Structure of medical care defects taking into account errors and omissions

Abstract

The article for the first time describes a carried out comprehensive analysis of defects in the defects of medical care (MC), highlighting medical errors and omissions during the treatment and diagnostic process, taking into account their various combinations. An analysis of 208 conclusions of the commission forensic medical expertise (CFME) carried out during the period from 2006 to 2012 in the National Bureau of Expertises of the National Academy of Science of the Republic of Armenia is presented. It was revealed that in 141 cases (67.8 %) of CFME different MC defects were detected, but in 67 cases (32.2 %) of CFME such defects were not registered. Later, the classification of MC defects was made: defects diagnostics, defects of treatment, defects of the organization of medical care and defects of keeping medical records. Among the MC defects the defects of diagnostics prevail – 123 cases (30.1 %). In the overwhelming majority of cases (90.1%), MC defects have combined character: the incompleteness of the examination led to incorrect or untimely diagnosis and, consequently, to inadequate or late treatment. In 9.9 % of cases isolated MC defects were registered. The analysis of the ratio of medical errors and omissions during the diagnostic and treatment processes in the total set of defects of diagnosis and treatment was also conducted. During the subdivision of diagnostic and treatment defects into two types (‘errors’ and ‘omissions’), their occurrence was detected in various combinations: from the absence of both to their presence.