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Medical Harm: Patient Perceptions and Follow-up Actions

Lyu, Heather G. MD*; Cooper, Michol A. MD, PhD*; Mayer-Blackwell, Brandan BS*; Jiam, Nicole BA*; Hechenbleikner, Elizabeth M. MD*; Wick, Elizabeth C. MD*; Berenholtz, Sean M. MD, MHS; Makary, Martin A. MD, MPH*‡

doi: 10.1097/PTS.0000000000000136
Original Articles

Objectives Much research has been conducted to describe medical mistakes resulting in patient harm using databases that capture these events for medical organizations. The objective of this study was to describe patients’ perceptions regarding disclosure and their actions after harm.

Methods We analyzed a patient harm survey database composed of responses from a voluntary online survey administered to patients by ProPublica, an independent nonprofit news organization, during a 1-year period (May 2012 to May 2013). We collected data on patient demographics and characteristics related to the acknowledgment of patient harms, the reporting of patient harm to an oversight agency, whether the patient or the family obtained the harm-associated medical records, as well as the presence of a malpractice claim.

Results There were 236 respondents reporting a patient harm (mean age, 49.1 y). In 11.4% (27/236) of harms, an apology by the medical organization or the clinician was made. In 42.8% (101/236) of harms, a complaint was filed with an oversight agency. In 66.5% (157/236) of harms, the patient or the family member obtained a copy of the pertinent medical records. A malpractice claim was reported in 19.9% (47/236) of events.

Conclusions In this sample of self-reported patient harms, we found a perception of inadequate apology. Nearly half of patient harm events are reported to an oversight agency, and roughly one-fifth result in a malpractice claim.

From the *Department of Surgery, School of Medicine, †Departments of Anesthesiology/Critical Care Medicine and Surgery, School of Medicine, and ‡Departments of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.

Correspondence: Martin A. Makary, MD, MPH, Department of Surgery, Johns Hopkins Hospital, Halsted 610, 600 N. Wolfe St, Baltimore, MD 21231 (e-mail:

The authors disclose no conflict of interest.

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