The term error is also used in medical service, as stated by J. Guwandi (2005), which mentioned that the term "Medical Error" in the medical service has its own scope and understanding, because the interpretation of the terms of medical error should be based on a medical standpoint related to the medical profession and it may not be interpreted from legal and laity standpoint.
The definition of medical error by Bryan A. Liang: A medical error is a mistake, an inadvertent occurrence, or an unintended event in the delivery of health care that may, or may not, result in patient injury.
Furthermore, J. Guwandi stated that medical error is a result of medical action that can be distinguished as follows:
1. Failure of therapy in operation, which is partly due to:
- The occurrence of complications (complications)
- Accidents (surgical mishap)
- Anesthetic accident (hypersensitive reaction to anesthetic drugs and so on).
2. The failure in the treatment given, which can be due to the following matters:
Complications of treatment, medical accidents, errors in determining the diagnosis, errors in selecting drugs
Some causes of unsuccessful in drug delivery to the patient are specified by American Society of Consultant Pharmacists:
1. Under-use of medication consists of:
- There are indications that the patient is not treated / handled properly, for example, the patient is not given the drug they need.
- sub therapeutic dosage, for example, the patient is given the right medicine, but the dose does not fit or less than they should.
2. Overuse of medications consists of:
- Provision of drug without clear indication, for example, antibiotics that are given to patients without symptoms of infection or the possibility of an infection.
- overdosage, for example, the dose given is exceeding the needs of the patient (drug dosage should be adjusted to the patient's weight).
- Use of Inappropriate medications, for example, improper drug selection.
- Unwanted drug reactions consist of:
a. Adverse drug reactions. For example, it is happened to Stevens-Johnson syndrome after patients taking Bactrim.
b. Drug interactions. For example, the provision of co-trimoxazole together with pyremethamine can cause interaction with the increasing risk of anemia as the result.
- Patients do not get the drugs needed for the treatment (lack of adherence to drug therapy / patient non-compliance). For example, the patient does not receive the treatment due to economy, sociology and so on.
Associated with medical error, Guwandi mentioned two terms:
1. Error of omission (failure) e.g. wrong diagnosis, late diagnosis, the occurrence of complications in drug delivery.
2. Error of the Commission is a form of misconduct, such as wrong drug, wrong dose, wrong route of administration of drug, wrong patient, wrong time and so on.
