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Wrong tooth extraction: further analysis of "never event" data
1Division of Dentistry, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Higher Cambridge Street, Manchester M15 6FH, UK; University Dental Hospital of Manchester, Higher Cambridge Street, Manchester M15 6FH, UK.
The British Journal of Oral & Maxillofacial Surgery
|September 15, 2019
Summary
Wrong tooth extraction remains a frequent patient safety issue in England. Despite efforts, this "never event" persists, highlighting the need for improved prevention strategies in dental settings.
Area of Science:
- Patient Safety
- Surgical Errors
- Healthcare Quality Improvement
Background:
- The National Health Service (NHS) in England mandates reporting of specific
- never events
- to enhance patient safety.
- Previous analyses covered 2012-2015 data on these incidents.
Purpose of the Study:
- To analyze trends in
- never events
- from 2015-2019.
- To assess the frequency and impact of wrong tooth extraction incidents.
Main Methods:
- Analysis of national patient safety incident reports.
- Examination of data from 2015 to 2019.
- Categorization of incidents as
- wrong-site surgery
- and
- never events
- .
Main Results:
- Wrong tooth extraction did not decrease in frequency between 2015-2019.
- These incidents constitute 16%-24% of wrong-site surgery
- never events
- ,
- and 7%-10% of all reported
- never events
- .
Conclusions:
- Wrong tooth extraction remains a significant and common patient safety concern.
- Reports now originate from hospitals, community trusts, and primary dental care.
- Enhanced implementation of existing preventive measures is crucial to reduce wrong tooth extractions.
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