[Impact of the COVID-19 pandemic on patient safety incident and medication error reporting systems]. / Impacto de la pandemia COVID-19 en los sistemas de notificación de incidentes de seguridad del paciente y errores de medicación.

BACKGROUND AND AIM: To determine the impact of the COVID-19 pandemic on the epidemiology of safety incidents (SI) and medication errors (ME) reported to the CISEMadrid notification system in the hospital and primary care settings of the Madrid Health Service (SERMAS). MATERIALS AND METHODS: Observational and descriptive study with a retrospective analysis of data including all CISEMadrid notifications from 01-Jan-2018 to 31-Dec-2020, from 33 hospitals and 262 health care centres of the SERMAS. The two periods in 2020 with the greatest increase in COVID-19 cases were identified to compare incidents reported in the pre-pandemic and pandemic periods. RESULTS: 36,494 incidents were reported. Comparing both periods, an overall decrease in pandemic notifications of 60.7% was observed, being higher in primary care, falling to 33% of previous levels. The reduction in notifications was similar in the peaks and valleys of the waves. The three most frequent SIs in both periods and care settings were: diagnostic tests, medical devices/equipment/clinical furniture and organisational management/citations. In ME, dose failure and inappropriate selection were the most frequent in both settings and periods. There were no relevant differences in patient consequences in both periods. CONCLUSIONS: During the pandemic, patient safety notifications decreased although the most frequent types remained the same, as did their impact on the patient, both in hospitals and in primary care. The safety culture of organisations is a critical aspect for the maintenance of reporting systems.

[Analysis of judicial sentences against neurosurgeons resolved in second court of justice in Spain in the period from 1995 to 2007]. / Análisis de las sentencias judiciales contra neurocirujanos resueltas en segunda instancia en España entre 1995 y 2007.

OBJECTIVES: With the aim of identifying the factors related to sentences against neurosurgeons, we have analyzed all the sentences issued in the second court of justice in Spain against neurosurgeons in the period from 1995 to 2007. MATERIAL AND METHODS: Of a total of 1899 sentences of the second or last appeal, during the period from 1995 to 2007 issued in Spain, 61 were chosen which fulfill the criteria to be included in our study. 25 variables were included on the record of compiled data. A complete descriptive and comparative study was elaborated, as well as an analysis of the type of suits, circumstances, and professionals involved. RESULTS: In a third of the cases, complete malpraxis was identified. In regards to the sentences, they were absolved in approximately half the cases, resolved with one fifth of the cases being penal, and four fifths with compensation. Indemnity quantities range from 60,000 to 600,000euro. Deficiency of information or consent was noted in 17% of lawsuits. 62.5% of operations in our sample were on the anatomic region of the vertebral column followed in frequency by the cranial region with 28.6%. Consequences of surgical procedure included major permanent sequelae in 40% of the cases and death in 22%. CONCLUSIONS: It is wise to invest time to deal with patients, including the verbal informed consent, which must be confirmed by the written informed consent form. It is also important to leave a written proof of medical praxis, both related to surgical records and to diagnosis and follow-up of the patient. Procedures with a lower life-threatening risk should not be underestimated, since they comprise the greatest demanded group. The greatest amount of demands is related to economic reimbursement, especially in private practice.