scholarly journals Adverse Events and Malpractice Claims in Endodontics

2018 ◽  
Vol 2 (1) ◽  
pp. 367-375
Author(s):  
Gabriel Fonseca ◽  
Karina Mira ◽  
Héctor Beltrán ◽  
Katherine Peña ◽  
Violeta Yendreka
Keyword(s):  
Health Care ◽  
Risk Management ◽  
Adverse Event ◽  
Adverse Events ◽  
Inappropriate Drug ◽  
Negative Effects ◽  
Significant Frequency ◽  
Iatrogenic Complications ◽  
Malpractice Claims ◽  
Health Care Treatment

An "adverse event" has defined as a non-intentional complication result of health care treatment, and although it can have different causes, always involves the providing care, but not the complications inherent to the patient’s disease itself. Adverse events, iatrogenic complications and malpractice have been clearly differentiated because only malpractice causes liability: while iatrogenic events can be result of a well-performed procedure, malpractice involves damage caused by negligence or lack of knowledge, and it is a potential for complaint and liability claim. In dentistry, endodontics is one of the specialties of greatest challenge where adverse events and malpractice claims have been reported with significant frequency. We present a literature review searching the main causes and results of malpractice claims in endodontics. Three articles from Italy, Israel and Denmark were selected, where the most claimed adverse events were root perforations, inappropriate drug therapies, defective root fillings and instrument fracture. One of the articles referred to malpractice verdicts in 97.5 % of claims. Since endodontics leads dental malpractice claims in Chile, strategies of risk management for these procedures are discussed; the adherence to strict protocols is proposed and measures to minimize the negative effects of these events are recommended.

scholarly journals Presumed adverse events in health care are a frequent indication for medico-legal autopsy in Finland

2019 ◽  
Vol 16 (1) ◽  
pp. 65-70
Author(s):  
Lasse Pakanen ◽  
Noora Keinänen ◽  
Paula Kuvaja
Keyword(s):  
Health Care ◽  
Risk Management ◽  
Adverse Event ◽  
Adverse Events ◽  
Gastrointestinal Surgery ◽  
Legal Protection ◽  
Clinical Risk Management ◽  
Data Set ◽  
Manner Of Death ◽  
Clinical Risk

AbstractThe medico-legal autopsy is an essential tool in investigating deaths caused by an adverse event in health care, for both clinical risk management and for professional liability issues. However, there are no statistics available regarding the frequency of autopsies performed due to suspected adverse events. This study aimed to determine the number of medico-legal autopsies done because of presumed adverse events, whether these events were unintentional, medical errors or cases in which malpractice was suspected. Furthermore, differences in treatment types, causes and manner of death were analyzed. The data was obtained from all medico-legal autopsies performed in Northern Finland and Lapland during 2014–2015 (n = 2027). Adverse events were suspected in 181 (8.9%) cases. The suspicions of an adverse event occurring were most often related to medication, gastrointestinal surgery and orthopedic surgery. The manner of death was classified as medical (or surgical) treatment or investigative procedure in 22 (12.2%) cases. The causes of death were completely unrelated to the suspected adverse event in 41 (22.7%) cases. In conclusion, the frequency of presumed adverse events was quite high in this data set, but in the majority of the cases, the suspicion of an adverse event causing death was disproved by an autopsy. Nonetheless, proper investigation of these cases is essential to ensure legal protection of the deceased, next of kin and health care personnel, as well as to support clinical risk management.

Filing Sources after Oral P2Y12 Platelet Inhibitors to the Food and Drug Administration Adverse Event Reporting System (FAERS)

Cardiology ◽  
2017 ◽  
Vol 138 (4) ◽  
pp. 249-253 ◽  
Author(s):  
Victor L. Serebruany ◽  
Vasily Cherepanov ◽  
Moo Hyun Kim ◽  
Oleg Litvinov ◽  
Hector A. Cabrera-Fuentes ◽  
...  
Keyword(s):  
Health Care ◽  
Adverse Event ◽  
Adverse Events ◽  
Drug Administration ◽  
Health Care Professionals ◽  
Reporting System ◽  
Adverse Event Reporting System ◽  
Adverse Event Reporting ◽  
Platelet Inhibitors ◽  
Event Reporting

