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X-ray mistakes due to wrong patient


14 March, 2008  

A third of mistakes relating to X-rays and scans are down to the wrong patient being treated, a new report claims.

The Healthcare Commission looked at 329 errors relating to X-rays, and radiation exposure, reported over the 14 months to the end of December last year.

The biggest cause of unnecessary X-ray examinations was where the wrong patient was sent for a scan, a statistic the Commission said “indicates a systems failure that has much broader implications for patient safety”.

“Sometimes, the wrong inpatient may be collected from the ward and taken to the X-ray department because of inadequate checks made between nursing staff and porters,” it added.

A further 35% of the 240 X-ray incidents involved errors made by the operator, while 10% involved the wrong body part being scanned.

Anna Walker, chief executive of the Healthcare Commission, said: “We applaud those trusts that have reported incidents to us – this shows that they have systems in place for identifying when things go wrong and this is the first step in learning from mistakes.

“Our report shows that over 300 people in this period have been given an unnecessary dose of radiation, which can cause distress, and in extreme cases, has the potential to cause harm.”

Copyright © PA Business 2008

Healthcare Commission

Your comments: (Terms and conditions apply)

“Do you have any statistics for errors of a similar type in Radiotherapy?” – David Bainbridge, Gloucestershire, UK.

Thanks for your comment, David. We’ll look into this and post a response shortly.

David – the report took radiotherapy in cancer patients into account. Of the 329 incidents studied in the report, 66 were concerned with radiotherapy:

According to the Healthcare Commission:

“…the most common incidents related to a treatment error (64%), including missing the designated site. Other errors were the result of planning mistakes such as writing the wrong instructions for people delivering treatment (20%), referral mistakes such as prescribing the wrong dose (11%), and other issues (5%).”

View the press release here

View the report here