Internal HSE documents recorded incidents including multiple deaths due to misdiagnosis and medical error, sexual assaults, and deaths and serious injuries linked to falls and patients absconding from a healthcare facility.
The details released under Freedom of Information show there were 483 serious incidents recorded at HSE hospitals, mental health facilities and social care settings between September 2015 and December last year, a rate of more than one incident daily.
More than a fifth (21%) of these incidents involved a patient’s death, as the HSE confirmed 106 patients died. However, the HSE said this does not necessarily mean these deaths resulted from the incidents concerned, as it may have resulted from other factors including illnesses or diseases.
The documents detail:
- 155 deaths or serious disabilities occurred as a result of a fall while in a healthcare facility or during a clinical intervention from a healthcare professional, including in the community setting, pre-hospital care and the Ambulance Service;
- 18 incidents where a patient died or suffered a serious disability after receiving the wrong diagnosis;
- 22 unexplained deaths or serious injury in mental healthcare facilities;
- Five incidents where a patient died or suffered a serious injury due to a medication error;
- One incident where a patient died or suffered a serious disability after being restrained;
- One incident where a patient died or suffered a serious disability due to the administration of incompatible blood or blood products.
There were also 62 recorded infant deaths, which includes stillbirths and neonatal deaths from birth up to seven days.
Serious incidents, many of which result in death or significant injury, are classified by the HSE as serious reportable events (SREs).
The serious incidents include:
- 15 reported sexual assaults on the grounds of a healthcare service facility;
- 11 cases of foreign objects, such as swabs, needles, or instruments other than micro-needles, unintentionally left in a patient’s body after surgery;
- Four patients who had no known medical problems died after surgery or other interventional procedures;
- One person was given the wrong formulation or route administration of chemotherapy;
- One person had surgery performed on the wrong body part;
- One person had the wrong surgical procedure performed;
- Four incidents of death or serious injury after a patient absconded from a healthcare facility.
Irish Patients’ Association chairman Stephen McMahon said he believes tens of thousands of preventable errors are happening within our healthcare system.
“The numbers of preventable funerals and injury run into the thousands and we have no handle on what is happening in the community, nursing homes (or) general practice,” Mr McMahon said.
“I’m deeply concerned that far more people die or are injured as a result of preventable error and this does not get the same degree of attention as road vehicle accidents,” he added.
The HSE said excellent care and outcomes are most often the result of many of its interventions.
A spokesperson said: “Every year the health service has millions of interactions with patients and service users.
“But modern health care also carries significant risks and, at times, things do not go to plan.
“Adverse events and patient harm can and do happen. While there will always be risks in the delivery of healthcare, it is essential that all safety incidents are reported, managed and investigated.”