What Are the Top 5 Medical Errors? Warning Signs and FAQ
Medical errors are the third-leading cause of death in the U.S. With patient safety a top priority, alarming medical error statistics like this raise the question, What are the top 5 medical errors?
It’s a good question. Busy work environments where staff are trying to focus on multiple patients at any given time can lead to missteps in the care process despite efforts to ensure quality care. For facility leaders, recognizing the most common medical errors can provide insight into how to better support better and effectively target safety initiatives.
What Are the Top 5 Medical Errors? Causes and Warning Signs
The types of medical mistakes that frequently occur range widely across healthcare settings. Yet, many are avoidable through proper safety practices. Here, we’ll answer the initial question (What are the top 5 medical errors?) in addition to some contributing causes of medical errors and their warning signs. We’ll then follow with answers to a few other key questions about this urgent topic.
1. Medication Errors
So, what is the most common type of medical error? According to health experts, medication errors rank as one of the most frequent healthcare errors, causing somewhere between 7,000 to 9,000 deaths each year. However, not all types of medication errors lead to fatalities or other serious events. Medication mistakes can range from the seemingly benign (like a missed heartburn medication) to the severe.
Common causes include:
- Incorrect labeling, packaging, or dosing.
- Lack of proper oversight or pharmacy support.
- Misplaced or incorrectly stored medications.
- Lack of proper medication reconciliation or missed safety checks.
Warning signs include:
- Patient identifiers that don’t match the medication label.
- Patient confusion over the type or use of a medication.
- Medication that doesn’t align with standard practice (for the patient’s condition or dosing standards, for example).
2. Diagnostic Errors
Statistics also demonstrate that diagnostic-related mistakes are unfortunately common types of medical errors, accounting for up to 17% of adverse events in hospital settings. Diagnostic errors happen when proper treatment is impeded by problematic investigations into the patient’s condition. They typically fall into three main categories.
| Delayed Diagnosis | A diagnosis that could and should have been made earlier |
| Wrong Diagnosis | An original diagnosis that is later found to be incorrect |
| Missed Diagnosis | A diagnosis that was never identified upon assessment |
Common causes include:
- Missed or lacking patient history or physical information.
- Premature diagnosis of conditions.
- Incorrect or insufficient diagnostic orders (such as inappropriate laboratory workups).
- Failure to follow-up or refer patients for further treatment or evaluation.
Warning signs include:
- Inconsistencies between diagnostic orders and standards of care.
- Symptoms which don’t support (or go beyond) the current diagnosis.
- Cognitive biases that allow presumptions to guide diagnoses rather than data.
3. Surgical Errors
Roughly 4,000 surgical errors occur each year, making it another one of the most common medical errors in healthcare. Some of these incidents are so egregious they’re designated as never events. Examples of medical errors (surgical-specific) that qualify as never events include operating on the wrong patient or the wrong surgical site.
Common causes include:
- Lack of adherence to protocols.
- Poor communication or miscommunication between the surgeon and patient/healthcare team.
- Rushing procedures to finish cases more quickly.
- Improper follow-up or post-procedure management.
Warning signs include:
- Unexplainable and sudden changes in vital signs (high fever, drop in blood pressure, for example).
- Inconsistencies or ambiguities on consent forms.
- Redness or abnormally colored fluid at surgical site.
4. Device and Equipment Errors
There are thousands of different medical devices used to support care delivery each day. From pacemakers and ventilators to feeding tubes and blood pressure cuffs, this wide range of equipment can enable user errors in application or use.
Common causes include:
- Lack of staff training.
- Adoption of new devices without proper education.
- Poorly designed interface, resulting in confusion and faulty use.
- Inadequate equipment testing (like routine quality checks) or maintenance.
Warning signs include:
- Readings that don’t align with the patient’s condition or physical assessment.
- Tangled tubes or wires, compromising the understanding and integrity of equipment in use.
- Equipment that behaves or sounds differently from what’s usual.
5. Documentation Errors
These types of medical errors occur when inaccurate or faulty documentation results in patient harm. It can occur across various health settings. With paper charting, handwriting may be the culprit for bad communication. With electronic health records (EHRs), accessing the wrong patient charts, cutting corners by copying and pasting between charts, or forgetting to record pertinent information altogether can jeopardize patient safety.
