More than 4,000 adverse incidents occur in Irish hospitals each month

8 March 2010

MORE THAN 4,000 adverse incidents occur in Irish hospitals each month, new figures show.

The figures, which include major and minor incidents ranging from medication errors to slips, trips and falls, have been collated by the State Claims Agency.

Its records show some 282,045 clinical incidents or near misses were reported by hospitals between January 2004 and mid-August 2009 – the equivalent of 4,178 reports being made every month. The data was presented to the annual conference of the Irish Hospital Consultants Association in Cavan at the weekend.

Dr Ailis Quinlan, head of the clinical indemnity scheme at the agency, told the conference that just a fraction of the adverse incidents reported – 3,522 of them – had gone on to become claims.

But she said the agency paid out a total of €73.9 million in respect of clinical claims between 2003 and 2008, and expects to pay out €60 million in medical negligence claims in 2009. The increased costs this year relate to the fact that some cases take time to be finalised, but she stressed that since its inception in 2002, the agency’s clinical indemnity scheme has reduced the time taken to settle claims from five-seven years to 2.3 years in 2008.

On average, the agency gets around 500 new medical negligence claims a year. Nearly half of all new claims lodged last year related to obstetrics or surgery. Overall, Dr Quinlan said 22 per cent of claims come from obstetrics, but they account for 65 per cent of the costs.

In terms of the specific types of claims lodged last year, her figures show 18 per cent concerned surgical issues, 17 per cent were around childbirth, 17 per cent related to a treatment incident, 14 per cent related to a diagnosis incident, 13 per cent to infection control and 2 per cent to medication incidents.

Among the adverse events reported last year were 1,569 cases where an incorrect dose of medication was given to a patient and 1,136 cases where wrong medical records were applied to a patient.

Dr Quinlan said after a serious adverse event, patients and families want an acknowledgement of what happened, an explanation, an apology and reassurance it will not happen again. “Failure to communicate with patients appropriately after such events undermines public confidence, suggests preservation of narrow professional interests over patient well-being, and is in breach of professional ethics,” she said.

She added that the University of Michigan Health System found that when it adopted an open approach, and apologised rather than denying everything when errors occurred, it actually faced less litigation. Since 2002, when it made the change in policy, claims have fallen and significant savings have been made in insurance and litigation costs.

“By doing the right thing when patients are harmed by the healthcare system, costs to the exchequer are likely to be reduced,” she said.

Meanwhile, Dr Quinlan said just six claims to date under the clinical indemnity scheme had been settled by mediation. But she said the agency and the HSE had set up a committee to look at expanding the use of mediation.

In July 2002, the agency’s indemnity scheme took over handling compensation claims against healthcare workers. In February 2004, it took over handling claims against hospital consultants.

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