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psnet.ahrq.gov/node/37441/psn-pdf
November 01, 2012 - Saving Mothers' Lives: Reviewing Maternal Deaths to
Make Motherhood Safer—2003–2005.
November 1, 2012
Lewis G, ed. London, England: Confidential Enquiry into Maternal and Child Health; 2007. ISBN:
9780953353682.
https://psnet.ahrq.gov/issue/saving-mothers-lives-reviewing-maternal-deaths-make-motherhood-safer-
200…
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psnet.ahrq.gov/node/42734/psn-pdf
November 13, 2013 - Healthcare Inspection—Emergency Department Patient
Deaths: Memphis VAMC, Memphis, Tennessee.
November 13, 2013
Washington, DC: Department of Veterans Affairs, Office of Inspector General; October 23, 2013. Report
No. 13-00505-348.
https://psnet.ahrq.gov/issue/healthcare-inspection-emergency-department-patient-deat…
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psnet.ahrq.gov/perspective/conversation-urmimala-sarkar-md-mph
August 22, 2014 - medical malpractice claims were for outpatient events; two-thirds of them resulted in disability or death
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psnet.ahrq.gov/web-mm/management-csf-leaks-after-elective-spine-surgery-routine-laminectomy-leads-fatal-discitis
March 09, 2022 - persistent pseudomeningocele formation, meningitis, hydrocephalus, arachnoiditis, and, in rare cases, death … Mixed Defense Ruling Related to Patient's Death Yield Lessons Regarding Experts.
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psnet.ahrq.gov/perspective/beyond-hospital-new-frontier-patient-safety
August 01, 2014 - medical malpractice claims were for outpatient events; two-thirds of them resulted in disability or death
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psnet.ahrq.gov/web-mm/dose-makes-poison-medication-error-during-procedural-sedation-pediatric-emergency-department
January 23, 2017 - obstruction, apnea, nonminimal hypoxia) and severe (e.g., aspiration, cardiac arrest, unplanned intubation, death … WebM&M Cases
Delay in Appropriate Diagnosis and Treatment Leading to Death
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psnet.ahrq.gov/node/35186/psn-pdf
July 13, 2005 - Saving lives: hospitals have signed on to a six-part plan
to avoid a multitude of unnecessary deaths.
July 13, 2005
Comarow A. US News & World Report. July 2005
https://psnet.ahrq.gov/issue/saving-lives-hospitals-have-signed-six-part-plan-avoid-multitude-unnecessary-
deaths
This article, accompanying the widely r…
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psnet.ahrq.gov/perspective/conversation-robert-hirschtick-md
January 01, 2018 - RW : So, have we entered a death spiral where people have devalued the physical examination so they don't … RH : I wouldn't say death spiral.
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psnet.ahrq.gov/perspective/conversation-gregg-s-meyer-md-msc
June 01, 2016 - errors ( 1,2 ), the NECC incident ( 3 ) and the case of an antiseptic switch that resulted in a woman's death … Terrible tragedy—and powerful legacy—of preventable death.
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psnet.ahrq.gov/perspective/rapid-response-teams-lessons-early-experience
November 01, 2005 - Studies have demonstrated impressive decreases in death and code blue rates after the implementation … WebM&M Cases
Delay in Appropriate Diagnosis and Treatment Leading to Death
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psnet.ahrq.gov/node/44701/psn-pdf
June 07, 2016 - The problem with preventable deaths.
June 7, 2016
Hogan H. The problem with preventable deaths. BMJ Qual Saf. 2016;25(5):320-3. doi:10.1136/bmjqs-
2015-004983.
https://psnet.ahrq.gov/issue/problem-preventable-deaths
A key goal of patient safety improvement is preventing error, but challenges remain in distinguishi…
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psnet.ahrq.gov/node/47211/psn-pdf
November 16, 2018 - A conceptual framework to reduce inpatient preventable
deaths.
November 16, 2018
Davis DP, Aguilar SA, Lawrence B, et al. A Conceptual Framework to Reduce Inpatient Preventable
Deaths. Jt Comm J Qual Patient Saf. 2018;44(7):413-420. doi:10.1016/j.jcjq.2018.01.003.
https://psnet.ahrq.gov/issue/conceptual-framework-…
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psnet.ahrq.gov/node/38783/psn-pdf
September 02, 2009 - Medical negligence in drug associated deaths.
September 2, 2009
Madea B, Musshoff F, Preuss J. Medical negligence in drug associated deaths. Forensic Sci Int.
2009;190(1-3):67-73. doi:10.1016/j.forsciint.2009.05.014.
https://psnet.ahrq.gov/issue/medical-negligence-drug-associated-deaths
This study reports that acc…
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psnet.ahrq.gov/node/49726/psn-pdf
March 01, 2015 - Wrong-site surgery has long been recognized as a sentinel event—an unexpected occurrence
involving death
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psnet.ahrq.gov/node/49560/psn-pdf
April 01, 2008 - below-the-knee amputations, and
poor quality of life had previously been resuscitated from sudden death
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psnet.ahrq.gov/node/49820/psn-pdf
February 01, 2018 - in skilled nursing facilities are at high risk for rehospitalization, emergency
department use, and death
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psnet.ahrq.gov/perspective/acgmes-2017-revision-common-program-requirements
January 31, 2018 - January 31, 2018
Causes of death of residents in ACGME-accredited programs 2000 through
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psnet.ahrq.gov/web-mm/untimely-end-despite-end-life-care-planning
February 01, 2012 - Use of a checklist for the withdrawal of ventilatory support to improve the quality of death and dying
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psnet.ahrq.gov/node/50701/psn-pdf
November 26, 2019 - patients worries about the harm we inflict on patients when we’re
trying at all costs to prevent a death
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psnet.ahrq.gov/sites/default/files/2022-12/spotlight_case_strongyloides_final_11.21.22.pdf
January 01, 2022 - Diagnostic delays can
significantly increase the risk of death.
REFERENCES
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References
1.