In medical practice, ‘accident’ is widely utilised, which in its origin is substantially different from a medical error, because it does not depend on any actions or omissions of the physician. However, an ‘accident’ is treated as a medical error until the circumstances and details are figured out. The majority of professionals use the term ‘accident’ in situations where an unfavorable outcome is related to accidental circumstances, ‘force majeure’, ie the outcome doctor simply couldn’t foresee and prevent. The accidents include:
- 1. Unforeseen complications or death due to allergic or toxic reactions when using drugs or prophylactic vaccination, used in accordance with the instructions;
- 2. Sudden death before or during the operation because of the mental or emotional shock;
- 3. Postoperative complications (air embolism or bleeding);
- 4. Reflex cardiac arrest during the manipulation (angiography, pyelography, EGD, cardiac catheterisation, and etc.).
We believe that the list could be quite long, as combining a comprehensive list of accidents in medicine is a hardly implementable mission. Thus, each accident that happened for the first time became a reflection of a confluence of fortuitous circumstances.
As an example, let’s consider following case, which occurred more than 25 years ago in Birmingham. A girl 6 years old in good condition with a diagnosis of small focal pneumonia in acute course and non-complicated form, was brought to children’s department. The doctor on duty appointed an intramuscular injection of penicillin in age dosage, acting in accordance with standard instructions at that time; the doctor gathered the info on allergic history from relatives, and conducted the appropriate test for penicillin. There was no reaction to intradermal injection of penicillin. After 2 hours, another intramuscular injection of penicillin was introduced in the therapeutic dosage. Suddenly, the child has started to experience seizures, breathing and blood circulation stopped. Despite resuscitation procedures, death occurred within 40 minutes after injection. According anatomopathological study, the results of an official investigation and examination conducted by a commission, the cause of death was anaphylactic shock, developed as a result of intolerance to penicillin.
In this case, medical care was carried out properly, but in the course of the normal treatment process a random factor invaded, and became the direct cause of the death of the patient. Talking about such a specific cases, this was a nothing but a factor that couldn’t have been covered by foresight. It comes suddenly, and so it becomes unavoidable for the doctor. Circumstances excluding the responsibility of the attending physician and health facility for damages arising as a result of random factors, which are regarded to as force majeure in the proper, legitimate treatment.
This way or the other, according to a number of legal platforms focusing on medical negligence and offering huge stats database replenished by medical negligence solicitors, the a number of cases where a compensation issue to the claimant was the outcome, accounted for 37% of cases in 2014, meaning the number of accidents seems to be really high against the background of medical errors.