The medical errors that cause the most harm to patients

Patient safety is a discipline of the real of healthcare that has been created following the increase of complexity of the patient care systems and the consequent growth of the harm to patients at care centers. Its objective is to prevent and reduce the risks, errors and harm suffered by patients during the rendering of healthcare assistance. Nevertheless, according to the World Health Organization the adverse events resulting from a less than ideal rendering are probably one of the top 10 causes of deaths and physical impairment in the world. Among richer countries, it is estimated that one in 10 patients suffer some sort of harm while hospitalized, of which it is estimated that 50% are preventable.

Humans are prone to error, and even more so at a highly stressful environment, what makes the complete elimination of errors a hard to overcome challenge. On the other hand, to reduce their occurrence is not unachievable, mainly when we take into consideration the high percentage of errors that are avoidable. As digital health becomes more of the norm, there is no reason why those preventable medical errors should represent a challenge to patient safety.

This is precisely the mission of the Foundation for the Innovationa and Development of Health Safety: to promote the improvement of the quality and the safety of the processes of healthcare and to alert society and the healthcare community about patient safety within its medical and pharmaceutical treatments.

The World Health Organization has crafted a list that summarize the most common medical practices and errors that take place and the consequences they provoke.

Unsafe medication practices and medication errors harm millions of patients and costs billions of US dollars every year

1. Unsafe medication practices and errors – such as incorrect dosages or infusions, unclear instructions, use of abbreviations and inappropriate prescriptions – are a leading cause of avoidable harm in health care around the world. Globally, the cost associated with medication errors has been estimated at US$ 42 billion annually, not counting lost wages, productivity, or health care costs. This represents almost 1% of global expenditure on health. Medication errors may occur when weak medication systems and/or human factors such as fatigue, poor working conditions, or staff shortages affect prescribing, storage, preparation, dispensing, administration and monitoring practices. Any one or a combination of these can result in severe patient harm, disability and even death.

2. Out of every 100 hospitalized patients, at any given time, seven in high-income countries and 10 in low- and middle-income countries will acquire one or more health care-associated infections (HAIs). Hundreds of millions of patients worldwide are affected by HAIs each year. People with methicillin-resistant Staphylococcus aureus (MRSA), a bacterium increasingly found in hospital settings that is resistant to most antibiotics, are estimated to be 64% more likely to die than people with a non-resistant form of the infection. Regardless of a country’s income level, different types of interventions, including appropriate hand hygiene, can reduce HAI rates by up to 55%

3. Findings by WHO suggest that, globally, unsafe surgery still results in high rates of illness, disease and death. Unsafe surgical care procedures cause complications in up to 25% of patients. Almost 7 million surgical patients suffer significant complications annually, 1 million of whom die during or immediately following surgery. As a result of improved patient safety measures, deaths related to complications from surgery have decreased in the past 50 years. Nevertheless, they remain two to three times higher in lowand middle-income countries than in high-income countries.

4. Diagnostic error, that is the failure to identify the nature of an illness in an accurate and timely manner, occurs in about 5% of adults in the United States outpatient care settings. About half of these errors have the potential to cause severe harm. A study of primary care clinics in Malaysia established the occurrence of diagnostic errors at 3.6%. In the United States, extensive autopsy research performed in the past decades has shown that diagnostic errors contribute to approximately 10% of patient deaths. Furthermore, medical record reviews demonstrate that diagnostic errors account for 6–17% of all harmful events in hospitals. Evidence from low- and middle-income countries is limited, however, it is estimated that the rate is higher than in high-income countries as the diagnostic process is negatively impacted by factors such as limited access to care and diagnostic testing resources.

5. Worldwide, there are more than 3.6 billion x-ray examinations performed every year, with around 10% of them occurring in children. Additionally, there are over 37 million nuclear medicine and 7.5 million radiotherapy procedures annually. Inappropriate or unskilled use of medical radiation can lead to health hazards, both for patients and staff. Radiation errors involve overexposure to radiation and cases of wrong-patient or wrong-site identification. A review of 30 years of published data on safety in radiotherapy estimates that the overall incidence of errors is around 15 per 10 000 treatment courses.

6. Quite often, septicemia is not diagnosed in time to save patients lives. It is estimated that 31 million are affected around the world, and that more than 5 million die because of it.

7.Venous thromboembolism are some of the most frequent and preventable causes of harm to patients, and represent one third of the complications during hospitalizations. It is calculated that annually 3.9 million cases in high-income countries and 6.0 million cases in low- and middle income countries.

8. The administration of low-safety injections within healthcare facilities may lead to contagion of viral infectious diseases such as HIV or hepatitis B or C.

9. The practice of low-safety transfusions exposes patients to risks such as adverse reaction to the transfusion and the transmission of infections.

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