Background: The US Food and Drug Administration Adverse Event Reporting System (FAERS) is a global passive surveillance database that relies on voluntary reporting by health care professionals and consumers as well as required mandatory reporting by pharmaceutical manufacturers. However, the initial filers and comparative patterns for oral P2Y12 platelet inhibitor reporting are unknown. We assessed who generated original FAERS reports for clopidogrel, prasugrel, and ticagrelor in 2015. Methods: From the FAERS database we extracted and examined adverse event cases coreported with oral P2Y12 platelet inhibitors. All adverse event filing originating sources were dichotomized into consumers, lawyers, pharmacists, physicians, other health care professionals, and unknown. Results: Overall, 2015 annual adverse events were more commonly coreported with clopidogrel (n = 13,234) with known source filers (n = 12,818, or 96.9%) than with prasugrel (2,896; 98.9% out of 2,927 cases) or ticagrelor (2,163, or 82.3%, out of 2,627 cases, respectively). Overall, most adverse events were filed by consumers (8,336, or 44.4%), followed by physicians (5,290, or 28.2%), other health care professionals (2,997, or 16.0%), pharmacists (1,125, or 6.0%), and finally by lawyers (129, or 0.7%). The origin of 811 (4.7%) initial reports remains unknown. The adverse event filing sources differ among drugs. While adverse events coreported with clopidogrel and prasugrel were commonly originated by patients (40.4 and 84.3%, respectively), most frequently ticagrelor reports (42.5%) were filed by physicians. Conclusion: The reporting quality and initial sources differ among oral P2Y12 platelet inhibitors in FAERS. The ticagrelor surveillance in 2015 was inadequate when compared to clopidogrel and prasugrel. Patients filed most adverse events for clopidogrel and prasugrel, while physicians originated most ticagrelor complaints. These differences justify stricter compliance control for ticagrelor manufacturers and may be attributed to the confusion of treating physicians with unexpected fatal, cardiac, and thrombotic adverse events linked to ticagrelor.

Improving safety for children with cardiac disease

2007 ◽  
Vol 17 (S4) ◽  
pp. 127-132 ◽  
Author(s):  
Ravi R. Thiagarajan ◽  
Geoffrey L. Bird ◽  
Karen Harrington ◽  
John R. Charpie ◽  
Richard C. Ohye ◽  
...  
Keyword(s):  
Health Care ◽  
Adverse Event ◽  
Adverse Events ◽  
Cardiac Disease ◽  
Medical Error ◽  
The United States ◽  
Team Work ◽  
Institute Of Medicine ◽  
Unique Challenge ◽  
Congenital Cardiac Disease

AbstractThe complexity of the modern systems providing health care presents a unique challenge in delivering care of the required quality in a safe environment. Issues of safety have been thrust into the limelight because of adverse events highly publicized in the general media.In the United States of America, improving the safety and quality in health care has been set forth as a priority for improvements in the 21st century in the report from the Institute of Medicine. Many measures have now been initiated for improving the safety of patients at hospital, regional, and national level, and through initiatives sponsored by governments and private organizations. In this review, we summarize known concepts and current issues on the safety of patients, and their applicability to children with congenital cardiac disease. Prior to examining the issues of medical error and safety, it is important to define the terminology.An error is defined as the failure of a planned action to be completed as intended, also known as an execution error, or the use of a wrong plan to achieve an aim, this representing a planning error. An active error is an error that occurs at the level of the frontline operator, and the effects of which are felt immediately. A latent error is an error in the design, organization, training and maintenance, that leads to operator errors, and the effects of which are typically dormant in the system for lengthy periods of time. Latent errors may cause harm given the right circumstances and environment.An adverse event is defined as an injury resulting from medical intervention. A preventable adverse event is an adverse event that occurs due to medical error. Negligent adverse events are a subset of preventable adverse events where the care provided did not meet the standard of care expected of that practitioner.The study of improving the delivery of safe care for our patients is a rapidly growing field. Important components for development of programmes to improve the safety of patients include the leadership for the programme, the implementation of process design based on human limitations, the promotion of teamwork and function, the anticipation of unexpected events, and the creation of a learning environment.Much is yet to be learned about the risk and incidence of adverse events during hospitalization of children with congenital cardiac disease. Errors due to human factors, such as poor communication, poor coordination, and suboptimal team work, have shown to be important causes of adverse outcomes in children undergoing cardiac surgery, and should be a focus for improvement. Future research on evaluating causes and prevention of medical errors and adverse events in this population at high risk, and consuming high resources, is essential.Issues of inadequate safeguards for patients have been prominent in the media, and have been highlighted in reports from the Institute of Medicine. Our review discusses research on the causes of medical error, and proposes concepts to design successful programmes to improve safety for the patients on a local level.

