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Patient injuries in pediatric otorhinolaryngology
Johanna Nokso-Koivisto1, Karin Blomgren1, Leena-Maija Aaltonen1
1Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Insights
Pediatric patient injuries in otorhinolaryngology (ORL) are primarily linked to surgical errors, often occurring during routine procedures. Awareness of these common incidents can help prevent harm to children undergoing ORL care.
Area of Science:
- Pediatric Otolaryngology
- Medical Error Analysis
- Patient Safety
Background:
- Pediatric patient injuries can lead to lifelong consequences for children and families.
- Understanding the causes of these injuries is crucial for improving care.
- Accepted patient injury claims provide valuable data for analysis.
Purpose of the Study:
- To identify errors and incidents causing patient injuries in pediatric otorhinolaryngology (ORL).
- To analyze accepted patient injury claims to understand contributing factors.
Main Methods:
- Reviewed accepted ORL patient injury claims from 2001-2011.
- Analyzed pediatric injuries, focusing on contributing factors.
Main Results:
- 17 (7.6%) of 223 ORL injuries involved children; 15 (88%) were operative care.
- Common incidents included incomplete surgery, retained foreign bodies, adjacent structure injury, and documentation errors.
- Burns were the most frequent consequence; one fatality occurred due to post-tonsillectomy hemorrhage.
Conclusions:
- Pediatric ORL injuries are strongly associated with surgical procedures.
- Most injuries occurred during routine operations performed by specialists.
- Clinicians must be aware of common injury scenarios to enhance patient safety.
Objectives:
Patient injuries in children can have lifelong effects on the patient and a marked impact on the whole family. The aim of this study was to identify the errors and incidents leading to patient injuries in pediatric otorhinolaryngology (ORL) by evaluating accepted patient injury claims.
Methods:
The records of all accepted patient injury claims in ORL between 2001 and 2011 were searched from the nationwide Patient Insurance Centre registry. Pediatric injuries were reviewed and evaluated in detail, and factors contributing to injury were identified.
Results:
In the 10-year study period, 17 (7.6%) of the 223 patient injuries occurred in children, and of these, 15 (88%) were considered operative care. The median age of the patients was 8 years (range 3-16 years). All operations were performed as daytime elective surgery and by a fully trained specialist in 93% of the cases. One-half of the cases were routine surgeries for common ORL diseases. The most common incidences were incomplete surgery, retained gauze or foreign body, injury to adjacent anatomic structure, and insufficient charts or instructions (each occurred in 3 cases). The most frequent consequence was burn (n = 4). One child died because of post-tonsillectomy hemorrhage.
Conclusions:
Patient injuries in pediatric ORL are strongly related to surgery. Most injuries occurred after routine operations by a fully trained specialist. Clinicians should be aware of the most likely scenarios resulting in claims.
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