Adverse Events: Deciding When Apology and Disclosure Is Needed

Adverse event disclosure starts with a determination of whether the outcome was preventable, says Susan Marr, M.S.A., CPHRM, LHRM, patient safety/risk management account executive at the Doctors Company (Napa, California). Marr spoke at the American Society for Healthcare Risk Management’s April 25, 2013, webinar, “Adverse Event Disclosure—Developing a Process.” As an example, Marr described a hospitalized patient’s extreme allergic reaction to a new antibiotic; the patient had no history of medication allergies and had taken other medications in the same family of antibiotics. The hospital apologized to the patient despite the fact that there was no error or negligence in her care, Marr said. Given that the event was unforeseeable, the hospital did not need to offer an apology, although it would be reasonable to offer a compassionate explanation of the event, she said. In this situation, the apology may have had the unintended effect of exacerbating the patient’s anger because the patient reported the event to the state and threatened litigation. “Apologizing when there was no error is not appropriate; being compassionate always is.”