurological surgery; quality improvement; systems-based practice