MEDICAL ERROR VS MEDICAL

MALPRACTICE

Tarrinni I.
1318011163

What is patient safety?

The avoidance, prevention and amelioration of
adverse outcomes or injuries stemming from the
process of health care (US National Patient
Safety Foundation, 1999).

Medical Error
The failure of a planned action to be completed as
intended (an error of execution) or the use of a wrong
plan to achieve an aim (an error of planning) (Reason,
1990).
An act of omission or commission in planning or
execution that contributes or could contribute to an
unintended result (Grober, 2005).
Kekeliruan yang tidak diduga akan terjadi
/dikehendaki dalam pemberian pelayanan medis yang
dapat mengakibatkan luka ataupun tidak terhadap
pasien Gunwadi (2005).

Unintended injury
or complication that
results in disability,
death, or prolonged
hospital stay and is
caused (including
acts of omission
and acts of
commission) by
health care
management rather
than the patients
disease (Quality in
Australian Health
Study, 1995).

142,000 people died in 2013 from

adverse effects of medical treatment

Causes
Healthcare complexity
Complicated technologies, powerful drugs, intensive care,
prolonged history stay

System and process design

Poor communication, unclear lines of authority, lack of
coordination, inadequate assessment of patients condition,
poor leadership

Competency, education, and training

Various healthcare provider training and experience, failure
to know prevalence and seriousness of medical error

Human factors and ergonomics

Cognitive errors, sleep deprivation, fatigue, depression,
burnout, unfamiliar settings, time pressures, and increased
patient-to-nurse staffing ratio increases, drug names that look
alike or sound alike.

Penyebab terjadinya medical error (Merry,

2004)
Skilled-based error, misalnya technical error
Rulled-based error, misalnya menyalahi
prosedur yang ada
Knowledge-based error, misalnya kesalahan
perhitungan dosis obat

Klasifikasi secara teknis:

Error of omission
Kesalahan dalam mendiagnosa, keterlambatan dalam
penanganan pasien, tidak meresepkan obat untuk
indikasi yang tepat, dan melakukan apendiktomi tanpa
disertai dengan pemeriksaan patologi anatomi termasuk
sering terjadi.
Error of commission.
Kesalahan dalam memutuskan pilihan terapi,
memberikan obat yang salah atau obat diberikan melalui
cara pemberian yang keliru, kebiasaan untuk meresepkan
antibiotika pada penyakit-pentakit ringan, memberi obat
per injeksi padahal pemberian secara oral lebih aman.

What to do after the errors happened?

Recognizing that mistakes are not isolated
events
Placing the practice of medicine in perspective
Disclosing mistakes to oneself, patients, nonphysicians, other physicians, physicians
institution.

Medical Malpractice
Professional negligence by act or omission by
a health care provider in which the treatment
provided substandard of practice in the medical
community and causes harm, injury, or death to
the patient (Mello, 2014).
Negligent, improper, or unskilled treatment of
patients by health care provider where the they
have failed to follow accepted medical practice
standards, and the result is the harm or even the
death of the patient.

Elements:
A duty of care is owed by medical professionals to
patients who seek their medical care and
treatment. The medical professional failed to
deliver applicable standard of care.
Due to negligent care the patient suffered a
compensable injury.
The proximate cause of the patients injury was
negligence on the part of the medical professional
or substandard conduct on his or her part.

Characteristics for medical

malpractice to be considered
Failure to provide a proper standard of care
Patients have the right to expect to receive these
standards when being treated.

An injury was the consequence of negligence

An injury with no negligence is not malpractice, and
neither is apparent negligence if there is no injury.

The patients injury must have very damaging

consequences
The patient doesnt give consent in informed consent
and still the act is done and resulted in some harm
though the act was done successfully

Types:
Birth injuries, such as cerebral palsy.
Mistakes made during surgery, such as leaving sponges or surgical
instruments inside patients, wrong-patient surgeries, wrong-organ
surgeries, or the use of unsanitary surgical instruments in the surgical
procedure.
Errors in administering anesthesiaAnesthesiologists make mistakes
in monitoring patients vital signs for signals that dosages are not
appropriate.
Errors in administering pharmaceuticalsPatients receipt of the
wrong drugs or the wrong dosages. They may occur as the result of
negligence, carelessness, or simply illegible handwriting or mistaken
use of medical abbreviations.
Misdiagnosis
Failure to diagnose
Failure to call for specific diagnostic tests or to consult an appropriate
medical specialist in order to treat a specific medical condition