Parulekar SV

Medical errors may occur due to an error in judgment, lack of knowledge, inadequacy of training, ttempting techniques beyond one's ability, lack of concentration or negligence. These errors could be in diagnostic or therapeutic decision making or in carrying out the treatment in time or effectively. Therapeutic errors may be in medication or surgical procedures.These may result in mortality, serious or not so serious morbidity, or may be 'near misses' which could have resulted in serious injury to the patient but luckily did not. Medical errors are far more common than believed. According to one report these are said to be the third leading cause of death in US. The scenario is probably not very different in other countries. What varies is the degree to which such errors are reported. It is said that about one third patients admitted to hospitals experience errors in their management. It is also said that 90% of these errors go unreported. There is a tendency to hide such errors for reasons like fear of litigation, need for compensation, loss of face, damage to reputation and practice, criticism by peers, and disciplinary action by employers. Ethically it is mandatory that such errors be reported to the patients. But there is another reason for such reporting too. It creates awareness of such errors, which helps peers and administrators devise methods of minimizing or avoiding such errors. Errors may be  reported in internal audits and departmental meetings. However such information reaches very few individuals. The only known method that will disseminate the information to a large number of individuals involved with giving healthcare  is reporting in scientific journals. Such reports may be in the form case reports or results of analysis of mandatory reporting to governmental agencies. Confidentiality of patients is always maintained in journal reports, and hence the physician's fear of admission of an error may be reduced by that measure. This fear can be reduced further by giving legal protection to the person reporting the error, so that more people are encouraged to report errors. This will need a change in the legislature. That may or may not occur, at least not in the near future. In the meantime, we have started a new feature in JPGO under the category 'error'. We published one error in the December issue of the journal. It was widely appreciated. We propose to publish errors which are unique, perhaps the first such occurrences in the world literature. We are proud to say that JPGO is one of the very few journals which publish errors. We are sure that it will go a long way in advancing scientific knowledge and reducing the risk of occurrence of such errors in future.