Published online December 1, 2005
PEDIATRICS Vol. 116 No. 6 December 2005, pp. 1276-1286 (doi:10.1542/peds.2005-0946)
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Parental Preferences for Error Disclosure, Reporting, and Legal Action After Medical Error in the Care of Their Children

Cherri Hobgood, MD*, Joshua H. Tamayo-Sarver, MD, PhD{ddagger}, Andrew Elms, MSII§ and Bryan Weiner, PhD||

* Department of Emergency Medicine
§ University of North Carolina School of Medicine, Chapel Hill, North Carolina
{ddagger} Department of Epidemiology and Biostatistics, Case Western Reserve University School of Medicine, Cleveland, Ohio
|| Department of Health and Policy Administration, University of North Carolina School of Public Health, Chapel Hill, North Carolina

Objective. No data exist on parental preferences for disclosure, reporting, and seeking legal action after errors in the care of their children are disclosed. This study examined parental preferences for error disclosure and reporting; responses to error disclosure; and preferences and responses by race/ethnicity, gender, age, and insurance.

Methods. A 4-scenario survey instrument portraying a range of medical error was provided to a convenience sample of parents who presented with children to an emergency department. Parents were asked to categorize the error, express preferences for disclosure and reporting, and then report how they expected to respond with and without disclosure. Basic demographics were collected also. Bivariate analyses of demographics were performed with Fisher's exact tests, analysis of scenario responses was performed with Somers' D, and the independent effects of the study variables were assessed with a generalized estimating equation.

Results. Research assistants approached 661 parents; 499 participated (75% response rate). Of all scenarios presented to the parents, they judged 54% of the scenarios as severe, 99% wanted disclosure, 39% wanted the error reported to a disciplinary body, and 36% were less likely to seek legal action if the error was disclosed by the physician. In multivariate modeling, severity was associated with desire for disclosure, reporting, and change in likelihood of legal action with disclosure.

Conclusions. Regardless of severity, parents want to be informed of error. Educational interventions to improve error disclosure should emphasize the uniformity of parental preferences for disclosure, reporting, and the decreased likelihood of legal action when errors are disclosed than if discovered through other means.

Key Words: emergency department • patient safety • medical error • reporting systems • pediatrics

Abbreviations: RR, relative risk • CI, confidence interval

Accepted Jun 23, 2005.


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