It`s pretty common to talk about errors in regard to a medical setting and trying to figure out "what went wrong?" Or, in relation to the patient, what were the consequences and what happened to them? Unfortunately, most of the consequences we see are those that result in the patient`s injury, or worse, death.

Let`s take the drug Lidocaine, for example. There are a number of errors involving this drug but the statistics don`t tell us anything about why the errors occur. If they`re this common there must be a reason. Why?

The thing is, what we don`t see are the errors that are committed and then caught before they were completed and became serious. The reason we don`t see them is because they are caught, corrected, and in turn prevent the patient from suffering harm, thus preventing any action of malpractice. The variables involved with why errors occur don`t tell us how many errors occur because of the probability of substitution errors on the night shift, or by physicians, or by pharmacists. Determining what causes an error is vital in determining if a new drug should be released or a new procedure should be allowed to continue.

For example, just recently the first face transplant was performed. In spite of the fact that the risks were told to the patient before the procedure, there could still be more serious complications than what were discussed that could ultimately lead to a malpractice suit. In this case, the first thing that needs to be determined is if the procedure itself should be allowed to continue as it is new and we know very little about it.

To put this in a more general explanation, an error must be evaluated based on what is available as treatment for the particular condition in the first place. All factors must be considered including surgical procedure, drugs available, equipment available and the current training for the physician that is available. Was the right act substituted by a wrong act or was the procedure or drug or equipment faulty to begin with thus making success highly unlikely?

Then there is the matter of what is called consequence. In other words, something is going to happen, most likely bad, based on the error that was committed. In some cases the consequence is mild. In other cases the consequence is serious. These are the cases that usually make it to court in the form of a malpractice suit.

Again, this all comes back to what we as humans can be held accountable for. If the error is caused by the doctor making an obvious mistake in a procedure that has been done for years with no problem then most likely he is guilty of malpractice. But if the error occurs because of faulty procedure or equipment then more data is needed to determine if the doctor is indeed at fault.

In the next article we`re going to discuss what can be done about errors.