MEDICAL MISHAPS: Pieces of the puzzle is edited by Linda Mulcahy (School of Law, University of North London), Marilynn Rosenthal (Professor of Sociology and Director, Program in Health Policy Studies, University of Michigan), and Sally Lloyd-Bostock (Department of Law, University of Birmingham, U.K.); 265 pages.

How often does medical mishap occur? Can we extend notions of responsibility beyond problem doctors? How do we improve data on the incidence, characteristics and causes of medical mishap?

This book explores what we know about the incidence, causes and aftermath of medical mishaps. Increasingly the medical profession is being expected to review the performance of doctors more rigorously and systematically and to adopt proactive approaches to the management of risk. Little is known about how often medical mishaps occur, the proportion which are preventable and the impact of the mishap on those involved. Contributors to this volume are all experts in their field who can reveal something about medical mishap puzzles from a UK and international perspective. Medical mishaps are traced from their genesis and cause through to the impact they have on doctors, patients, managers, educators and those responsible for the resolution of complaints and medical negligence disputes arising from them. This volume is unique in bringing together a number of different voices. The contributions are multi-disciplinary and report both empirical studies of these phenomena as well as the experiences of those who have to deal with medical mishaps on a day to day basis.

The contents include:

Part one: Mapping and understanding medical mistakes; Beyond blaming and perfection: a multi dimensional approach to medical mishaps; Error in medicine; Human factors approaches in medicine.

Part two: An international perspective – Medical accidents in the UK: a wasted opportunity for improvement? Research on errors and safety in Dutch general and hospital practice; Medical accidents and mishaps: the Swedish situation; Safety of health care in Australia: adverse events to hospitalized patients in Australia.

Part three: The escalation and mitigation of mishaps; Calling doctors and hospitals to account: complaining and claiming as social processes; Doctors’ responses to patient complaints; How doctors think about medical mishaps; Mediation of medical negligence actions: an option for the future? Medical education: tomorrow’s doctors today.

Part four: Views from the coalface – The doctors’ perspective; Reflecting on medical mishaps; Dysfunctional doctors: the GMC’s new approach; Medical mistakes: a view from the BMA; The role of quality improvement; The managers’ perspective – Medical mishaps: a managerial perspective; Managing risk and claims: pieces of the puzzle; The patient’s perspective – Community health councils: helping patients through the complaints procedure; The right to redress: complaints and principles of grievance procedures; The price of deceit: the reflections of an advocate.

Lorri Zipperer
Information Project Manager
National Patient Safety Foundation
Chicago, IL