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Long-Term Impacts Faced by Patients and Families After Harmful Healthcare Events

Ottosen, Madelene J. PhD, RN*; Sedlock, Emily W. MPH*; Aigbe, Aitebureme O. DrPH*; Bell, Sigall K. MD; Gallagher, Thomas H. MD; Thomas, Eric J. MD, MPH§

doi: 10.1097/PTS.0000000000000451
Original Article: PDF Only

Background Patients and families report experiencing a multitude of harms from medical errors resulting in physical, emotional, and financial hardships. Little is known about the duration and nature of these harms and the type of support needed to promote patient and family healing after such events. We sought to describe the long-term impacts (LTIs) reported by patients and family members who experienced harmful medical events 5 or more years ago.

Methods We performed a content analysis on 32 interviews originally conducted with 72 patients or family members about their views of the factors contributing to their self-reported harmful event. Interviews selected occurred 5 or more years after the harmful event and were grouped by time since event, 5 to 9 years (22 interviews) or 10 or more years (10 interviews) for analysis. We analyzed these interviews targeting spontaneous references of ongoing impacts experienced by the participants.

Results Participants collectively described the following four LTIs: psychological, social/behavioral, physical, and financial. Most cited psychological impacts with half-reporting ongoing anger and vivid memories. More than half reported ongoing physical impacts and one-third experienced ongoing financial impacts. Long-term social and behavioral impacts such as alterations in lifestyle, self-identity, and healthcare seeking behaviors were the most highly reported.

Conclusions These patients and families experienced many profound LTIs after their harmful medical event. For some, these impacts evolved into secondary harms ongoing 10 years and more after the event. Our results draw attention to the persistent impacts patients and families may experience long after harmful events and the need for future research to understand and support affected patients and families.

From the *University of Texas – Memorial Hermann Center for Healthcare Quality and Safety, McGovern Medical School, Department of Family Health, University of Texas Health Science Center at Houston, School of Nursing, Houston, Texas; †Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; ‡Department of Medicine, University of Washington School of Medicine, Seattle, Washington; and §Department of Internal Medicine, University of Texas – Memorial Hermann Center for Healthcare Quality and Safety, McGovern Medical School, Houston, Texas.

Correspondence: Madelene J. Ottosen, PhD, RN, 6410 Fannin St Suite 1100.45, Houston, TX 77030 (e-mail:

The authors have no conflicts of interest to disclose.

The data for this project were supported by a grant from Agency for Healthcare Research and Quality, 1R18HS019561-01, to co-author E.J.T.

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