never event
never event
A term of art for an event (for which there is universal professional agreement) that should never happen during surgery.Examples
Sponge, gauze or surgical instrument left in the body after surgery; performing the wrong procedure, or on the wrong site or on the wrong patient.
Profile of Never Event surgeons
35% were age 40 to 49; 62% had more than one Never Event.
Consequences
Death in 7%, permanent injury in 33%, temporary injury in 60%; malpractice judgements.