Doctors not open about mistakes, finds researcher

A SENIOR medical researcher has expressed concern that doctors are not being open about the incidence of surgical errors given the low level of reporting of clinical mistakes by medical staff.

Oisín Breathnach, a lecturer at the Royal College of Surgeons Ireland said doctors accounted for just 4% of all adverse surgical incidents reported to the Clinical Indemnity Scheme (CIS) which is overseen by the State Claims Agency.

“The low figure of reporting of adverse events among medical staff is concerning, in particular when the guidelines in relation to dealing with error from the World Health Organisation are reviewed,” said Mr Breathnach.

His comments follow a review of closed claims made to the CIS which recorded 42,094 adverse surgical events between January 2004 and May 2010.

In a study of 242 closed surgical claims, unexpected complications following an operation accounted for 48% of all documented events. Mr Breathnach said nurses and midwives had reported 85% of all surgical events, while medical staff including doctors had accounted for only 4%.

However, Mr Breathnach acknowledged while the reporting level by doctors was low, it was not unusual by international standards.

Meanwhile, Ciarán Breen, director of the State Claims Agency, said it strongly believed financial incentives were the most effective way of managing clinical negligence costs and engaging hospitals on risk management issues.

Mr Breen said the SCA endorsed insurance premiums being set on the basis of the number and speciality of medical staff employed by each member of a risk pooling scheme, except for obstetric units where they should be based on the number of births.

The SCA director said while the modern approach was against blaming individuals to avoid creating a culture of fear and defensiveness, hospitals must take responsibility for medical errors in their facilities.

Mr Breen said a number of developments, including the launch of the Patient Safety First initiative and new standards by the Health Information and Quality Authority, should ensure greater levels of safety.

Health Minister Mary Harney reported last month compensation paid by the SCA amounted to €59.9m up to the end of August.