"Never Events"--Medical Errors That Should Never Happen

Good health permitting, the vast majority of us want to avoid being a patient (or a family member of a patient) in a hospital.  At a minimum, it means being injured or sick and having to deal with the added expense, uncertainty, and overall disruption that comes along with being hospitalized.  Thus, even in the best-case scenario, hospitalizations represent an extremely vulnerable time for patients and their families.  Far too often the negative impact of hospitalization doesn't end with “best care scenarios,” especially when patients and their families must deal with the consequences of inexcusable medical errors known as “never events”—i.e., the kind of medical act or omission that should never happen in a modern hospital setting.

We have previously noted on this blog the alarming number of people that are estimated to die each year due to negligence while being cared for a hospital.  The estimate ranges from the as few as 98,000, to more recent estimates which suggest the number may be anywhere from 210,000 to 440,000.   One of the ways the health care industry has tried to address these startling numbers is through the identification and prevention of “never events.”

In 2002, the National Quality Forum (NQF) introduced the term “Never Event” to describe 27 particularly egregious medical errors (such as operating on the wrong patient or wrong body part) that should never happened.  Currently, there are 29 different events grouped into the following six categories:  Surgical Events, Product or Device Events; Patient Protection Events; Care Management Event; Environmental Events; Radiologic Events and Criminal Events.  For a complete listing of the NQF’s 29 never events click here.

While no act of medical negligence is ever acceptable and should in theory never occur, the NQF’s 29 “never events” represent some of the most egregious forms of medical malpractice.   Far too often, the health care industry has attempted to sweep under the rug the problem of medical negligence and its detrimental impact.  The public acknowledgement by the health care industry that these events should never happen is a positive step toward addressing the problem and impact of medical negligence, instead of simply trying to minimize the public perception of the problem.  

-Ryan and Tom