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Briefing and Opinion
October 22, 2004

Stress Factor
Errors & Causes

Taxonomy of Etiologies (Causes) of Medical Errors

A small sample of some of the causes of error, along with examples illustrating the impact of these errors on the delivery of medical care.

Deficient knowledge
Never learned a particular entity (physician cannot recognize a scleroderma.)

Deficient judgment or cognitive skills
Failure to recognize own limits in ability to identify and/or treat the patient.

Internal systems failure
Equipment malfunction (can be unavoidable or avoidable, if for example no attention to maintenance.)

External systems failure
"Production quotas" set that strain medical staff availability for practice of medicine.

Inadequate or inaccurate data
Medical history inaccurately reported by the patient (intentionally or unintentionally.)

Miscommunication
Verbal order confused due to similarity of names (HiB given rather than Hep B vaccine.)

Failure to convey empathy
Poor patient compliance with follow-up and treatment recommendations.

Cavalier personality
Overconfidence in technical skills (performs new procedure without previous experience, or performs familiar procedure in atypical circumstances.)

Source: MEDICAL ERROR, edited by Marilynn Rosenthal and Kathleen M. Sutcliffe of the University of Michigan, Chapter 3, Medical Error in Primary Care by Michael D. Fetters.