PUBLIC HOSPITALS, ADVERSE EVENTS

87 Dr McFETRIDGE (Morphett) (31 July 2007).

1. In each year since 1995, how many South Australians have died from 'adverse events' or medical mistakes within the State's Public Hospital System?

2. In each year since 1995, how many South Australians have died from 'adverse events' or medical mistakes at each of the following hospitals: Royal Adelaide Hospital, Flinders Medical Centre, Modbury Hospital, Queen Elizabeth Hospital, Daw Park Repatriation General Hospital, Women's and Children's Hospital, Lyell McEwen Hospital, Noarlunga Hospital, St Margaret's Rehabilitation Hospital, Gawler Hospital and Glenside Hospital, and in each case, what were the reasons and details of these events?

The Hon. J.D. HILL (Kaurna—Minister for Health, Minister for the Southern Suburbs, Minister Assisting the Premier in the Arts): I am advised:

1. Since 1995, no formal study such as the 'Quality in Australian Healthcare study' has been conducted to establish the number of South Australians that have died from 'adverse events' or medical mistakes in South Australian Public Hospitals. Without such a rigorous study, which in itself is subject to methodological weaknesses that can affect reliability and validity, it is impossible to accurately quantify deaths from adverse events or medical mistakes.

2. While no formal study has been conducted since 1995 into the number of deaths from adverse events or medical mistakes in Australia, the South Australian Department of Health introduced in 2003 a reporting system for health services to report sentinel and serious adverse events (events in which death or serious harm to a patient has occurred) to the Department of Health. Not all events reported to the Department of Health have resulted in death. Reported deaths may not be directly attributable to an adverse event or medical mistake. Nonetheless, the health service investigates the death to identify vulnerabilities in the system and takes corrective action.

26 deaths have been reported to the Sentinel and Serious Adverse Event System from all South Australian Public Hospitals from 2003-04. In 2004-05 there were 27 deaths and in 2005-06 there were 30 deaths reported. The reporting system is not designed to determine if an adverse event could conclusively be causatively connected to the outcome of death in patients. Rather, the system is designed to review all cases of unexpected outcomes of death and serious injury of patients and improve hospital systems to reduce the likelihood that identified vulnerabilities could contribute to or cause harm in future.

The reported deaths from 2003-06 were associated with inpatient suicide, obstetric problems, medication problems, gas embolism, falls, clinical management of medical conditions including resuscitation techniques, misdiagnosis and delays in correct treatment and diagnosis.