Winnipeg’s review of medical errors
first in Canada
WINNIPEG – A special review of all
patient deaths in Winnipeg hospitals last year uncovered 27 new cases
where patients died as a result of an unintended medical error.
Quality control officials with the Winnipeg Regional Health Authority
reviewed all 2,577 deaths in hospitals in 2008 to see if any patients
died as a result of a systemic or medical error – the first time any
jurisdiction in Canada has undertaken such a review.
The review was done on top of the systems already in place to report
medical errors, which include a 24-hour hotline for patients, their
families and hospital staff to report medical errors.
Chief patient safety officer Dr. Rob Robson said that, as a result of
the review, 60 deaths deemed “worrisome” were turned over to patient
safety officials to investigate further. Of those, 32 were later deemed
critical incidents – unintended incidents that caused serious harm to a
Five of the incidents had already been reported as a critical incident
by patients’ families or hospital staff. An additional 27 were new
cases. A total of 72 patients died in hospital as a result of a critical
incident last year, up slightly from 2007, when 67 people died from a