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You cannot disclose the error as a resident due to hospital policy
4%
1/28
Tell the patient, but ask her not to tell her parents
0%
0/28
Speak to risk management before deciding whether or not to disclose the error
7%
2/28
Tell the patient and her parents about the error
71%
20/28
Since there was no lasting harm to the patient, it is not necessary to disclose the error
Select Answer to see Preferred Response
Physicians must disclose errors whether large or small, and whether there is lasting harm done or not. The appropriate way to handle the situation is to tell the patient and her family that she was accidentally given a dose of a medication she did not need, and that you will monitor her closely to make sure there are no side effects. Risk management consultation may be appropriate if the patient/family becomes extremely angry or threatens to sue, however the ideal answer on Step 1 is usually for physicians to disclose errors immediately rather than withholding information. Brazeau discusses a case of physician error that resulted in prolongation of patient symptoms. He notes that truth-telling about the error usually strengthens the physician-patient bond and helps patients to better understand their illness, but acknowledges the difficulties of disclosure in a malpractice-heavy climate. Nonetheless, 98% of patients want their physicians to disclose even minor errors. Clinton and Obama describe a position statement on reform of medical malpractice legislation and note that when the University of Michigan introduced a program that featured 1) swift acknowledgement of cases where a patient was hurt due to medical error and fair compensation 2) aggressive defense against malpractice cases deemed without merit and 3) studying all adverse events, there were remarkable drops in the number of cases of malpractice levied and amount spent on legal fees. Illustration A illustrates the relationships between near-misses, errors, and adverse events resulting from errors. Illustration B shows suggested components of an error disclosure based on materials from the University of Washington. Incorrect answers: Answer 1,2: Physicians need to disclose medical errors, and it is clearly inappropriate to inform a minor patient while asking her to keep information from her parents. Answer 3: The best choice on Step 1 is usually for physicians to disclose their own mistakes honestly and swiftly to patients. Risk management may be notified, but the error still must be disclosed. Answer 5: Whether there is lasting harm or not, errors must be disclosed.
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