Classification of Reported Events From Phases 1 and 2
Category | n | % |
---|---|---|
Errors of diagnosis | ||
Error or delay in diagnosis | 88 | 7.2 |
Patient misidentification | 30 | 2.4 |
Use of inappropriate tests or therapy | 5 | 0.4 |
Failure to use indicated tests | 12 | 1 |
Failure to act on results of monitoring or testing | 2 | 0.2 |
Subtotal | 137 | 11.2 |
Errors of treatment | ||
Wrong medication or wrong dose or schedule or infusion rate* | 581 | 47.2 |
Error in administration or method of using a treatment | 176 | 14.3 |
Patient misidentification | 85 | 6.9 |
Error in the performance of an operation, procedure, or test | 53 | 4.3 |
Avoidable delay in treatment or in responding to an abnormal test | 39 | 3.2 |
Inappropriate (not indicated) care | 15 | 1.2 |
Subtotal | 949 | 77.2 |
Errors of prevention | ||
Failure to provide prophylactic treatment | 0 | 0 |
Inadequate monitoring or follow-up treatment | 0 | 0 |
Patient misidentification | 0 | 0 |
Subtotal | 0 | 0 |
Other errors | ||
Other system failure | 84 | 6.8 |
Equipment failure | 23 | 1.9 |
Patient misidentification | 21 | 1.7 |
Failure of communication | 16 | 1.3 |
Subtotal | 144 | 11.7 |
Total | 1230 | 100 |
↵* Includes medications, nutritional agents, and blood products.