From iatrogenic harm to iatrogenic violence: corruption and the end of medicine

2021 ◽  
Vol 28 (2) ◽  
pp. 255-275
Author(s):  
Leah M. Ashe
Keyword(s):  
Iatrogenic Harm

Incidence of paediatric 10-fold medication errors in Wales

2020 ◽  
pp. archdischild-2020-319130
Author(s):  
Yincent Tse ◽  
David Tuthill
Keyword(s):  
Medication Errors ◽  
Reporting System ◽  
Patient Characteristics ◽  
Population Based ◽  
Population Surveillance ◽  
Near Miss ◽  
Surveillance Study ◽  
High Resource ◽  
Improvement Strategies ◽  
Iatrogenic Harm

ObjectivesTo estimate the incidence, characteristics and outcomes of 10-fold or greater or a tenth or less medication errors in children aged <16 years in Wales.DesignPopulation-based surveillance study July 2017 to June 2019. Cases were identified by paediatricians and hospital pharmacists using monthly electronic Welsh Paediatric Surveillance Unit (WPSU) reporting system.Patients‘Definite’ incident occurred when children received all or any of the incorrect dose of medication. ‘Near miss’ was where the prescribed, prepared or dispensed medication was not administered to the child.Main outcome measuresIncidence, patient characteristics, setting, drug characteristics, outcome, harm and enabling or preventive factors.ResultsIn total, 50 10-fold errors were reported; 20 definite and 30 near miss cases. This yields a minimum annual incidence of 1 per 3797 admissions, or 4.6/100 000 children. Of these, 43 were overdoses and 7 underdoses. 33 incidents occurred in children <5 years of age. Overall, 37 different medications were involved with the majority, 31 cases, being administered enterally. Of these 31 enteral medication errors, all definite cases (10) had received liquid preparations. Temporary harm occurred in 5/20 (25%) definite cases with one requiring intensive care; all fully recovered.ConclusionsIn this first ever population surveillance study in a high-resource healthcare system, 10-fold errors in children were rare, sometimes prevented and uncommonly caused harm. We recommend country-wide improvements be made to reduce iatrogenic harm. Understanding the enabling and preventive factors may help national improvement strategies to reduce these errors.

Reducing the burden of iatrogenic harm in children

The Lancet ◽  
2015 ◽  
Vol 385 (9978) ◽  
pp. 1593-1594 ◽  
Author(s):  
Andrew Carson-Stevens ◽  
Adrian Edwards ◽  
Sukhmeet Panesar ◽  
Gareth Parry ◽  
Philippa Rees ◽  
...  
Keyword(s):  
Iatrogenic Harm

scholarly journals Just culture: “Evidence”, power and algorithms

2013 ◽  
Vol 2 (3) ◽  
pp. 73 ◽  
Author(s):  
Sidney W. A. Dekker ◽  
James M. Nyce
Keyword(s):  
Adverse Events ◽  
Organizational Justice ◽  
Medical Errors ◽  
Just Culture ◽  
Iatrogenic Harm ◽  
The Creation ◽  
Power Play

Background: The notion of “just culture” has become a way for hospital administrations to determine employee accountability for medical errors and adverse events. Method: In this paper, we question whether organizational justice can be achieved through algorithmic determination of the intention, volition and repetition of employee actions. Results and conclusion: The analysis in our paper suggests that the construction of evidence and use of power play important roles in the creation of “justice” after iatrogenic harm. 

Muddying the waters? A false positive case of autoimmune psychosis

2020 ◽  
pp. 103985622096504
Author(s):  
Sarangan Ketheesan ◽  
Georgia Bertram ◽  
Robert Adam ◽  
Anne Stark ◽  
James G Scott
Keyword(s):  
Psychotic Disorders ◽  
Signs And Symptoms ◽  
Psychosocial Problems ◽  
Antibody Testing ◽  
Laboratory Findings ◽  
Antineuronal Antibodies ◽  
Neurological Signs ◽  
Iatrogenic Harm ◽  
Treatment Refractory ◽  
Autoimmune Psychosis

Objective: To discuss challenges with the diagnosis of autoimmune psychosis (AP) in people with chronic psychotic disorders. Method: We present a case of a 23-year-old man with an exacerbation of treatment-refractory psychosis after receiving intravenous immunoglobulin (IVIG) for suspected AP, diagnosed 4 years after the onset of psychosis. We highlight the diagnostic and management challenges in such cases. Results: The diagnosis of AP in people with long-standing illness relies on the interpretation of non-specific clinical and laboratory findings in individuals with psychosocial problems and challenges of acceptance and adherence to complex medical investigations and treatments. Equivocal results from investigations undertaken without logical clinical reasoning can lead to inappropriate interventions that are costly and can cause iatrogenic harm. Conclusion: Psychiatrists should restrict screening for antineuronal antibodies in people with chronic psychosis to those with higher risk features such as persistent treatment refractory symptoms with concurrent neurological signs and symptoms. Further research informing the clinical circumstances for antineuronal antibody testing is needed.

scholarly journals Protecting children from iatrogenic harm during COVID19 pandemic

2020 ◽  
Vol 56 (7) ◽  
pp. 1010-1012
Author(s):  
Anna Camporesi ◽  
Franco Díaz‐Rubio ◽  
Christopher L Carroll ◽  
Sebastián González‐Dambrauskas
Keyword(s):  
Iatrogenic Harm

Orthodontic Conundrums Part 1: Transposition – an Update on Presentation and Treatment Modalities

2020 ◽  
Vol 13 (4) ◽  
pp. 188-198
Author(s):  
Naeem I Adam ◽  
Adam Jowett ◽  
Trevor Hodge
Keyword(s):  
Clinical Features ◽  
Clinical Relevance ◽  
Treatment Options ◽  
The Other ◽  
Treatment Modalities ◽  
Dental Anomalies ◽  
Treatment Approaches ◽  
Dental Practitioner ◽  
General Dental Practitioner ◽  
Iatrogenic Harm

This is the first article in a three-part series considering uncommon dental anomalies and treatment approaches. Dental transpositions are rare anomalies which may present to the general dental practitioner or orthodontist. The management of transpositions is dependent on several factors, including the sub-type, severity and the other salient features of the malocclusion. Transposition may either be accepted or orthodontically corrected and the adoption of either approach must be preceded by thorough assessment of the patient. CPD/Clinical Relevance: The presentation and management of transposition is variable. The general dental practitioner must be aware of the clinical features of a developing transposition as certain treatment options are only possible before the transposition is fully established. In addition, the orthodontist must be mindful of the potential for iatrogenic harm if these dental anomalies are managed injudiciously.

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