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Behavioral factors in surgical errors

New York residents may not be aware of a recent Mayo Clinic study which examined the human behavioral factors behind certain types of surgical errors. These 'never events," named so because they should never take place, were found to be caused by a variety of factors. The researchers discovered 69 of these events over the course of 1.5 million invasive procedures performed over a five-year period at the clinic. Their causes were coded to identify underlying environmental, organizational, job and individual characteristics that led to the incidents.

Nearly two-thirds of these events occurred during minor procedures, such as line placements, endoscopies and soft tissue procedures. Even highly skilled and motivated medical teams experience never events, according to one of the study's senior authors. Multiple factors contribute to medical errors, and team vigilance is necessary in order to prevent potential problems.

The ability of any member of the medical team to speak up is crucial for the prevention of errors, according to researchers. It is also important to implement systems approaches, such as Mayo Clinic's sponge-counting system. The system uses bar code-scanning to track sponges and prevent them from being left inside patients. Cognitive capacity is another important factor to assess, including team composition, technology interfaces, time pressures and fatigue. When proper preventative measures are not taken, the stakes can be high for patients as well as hospital staff.

Patients who have been harmed as the result of surgical errors often suffer long-term complications that result in extensive time off from work and significant medical expenses. In order to demonstrate that the error amounted to a failure to observe the requisite standard of care, an attorney for an injured patient can examine the appropriate medical records and obtain the opinions of experts in order to determine whether the health care practitioner should be held responsible for the patient's losses.

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