Towards standardized measurement of adverse events in spine surgery: conceptual model and pilot evaluation

Table 2 Harvard Medical Practice Study categories for classifying etiology of adverse events and medical errors, with three added categories for patient factors.

Code	Type of Error	Description
1	Diagnostic	Error in diagnosis or delay in diagnosis
2	Diagnostic	Failure to employ an indicated test
3	Diagnostic	Use of outmoded tests or therapy
4	Diagnostic	Failure to act on the results of monitoring or testing
5	Treatment	Technical error in performance of an operation, procedure, or test
6	Treatment	Error in administering the treatment (including preparation for operation or treatment)
7	Treatment	Error in dose of drug or in the method of use of a drug
8	Treatment	Avoidable delay in treatment or in responding to an abnormal test
9	Treatment	Inappropriate (not indicated) care. Considering the patient's disease, its severity, and comorbidity, the anticipated benefit from the treatment did not significantly exceed the known risk, or a superior alternative was available
10	Preventive	Failure to provide indicated prophylactic treatment
11	Preventive'	Inadequate monitoring or follow-up of treatment
12	System	Failure in communication
13	System	Equipment failure
14	System	Other systems failure
15	Other	Unclassified
*16	No error	Patient disease, expected risk
*17	No error	Patient non-compliance
*18	No error	Patient disease, unrelated to spinal surgery

*Additional three categories not included in the Harvard Medical Practice Study. We group these as "no error" simply to distinguish them from the evaluation and treatment associated factors under direct control of the medical care system. Alternatively, these three factors may be considered errors in patient selection.

ISSN: 1471-2474