Inman listed reasons why a physician might not report an adverse drug reaction, He termed these the “seven deadly sins”.
Seven deadly sins that can contribute to under-reporting of drug-induced reactions:
(1) complacency: belief that drugs that are allowed on the market must be safe
(2) fear of involvement in litigation
(3) guilt: about harm done to the patient as a result of care
(4) ambition: delaying a report until a personal series of cases has been collected and reported
(5) ignorance: of the requirement to report (see also indifference below)
(6) diffidence: may be ridiculed for reporting a suspicion that turns out to be a nothing
(7) lethargy (and laziness): procrastination, etc
Other issues mentioned by Inman:
(1) greed: demanding to be paid for reports
(2) fear of a breach in confidentiality
(3) fear of being criticized for care given
Additional issues reported by Herdeiro et al:
(1) indifference
(2) insecurity in making the diagnosis of adverse drug event (unable to say with confidence that a drug did or did not cause a particular adverse event)
