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Criteria for Describing an Adverse Event & Negligence

Purpose: To review the medical care a patient received using the criteria of Hiatt et al.

Description

Hiatt et al developed criteria for determining if an adverse event occurred as a result of medical management and whether negligence was involved. This can help standardize quality reviews of medical care delivery. The authors are from Harvard Schools of Public Health, Medicine and Law and Syracuse University.


Criteria for an adverse event:

(1) There must be a definite injury caused at least in part by medical management.

(2) The injury must have produced a measurable disability. This may have prolonged the hospital stay or reduced function at the time of hospital discharge.

(3) The injury must have been unintended or the result of an act of omission.

 

Negligence is an adverse event caused by a failure to meet the standards reasonably expected of the average health care provider or delivery system.

 

When judging negligence:

(1) The presence of aggravating and mitigating factors need to be taken into account.

(2) Explicit criteria need to be applied as much as possible,

(3) The evidence supporting an opinion should be summarized,

 

Apparent Role of Negligence in Causation of an Adverse Event

Grade

no or little evidence

1

slight evidence

2

some (not quite likely, odds < 50:50 chance but close call) evidence

3

moderate (more likely than not, odds > 50:50 but close call) evidence

4

strong evidence

5

virtually certain

6

 


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Objective

ICD-10