The concept of medical errors in the modern healthcare systems

medical-diagnosisThe majority of patients treatment begins and ends outside the hospital, so the analysis and study of the subject of medical errors should primarily focus on hospitals. Defects of medical care provided by physicians in clinics are found in approximately in 30% of cases. More often errors happen in collecting history, using basic methods of medical examination of the patient and prevention recommendations. The frequency of diagnoses mismatch when in case of a referral to hospital examination and during the visit, according to different authors, varies in the range of 10-40%. According to various sources, the discrepancy between clinical and sectional diagnoses in hospitals of mixed type for adults balances around 11% (according to independent surveys among medical negligence solicitors), and the unrecognised rare diseases in this index are not significantly reflected. The majority of diagnoses with discrepancies account for serious conditions – mostly lung and gastric cancer, tuberculosis, pneumonia, atherosclerosis and its complications.

The errors in the treatment are much better studied in surgery because they are obvious for surgical interventions., while the treatment errors of therapeutic patients are mostly analysed superficially. Most often it is the wrong destination, the lack of recommendations by the regime and diet, non-use of physical therapy when indicated, physiotherapy and massage. Drug polypharmacy (unfounded co-administration of many drugs) is especially prevalent. In some cases, it is due to the treatment of patients at the same time from several doctors about various diseases. The principle of pharmacotherapy should base on ‘less medication, using what’s absolutely necessary’ principle. Polypharmacy should be more often seen as a sign of undisciplined medical thinking. Errors of drug treatment should also include the use of medications in the wrong dosages, mixtures of incompatible medications and underestimation of possible adverse reactions. The errors in the treatment of lead and deontological mistakes is often accompanied by psychological traumatisation of the patient.

The least studied field is the prevention of errors. Such errors may relate not only to the incorrect administration of the vaccine, but also to the theoretical and practical errors in the conduct of clinical examination. Errors in the organisation of medical care require special attention and prompt elimination, since they affect the health of large numbers of patients and healthy people.

clinical errorIn practice, medical errors are often mixed with carelessness or negligence, but different manifestations of negligence and its consequences in some cases forced to admit negligence offense, and in others – a crime. If a doctor in professional activities directly or indirectly violates the essential rules and requirements, criminal prosecution may follow. Differentiating errors from crimes is extremely difficult in some cases; sometimes it can cause erroneous excitation of criminal case against the doctor. In such uncertain and controversial cases, a highly skilled forensic examination with the participation of authoritative experts takes place. The final decision in such cases is rendered by competent legal authority.

The fight against medical errors is aimed at eliminating their sources. A reduction of medical errors contribute to the systematic training of doctors, especially in the course of daily work. The significance of medical consultation (which is sometimes wrongly neglected), a systematic error analysis on physician clinical-anatomical conferences.