GASTROENTROLOGY ARTICLE OF THE WEEK
March 6, 2008
Gallagher TH, Studdert D, Levinson W. Disclosing harmful medical errors to patients. N Engl J Med 2007:356;2713-9
1. A 43 year old female undergoes a liver biopsy for evaluation of chronic hepatitis C infection. The patient develops significant pain after the biopsy requiring IV analgesics and an overnight stay in the hospital. The biopsy report describes the liver biopsy findings and in addition mentions the presence of a 0.5cm core of normal renal tissue. You call the patient to discuss results, the patient is now asymptomatic. You (select only one answer): a. Discuss the results of the liver biopsy and leave it at that
b. Discuss the results of the liver biopsy and report that an inadvertent kidney biopsy was done
c. Discuss the results of the liver biopsy and profusely apologize for the kidney biopsy, describing that as an error
d. Have the patient come to the clinic for a face to face discussion
True or False
2. Providing an apology during disclosure of an error should be avoided as this is interpreted as admission of guilt
3. Disclosing all errors promptly has not been shown to increase the risk of a lawsuit.
4. When disclosing medical errors, it is recommended that the nature of the error be disclosed, but not the cause, even if known
5. In many states, information related to causality or fault that is disclosed during discussion of medical errors can be used in a court of law
6. It is likely that “rapid response teams” likely headed by Dr. Farmer will be created to conduct disclosures in the future