TABLE 1.

Classification of Reported Events From Phases 1 and 2

Categoryn%
Errors of diagnosis
 Error or delay in diagnosis887.2
 Patient misidentification302.4
 Use of inappropriate tests or therapy50.4
 Failure to use indicated tests121
 Failure to act on results of monitoring or testing20.2
 Subtotal13711.2
Errors of treatment
 Wrong medication or wrong dose or schedule or infusion rate*58147.2
 Error in administration or method of using a treatment17614.3
 Patient misidentification856.9
 Error in the performance of an operation, procedure, or test534.3
 Avoidable delay in treatment or in responding to an abnormal test393.2
 Inappropriate (not indicated) care151.2
 Subtotal94977.2
Errors of prevention
 Failure to provide prophylactic treatment00
 Inadequate monitoring or follow-up treatment00
 Patient misidentification00
 Subtotal00
Other errors
 Other system failure846.8
 Equipment failure231.9
 Patient misidentification211.7
 Failure of communication161.3
 Subtotal14411.7
Total1230100
  • * Includes medications, nutritional agents, and blood products.