Review Question - QID 217614

This patient who experienced a deep venous thrombosis despite being on optimal prophylactic therapy had a non-preventable adverse event because no change in management would have been appropriate for this patient.

An adverse event is any form of harm that comes to a patient as a result of medical or surgical treatment. These events can broadly be divided into preventable adverse events, which occur due to an error in medical treatment or a failure to follow optimal standards of treatment, and non-preventable adverse events, which occur despite adherence to the best available treatment evidence. Non-preventable events therefore represent the inherent risks of undergoing treatment and must be weighed against the benefits of the recommended treatment. For example, one of the known risks of hospitalization is the development of a deep venous thrombosis despite optimal prophylaxis.

Rodziewicz et al. present a review article on the types of medical errors and harm that can occur to patients. They discuss how only some adverse events are preventable given the current limitations of medical practice.

Incorrect Answers:
Answer 1: Malpractice describes improper, negligent, or illegal activity by a medical practitioner that results in patient harm. In this case, the harm occurred despite optimal, evidence-based treatment of the patient.

Answer 2: Near miss events describe errors in medical practice that could have resulted in patient harm but did not actually result in harm. In this case, harm occurred to the patient despite optimal treatment.

Answer 3: Negligence describes failure of a healthcare provider to meet the standard of care provided by an average qualified provider. In this case, providers gave this patient optimal medical treatment.

Answer 5: Preventable adverse events describe harm that occurs to patients as a result of healthcare interventions due to sub-optimal practice. For example, a deep venous thrombosis that occurs in a patient who was never started on prophylaxis likely could have been prevented if they had been on optimal treatment. In this case, optimal prophylaxis was already provided to the patient.

Bullet Summary:
Non-preventable adverse events are harms that occur to patients despite adherence to the best available treatment evidence.