Acts of omission
- A planned referral of a patient, prompted by a clinical suspicion of cancer, is not sent.
- An abnormal test result is received by a practice but not considered for action, or the considered action is not performed.
Prescribing medication, when known, absolute contraindications exist
- Prescribing teratogenic drugs to a patient known to be pregnant.
- Prescribing combined oral contraceptive after previous confirmed DVT/PE.
- Prescribing oestrogen-only HRT for women with intact uterus.
- Prescribing a drug to a patient that has correctly been recorded in the practice system as having previously caused them a severe adverse reaction.
Medication (prescribing, dispensing, administration, monitoring)
- Prescribing ‘high risk’ medication without ensuring adequate monitoring took place and results were satisfactory.
- Giving the right drug via the wrong route or at the wrong site.
- Prescribing immunosuppressives daily rather than weekly (unless initiated by a specialist for a specific clinical condition, eg leukaemia).
- Prescribing aspirin for a patient under 12 years old (unless recommended by a specialist for a specific condition, eg Kawasaki’s disease).
Medicolegal and ethical incidents
- Physical assault of patients or healthcare workers.
- Ignoring a patient’s living will.
- A practice team member working while intoxicated.
- Losing controlled drugs.
- Not referring a patient presenting with and treated for anaphylaxis to secondary care for observation.
- Not referring a child suspected to have non accidental injuries urgently.
- Performing a cervical smear without visualising the cervical os.
- A practice does not have an up-to-date and secure backup of their data.
- Medical waste and hazardous substances discarded in an inappropriate manner.
- Emergency medical equipment, eg defibrillator, is not in working order, maintained, available or checked regularly.
- A needlestick injury due to a failure to dispose of ‘sharps’ in compliance with national guidance and regulations.