Recognize and Address Inaccuracy - Patient fatalities following treatment missteps: 75 individuals
Instead of the intended surgery due to a cyst, a 39-year-old woman encountered an unintended sterilization - the reason being a mix-up. Mixing up patients or surgical sites, delivering the incorrect medication, or leaving medical equipment inside the body after procedures - these grave blunders, which should never occur and can be prevented, are known as "Never Events" in the medical field. Last year, around 150 such major occurrences were recorded by evaluators, which they highlighted at their 2023 annual statistics presentation in Berlin. The Medical Service serves as an evaluator for statutory health and long-term care insurance providers. A total of 75 patients lost their lives due to these errors, whereas 84 fatalities were reported the prior year.
To prevent such events, Stefan Gronemeyer, CEO of the Medical Service of the Federal Association, advocates for a mandated reporting system. Since such a system is not currently in place in hospitals, the statistics only reflect cases initiated by patients.
Damages resulting from errors are established in approximately 20% of assessments
Presently, the process is as follows: Should a patient suspect an error during their treatment, they can contact their statutory health insurance provider, allowing the company to engage the Medical Service in investigating the case. Only then is the case included in the statistics. In 2023, this occurred 11,500 times, a decrease of around 600 incidents compared to the previous year.
In most cases (71.1%), no wrongdoing by medical staff was uncovered by the experts. In around one in five cases (21.5%), or accounting for 2,679 treatments, patients incurred damage due to medical mistakes. This equates to a relatively stable number of cases from the previous year, with only 17 additional cases recorded. In all other assessments, either no damage or no clear link between the damage and wrongdoing could be established.
The number of documented errors is far lower than 1% of all medical treatments in Germany. For comparison's sake, the Federal Association of Statutory Health Insurance Physicians reports over 500 million treatment cases in practices annually. Nonetheless, these errors can still have significant consequences for patients.
What sort of harm do these errors inflict?
In the majority of cases (65.5%), patients experience temporary harm, whereas around 29.7% of those affected continue to encounter lasting effects. During 2022, the Medical Service categorized 180 of these long-term injuries as severe, meaning that patients now require care, have vision impairment, or are paralyzed.
The actual frequency of treatment errors is likely much higher. Experts hypothesize that preventable harm results from one percent of all stationary treatments. "Furthermore, experts estimate that around 17,000 preventable deaths occur annually in our hospitals due to errors," explained CEO Gronemeyer, citing a research study commissioned by the Action Alliance for Patient Safety.
To learn from these errors and avoid their recurrence, the Medical Service believes that a mandatory, penalty-free, and anonymized reporting system should be implemented for such cases.
Calls for a hardship fund and mandatory reporting
"When such errors occur, there are risks in the care process that require systematic resolution," demanded Gronemeyer. He criticized that the hospital reform proposed by the federal government does not include processes for preventing errors, which are widespread abroad.
The German Foundation for Patient Protection also heavily criticized the handling of errors in medicine. "Patients are left to fend for themselves. There is no error culture in practices and nursing homes," said the foundation's board member, Eugen Brysch.
In response to an inquiry by the dpa, the Federal Ministry of Health (BMG) acknowledged that clinics and practices are legally obligated to develop error reporting systems. "Both in the statutory health insurance sector and in hospitals, evaluations show a high level of implementation of error management and error reporting systems," the ministry stated.
To compensate those affected, a hardship fund, as promised in the coalition agreement, is required. "It cannot be that the injured must endure protracted waits before their rights are recognized," Brysch criticized and urged the health minister to submit a bill. The BMG confirmed that it is considering commissioning a concept for the design of a hardship fund.
The 75 patient deaths mentioned earlier are considered as a consequence of "Never Events," which are grave medical errors that should never occur and can be prevented. The research study commissioned by the Action Alliance for Patient Safety estimates that approximately 17,000 preventable deaths occur annually in hospitals due to errors.