The Activities of Risk Management

2009 ◽  
Vol 76 (3) ◽  
pp. 185-191
Author(s):  
G. Marino ◽  
O.G. Di Primio ◽  
F.C. Cortese ◽  
M. Pedalino ◽  
R. Vella ◽  
...  
Keyword(s):  
Health Care ◽  
Risk Management ◽  
Adverse Events ◽  
Health Workers ◽  
National Level ◽  
Common Denominator ◽  
Urological Procedures ◽  
Successful Approach

Introduction The activities of Risk Management at a department of urology involve specialist health workers, technical and administrative staff as the common denominator is communication, simplification of processes and the quality of health care provision. The Authors present their experience on the management of risk in urology and an attempted classification of adverse events with possible dysfunction in the clinical management in urology department. Materials and Methods Our analysis included those adverse events that occurred from January to December 2008. A total of 18 adverse events were identified from 638 urological procedures divided according to diagnosis, treatment and type of hospitalization. Results The following events were assessed: number of cases with wound infection: 5 (4.7%), diastasis of the surgical wound: 3 (0.47%), catheter obstructions that required therapeutic endoscopic or surgical haemostatic procedures: 5 (0.78%), delayed administration of treatment: 3 (0.47%) and accidental fall out of bed: 2 (0.31%). Conclusions The transition from a reactive to a preventive system remains the key to provide the citizen with the best health care in safety conditions. The involvement of different organizational and managerial levels in an optimal atmosphere in the absence of stress appears to be the most balanced and successful approach, especially putting aside the attitude of assigning error culpability. The transmission of individual experiences at a regional and national level will allow refining the project, which foresees the identification and classification of possible events and especially the ways and preventive procedures to achieve them.

scholarly journals Managing the Risk of Adverse Events Using the Example of a Hospital in Wroclaw

2014 ◽  
Vol 39 (1) ◽  
pp. 155-166
Author(s):  
Agata Lisiewicz Kaleta ◽  
Aleksandra Sierocka ◽  
Petre Iltchev ◽  
Michał Marczak
Keyword(s):  
Health Care ◽  
Risk Management ◽  
Adverse Events ◽  
Risk Identification ◽  
Treatment Costs ◽  
Research Material ◽  
Black Spots ◽  
Remedial Actions ◽  
Hospital Stays ◽  
Jaw Surgery

Abstract. Health Care Centres are institutions which, because of their specificity and character, are particularly exposed to various kinds of risk. One of the most important and most frequently used methods of risk management is the black spots method. The research material collected for the study comes from one of the hospitals in Wrocław. All hospital stays of the C22 (Face and Jaw Surgery Ward) and H05 (Injury and Orthopaedics Surgery Ward) settlement groups (DRG) were analysed - a total of 178 hospitalisations. The black spots method was used in the study, which consisted of risk identification, the ordering of threats and proposals for remedial actions. Using the black spots method, it was possible to identify adverse events that occurred during the hospitalisation of patients with H05 and C22 DRGs in the Injury and Orthopaedics Surgery Ward and Facial and Jaw Surgery Ward. In both cases, the treatment costs for patients with complications were higher than for the stays without complications.

A Probabilistic Method for Computing Quantitative Risk Indexes from Medical Injuries Compensation Claims

2013 ◽  
Vol 52 (05) ◽  
pp. 374-381
Author(s):  
S. Dalle Carbonare ◽  
F. Folli ◽  
E. Patrini ◽  
P. Giudici ◽  
R. Bellazzi
Keyword(s):  
Health Care ◽  
Risk Management ◽  
Adverse Events ◽  
Health Care Services ◽  
Care Delivery ◽  
Probabilistic Method ◽  
Parametric Modeling ◽  
Risk Level ◽  
Loss Distribution ◽  
Compensation Claims

SummaryBackground: The increasing demand of health care services and the complexity of health care delivery require Health Care Organizations (HCOs) to approach clinical risk management through proper methods and tools. An important aspect of risk management is to exploit the analysis of medical injuries compensation claims in order to reduce adverse events and, at the same time, to optimize the costs of health insurance policies.Objectives: This work provides a probabilistic method to estimate the risk level of a HCO by computing quantitative risk indexes from medical injury compensation claims.Methods: Our method is based on the estimate of a loss probability distribution from compensation claims data through para -metric and non-parametric modeling and Monte Carlo simulations. The loss distribution can be estimated both on the whole dataset and, thanks to the application of a Bayesian hierarchical model, on stratified data. The approach allows to quantitatively assessing the risk structure of the HCO by analyzing the loss distribution and deriving its expected value and percentiles.Results: We applied the proposed method to 206 cases of injuries with compensation requests collected from 1999 to the first se -mester of 2007 by the HCO of Lodi, in the Northern part of Italy. We computed the risk indexes taking into account the different clinical departments and the different hospitals involved.Conclusions: The approach proved to be useful to understand the HCO risk structure in terms of frequency, severity, expected and unexpected loss related to adverse events.

