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Commentary: Medical errors, sentinel events, and malpractice.

Robert I Simon1

  • 1Georgetown University School of Medicine, Washington, DC, USA. risimonmd@aol.com

The Journal of the American Academy of Psychiatry and the Law
|April 6, 2006
PubMed
Summary
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Medical errors are not always negligence. Minor patient injury from a deviation in the standard of care rarely leads to lawsuits, distinguishing it from quality of care.

Area of Science:

  • Medical Law
  • Healthcare Quality
  • Mental Health Services

Background:

  • Medical errors do not equate to negligence.
  • The standard of care differs from the quality of care.
  • Sentinel events, like suicide, do not automatically imply a standard of care deviation.

Purpose of the Study:

  • To clarify the distinction between medical errors, standard of care, and quality of care in mental health.
  • To analyze the legal implications of deviations from the standard of care.
  • To discuss the role of expert testimony in malpractice cases.

Main Methods:

  • Analysis of legal precedents and definitions.
  • Review of guidelines from the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and the Institute of Medicine (IOM).

Related Experiment Videos

  • Examination of the 'ordinarily employed' standard of practice.

    • Main Results:

    • Deviations from the standard of care with minor patient injury typically do not result in lawsuits.
    • Quality of care encompasses the totality of patient care, decisions, and services.
    • Sentinel events do not inherently indicate a breach in the standard of care.

    Conclusions:

    • The standard of care and quality of care are distinct concepts in healthcare.
    • Expert testimony should reflect the 'ordinarily employed' standard, not an unattainable 'best practice' standard.
    • Misapplication of 'best practice' standards in malpractice cases by experts can be erroneous.