Common causes include:
- Documentation burden among staff.
- Not following safety check protocols before inputting data.
- Using the wrong abbreviations, delays in charting information.
Warning signs include:
- Unexplained inconsistencies across a patient’s health records.
- Blank fields in a patient’s chart.
- Treatment orders that don’t align with the patient’s condition.
Medical Errors: FAQ
Now that you know the answer to the question, What are the top 5 medical errors? let’s get into some other common questions on this topic. Using the answers below, you’ll be better equipped to protect your patients from those top five. Learn how to respond to, and prevent, medication errors and other medical mistakes so you can better target the medical error reduction and prevention efforts of your organization.
How should staff respond to medical errors?
If you’re a healthcare staff member who finds that a near miss or medical mistake has occurred, it’s best to get ahead of it as soon as possible. Understand that these instances can be unavoidable (like with unforeseen equipment failures), despite your best efforts to deliver great care.
The priority next steps should always involve communication that is upfront and honest. Explain the error to patients, their families, and all relevant members of the healthcare team. This will help issues get resolved quickly and prevent the harm from escalating.
How should facilities respond to medical errors?
Facilities should have a clear reporting protocol for staff to document medical near misses or errors quickly. This information should also be analyzed and acted on to prevent future cases. In many cases, especially when a patient has come to harm, a root-cause analysis (RCA) is required to address systemic flaws that may have led to the adverse event.
Additional follow-up steps may include providing resources and support for staff and patients involved in the incident. It’s essential that the affected patient’s needs are thoroughly met. In some cases this may necessitate compensation.
How can medical errors be prevented?
There are many steps you can take to help prevent medical errors and promote a culture of safety at your facility. Follow these evidence-based measures to support the delivery of precise and accurate care among your staff:
- Use two-factor patient identification methods for medications and procedures.
- Utilize safety checklists for any surgeries and patient hand-offs.
- Implement standard protocols for medication administration and medical devices.
- Provide ongoing staff education and training on best care practices and nursing implications.
- Upgrade your documentation system by utilizing or optimizing EHR systems.
- Encourage open and consistent communication among your healthcare team.
Medical malpractice vs. negligence: What’s the difference?
Negligence happens when someone fails to meet their duty expectations. As a broader legal term, it often refers to situations where a person causes injury to another while acting in a careless manner. Medical Malpractice is a specific form of negligence. Malpractice-related healthcare errors are typically the result of actions that breach standards of care and expected professional competencies.
To better illustrate the difference between these terms, let’s compare how they might play out in clinical settings using examples of 3 types of prescription errors.
| Negligence Examples | Medical Malpractice Examples |
|---|---|
| 1. A medication is accidentally ordered for 100 mg instead of 10 mg due to distraction. The error is caught by the pharmacist, who calls to verify the dose.
2. Antibiotics are ordered for a patient with an associated allergy because patient safety information isn’t referenced (the nurse later voices concern and refuses to administer). 3. Due to fatigue, a prescription is written for a similarly named, but alternative medication (the patient then refuses the medication because it doesn’t match their standard regimen). |
1. The pharmacist recognizes that 100 mg is a large dose (aware that 10 mg is more appropriate), but delivers the medication to the patient anyway.
2. Nobody double checks the patient’s allergy list and fails to specify which antibiotic is being given to the patient during administration, leading to an anaphylactic reaction. 3. A physician orders a similarly-named drug instead of the intended medication. The EHR triggers a double-check, and despite recognizing that there may be an issue the physician decides to ignore the issue to avoid a delay. |
Find More Ways to Deliver Safe, High Quality Care
Now that you’ve learned the answer to, What are the top 5 medical errors?, you may be wondering how to reinforce other safety standards. Protect your patients from healthcare’s most pressing concerns with IntelyCare’s range of facility guides and best practice insights.
Legal Disclaimer: This article contains general legal information, but it is not intended to constitute professional legal advice for any particular situation and should not be relied on as professional legal advice. Any references to the law may not be current, as laws regularly change through updates in legislation, regulation, and case law at the federal and state level. Nothing in this article should be interpreted as creating an attorney-client relationship. If you have legal questions, you should seek the advice of an attorney licensed to practice in your jurisdiction.