scholarly journals Gydytojų ir slaugytojų požiūris į nepageidaujamų įvykių ir neatitikčių valdymą lietuvos bendrojo pobūdžio ligoninėse

2015 ◽  
Vol 1 (8) ◽  
pp. 29
Author(s):  
Loreta Marmienė ◽  
Ramunė Kalėdienė
Keyword(s):  
Health Care ◽  
Adverse Event ◽  
Adverse Events ◽  
Health Care Professionals ◽  
Work Experience ◽  
Near Miss ◽  
General Hospitals ◽  
Near Misses ◽  
Preventive Actions

Adverse events and near-miss management in Lithuanian general hospitals is analyzed in this article. The aim of the paper is to evaluate the attitudes of physicians and nurses towards adverse events and near-miss management. 1020 general hospitals health care professionals took part in the anonymous survey, which was performed during the period of June - December, 2014. The results suggested that 9.9% of the respondents did not know what adverse event is, and 10.7% did not know the meaning of near-miss. Nurses compared to physicians knew much more about the process of what and where to register the adverse event or near-miss. Most of the respondents declared that it is useful to register adverse events and near-misses. Older health care professionals with longer work experience were considerably more active in this process. Most of the respondents declared that after the near-miss happens, the efforts are put to examine causes of the event, but only half of them knew further near-miss investigation steps and were instructed about the adjustment and preventive actions.

The Impact of War on Population Health

2014 ◽  
Vol 1 (1) ◽  
Author(s):  
Turkan Ahmet
Keyword(s):  
Health Care ◽  
Health Status ◽  
Health Care Services ◽  
Negative Effects ◽  
The Past ◽  
Care Services ◽  
Physical Environments ◽  
The Social ◽  
Personal Experiences ◽  
The Impact

The past few decades of ongoing war in Iraq has had a dramatic impact on the health of Iraq’s population. Wars are known to have negative effects on the social and physical environments of individuals, as well as limit their access to the available health care services. This paper explores the personal experiences of my family members, who were exposed to war, as well as includes information that has been reviewed form many academic sources. The data aided in providing recommendations and developing strategies, on both local and international levels, to improve the health status of the populations exposed to war.

Novel Adverse Events of Iloperidone: A Disproportionality Analysis in US Food and Drug Administration Adverse Event Reporting System (FAERS) Database

2019 ◽  
Vol 14 (1) ◽  
pp. 21-26 ◽  
Author(s):  
Viswam Subeesh ◽  
Eswaran Maheswari ◽  
Hemendra Singh ◽  
Thomas Elsa Beulah ◽  
Ann Mary Swaroop
Keyword(s):  
Data Mining ◽  
Adverse Event ◽  
Adverse Events ◽  
Reporting System ◽  
Adverse Event Reporting System ◽  
Adverse Event Reporting ◽  
Disproportionality Analysis ◽  
Positive Signal ◽  
Data Mining Algorithms ◽  
Mining Algorithms

Background: The signal is defined as “reported information on a possible causal relationship between an adverse event and a drug, of which the relationship is unknown or incompletely documented previously”. Objective: To detect novel adverse events of iloperidone by disproportionality analysis in FDA database of Adverse Event Reporting System (FAERS) using Data Mining Algorithms (DMAs). Methodology: The US FAERS database consists of 1028 iloperidone associated Drug Event Combinations (DECs) which were reported from 2010 Q1 to 2016 Q3. We consider DECs for disproportionality analysis only if a minimum of ten reports are present in database for the given adverse event and which were not detected earlier (in clinical trials). Two data mining algorithms, namely, Reporting Odds Ratio (ROR) and Information Component (IC) were applied retrospectively in the aforementioned time period. A value of ROR-1.96SE>1 and IC- 2SD>0 were considered as the threshold for positive signal. Results: The mean age of the patients of iloperidone associated events was found to be 44years [95% CI: 36-51], nevertheless age was not mentioned in twenty-one reports. The data mining algorithms exhibited positive signal for akathisia (ROR-1.96SE=43.15, IC-2SD=2.99), dyskinesia (21.24, 3.06), peripheral oedema (6.67,1.08), priapism (425.7,9.09) and sexual dysfunction (26.6-1.5) upon analysis as those were well above the pre-set threshold. Conclusion: Iloperidone associated five potential signals were generated by data mining in the FDA AERS database. The result requires an integration of further clinical surveillance for the quantification and validation of possible risks for the adverse events reported of iloperidone.

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