Medical error documentation

Elias Peter pheski69 at GMAIL.COM
Thu May 5 13:10:51 UTC 2016


I forked and retitled the thread because I want to point out that this is not an issue limited to death certificates. Documentation of error, harm and risk should occur not just after death, but also during care.

I routinely used ICD 999.9 “Other and unspecified complications of medical care, not elsewhere classified” for all manner of errors and error-prone settings, putting it in the chart as an active (or resolved) problem, and using it as part of my assessment and plan.I discussed the errors or risks of errors with patients, and what we could (and couldn’t) do to mitigate it. And I gave all my patients copies of their office visit notes, including this.

Patients appreciated it. My colleagues and office staff found it useful. It never turned into a legal incident, and I suspect but cannot prove that it prevented many legal incidents. It clearly helped with care. My employer made it clear they were not happy about this, but never actually told me to stop.

Peter Elias, MD


> On 2016.05.05, at 8:35 AM, Joe Graedon <jgraedon at GMAIL.COM> wrote:
> 
> This is a very interesting concept. 
> 
> Just out of curiosity, has anyone ever asked the question or sought an answer to the question: 
> 
> How many times does "Error in Diagnosis" show up on death certificates? If I were a betting person I would guess rare to never. 
> 
> As to the second "Error in Medicine" I would guess never. 
> 
> To change that one would need to change the culture of medicine. 
> 
> Joe
> 
> Sent from my iPad
> 
> On May 4, 2016, at 11:11 PM, robert bell <0000000296e45ec4-dmarc-request at LIST.IMPROVEDIAGNOSIS.ORG <mailto:0000000296e45ec4-dmarc-request at LIST.IMPROVEDIAGNOSIS.ORG>> wrote:
> 
>> It is not common practice to put either Error in Diagnosis, or Error in Medicine on a death certificate. They seem to require some kind of diagnosis even if it may be incorrect.
>> 
>> Could this Society change that with action and recommendations or would you have to first change litigation law to achieve that?
>> 
>> Are there any other solutions that would be acceptable? 
>> 
>> This would seem to be part of that data lack that plagues the Error in Medicine discipline.  
>> 
>> Robert M. Bell, M.D., Ph.C.
>> 
>> 
>> 
>> 
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Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine


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