Errors in Otolaryngology Revisited

Abstract

Objectives:

1) Know the areas of risk for errors in otolaryngology. 2) Be able to discuss the implications of errors in otolaryngology. A decade ago, a survey study of errors in otolaryngology identified areas of risk and proposed a classification schema for errors. This study used a similar methodology to obtain current data for comparison.

Methods:

An anonymous online survey was distributed via the AAO-HNS weekly email. Respondents were asked to describe any event in their practice that they felt should not have happened. Events were classified using the prior schema.

Results:

445 (66%) of 681 respondents reported an event within the past six months. Mean age of affected patients was 41±24 years. An adverse consequence occurred in over half of events with corrective action taken in 82.8%. 68% of respondents subsequently changed their practice patterns. Domains with the most reported errors were technical (27.9% of all events, 71% with major morbidity), administrative (12.2%, 3.7%), errors in testing (10.8%, 8.3%), and surgical planning (9.9%, 45.5%). There were 8 wrong site surgeries, 23 cranial nerve injuries (91.3% major morbidity), and 9 errors during endoscopic sinus surgery (55.6% major morbidity). There were 4 deaths.

Conclusions:

Otolaryngologists remain vulnerable to error-related adverse events. The domains with the greatest risk for error-related major morbidity have changed little and include errors in surgical planning, equipment-related errors, and technical errors (surgery near cranial nerves and endoscopic sinus surgery). Awareness of high-risk areas may help us focus more preventive efforts in these domains.