It has been nine years since the first news of the Institute of Medicine reporting that 100,000 people were being killed unnecessarily in hospitals each year. Moreover, it has been almost three years since Healthgrades, a private hospital rating service, reported that the annual death toll was 195,000. There was a flurry of rhetoric coming from hospital public relations people about patient safety programs, yet the statistics kept getting worse. What's more, during the last three years,

Florida and several other states passed laws cutting lawyers' contingency fees by more than half on all medical malpractice cases. The same states passed laws requiring full disclosure of medical mistakes. No one thought to require full disclosure of dangerous conditions that increases the risk of falling victim to negligence, like a shortage of nursing staff, or equipment in disrepair. Thus, in the final analysis, hospitalization keeps getting more and more risky and victims have more difficulty in finding a lawyer.The most astounding aspect of hospital mistakes is the commonality of them. We continue to see the same mishaps in different hospitals all over the world. Thus we must conclude that there is a major flaw in hospital design whereby that there are conditions that lend themselves to acts of negligence. The key word is "avoidable". The hospital executives like to use the term "unfortunate but unavoidable" because it absolves the institution of liability. Therefore, in this series we shall examine the most common hospital errors and their root causes.

The Universal Hospital/Medical Errors

Errors of Commission: Overt acts that deviate from accepted standards such as:

1. Invasive blunders

2. Traumatic transfers

3. Misapplication of forceps

4. Administering harmful medication or treatment

5. Withholding medication or treatment

6. Physical abuse

Errors of Omission: Failure to provide services resulting in an adverse event:

1. Failure to take a proper history

2. Failure to report changes in clinical condition

3. Failure to maintain safety protocols

4. Failure to provide and maintain pressure ulcer prevention

5. Failure to wash hands between patients

6. Failure to make risk assessments

Risks and Root Causes

Risk Factors Predisposing to Medical/Hospital Errors

1. New Technology

2. Staffing Shortage

3. Teaching Hospital

4. High Patient Acuity

5. Patients with Mental Status Deterioration

6. Staff Members in ill health

7. Medical specialization "It's not my job"

8. Poor listening skills

9. Arrogance

Root Causes

1. Poor Communication

2. Emergency Room Overcrowded with Long Waiting Times

3. Non-Disclosure of Risks to Patients and Family

4. Chronic Cash Flow Deficit

5. Operating Rooms Closed at Night

6. Ineffective Nurse Recruitment

7. Poor Labor Relations

8. Equipment and Building in Disrepair