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Iatrogenic Diseases
- Iatro or iatros means Doctor
- Genic means :Caused by
- Iatrogenic diseases are doctor - created illness
- Iatrogenesis is inadvertent inattentiveadverse
effect or complications caused by medical
treatment or advice.
- Iatrogenesis can be due to other health
professionals (e.g. nurses, pharmacists etc)
- Iatrogenesis can also be due to therapy with
traditional (alternative) medicines
http://www.youtube.com/watch?
v=guC2SMjIHNA
Iatrogenesis literature
- Iatrogenic disorders in modern neonatology: a focus
on safety and quality of care. Clin Perinatol. 2008; 35:1- Iatrogenic skin injury in hospitalized patients. Clin
Dermatol. 2011;29:622.
- Iatrogenic laser complications. Clin Dermat. 2011,29, 691
Definitions
- Adverse event: An injury or complication
caused by medical management that prolongs
hospital stay or produces lasting disability or
death (33% of AE are due to negligence )
- Ameliorative Adverse event (AAE): An injury of
which the severity or duration could ve been
reduced if different action had been taken (e.g.
sexual dysfunction lasting for several months
while taking SSRI for depression)
Iatrogenic Diseases
- The 3rd Most Fatal Disease in the USA ??
- Close to 100,000 people die every year
from plane crashes?
- 2 millions / year die due to iatrogenesis
worldwide
Medical error
Side effects of treatment
Drug interactions
Negligence, faulty procedure, transfusion
unnecessary treatment for profit
Anxiety or annoyance in the physician in
relation to medical procedures / treatments
- unexamined instrument design
- Chance, illegible/ wrong prescriptions, etc
MEs vs AEs
- Must differentiate between MEs & adverse events
(AEs).
- Most MEs are not AEs (they do not harm patients) &
most AEs are not MEs & are therefore not
preventable.
- AE: An injury or complication caused by medical
management that prolongs hospital stay or
produces lasting disability or death.
- ME: Any act that will, based on currently
available information, substantially increases
the risk for an adverse event.
1. Problem focused
2. Emotion -focused
Increasing vigilance:
a) paying more attention to details
b) confirming data personally
c) changing data organization
d) ordering additional tests as
appropriate
- e) improving screening for disease
- f )Improving communication with patients
Defensive Changes in
practice following mistakes
- Being unwilling to discuss error
- Avoiding patients with similar problems
- Ordering additional but unnecessary tests