What Counts as a Medical Error
Errors, Adverse Events, and Bad Outcomes
In patient safety terms, a medical error is a failure in the care process – doing the wrong thing, doing the right thing incorrectly, or failing to do something that should have been done. Examples include giving the wrong medication, missing an abnormal test result, or operating on the wrong site.
Not every error causes harm. Some are caught before they reach the patient, and some reach the patient without causing injury. An adverse event is harm caused by medical care rather than by the underlying illness. Some adverse events are caused by errors and are considered preventable; others occur even when care is delivered correctly.
Errors vs. Malpractice
A medical error isn't automatically malpractice. Malpractice is a legal concept that generally requires showing that a provider failed to meet the accepted standard of care and that this failure caused significant harm. Many errors – especially those caught quickly or that cause little harm – never become legal matters. The aim of this guide is to help you understand what happened and protect your health, not to decide whether a legal claim exists.
A Simple Illustration
Bleeding is a known risk of surgery. If a patient bleeds despite appropriate technique and precautions, that's a complication. If bleeding results from a careless surgical injury, or because the team failed to stop a blood thinner before the procedure as required, it may be an error.
Common Types of Medical Errors
Diagnostic Errors
Diagnostic errors are among the most consequential errors in healthcare. One widely cited estimate suggests that hundreds of thousands of Americans each year die or are permanently disabled because of diagnostic errors. They include a misdiagnosis, such as mistaking a heart attack for indigestion; a delayed diagnosis, such as a cancer that is identified only after earlier signs were overlooked; and a missed diagnosis, in which a serious condition is never identified despite symptoms. Failures to order appropriate tests, misread results, or follow up on abnormal findings all fall into this category.
Treatment Errors
Treatment errors occur during care. They include surgical mistakes such as wrong-site procedures or retained instruments, medication errors involving the wrong drug, dose, or timing, overlooked allergies or dangerous interactions, mistakes during anesthesia, and failure to monitor a patient's condition properly during or after treatment.
Preventive Errors
Preventive errors involve failing to provide recommended protective care or follow-up – for example, not offering appropriate screenings to a high-risk patient, failing to start preventive treatment such as measures to reduce blood clot risk after surgery when indicated, or not following up on a result that called for monitoring.
System and Communication Errors
Many errors stem from flawed systems rather than one person's mistake: incomplete handoffs between shifts, poorly designed electronic records, look-alike medication packaging, understaffing, or test results that fall through the cracks between providers. Communication failures between providers, and between providers and patients, contribute to many other types of errors.
Red Flags Worth Taking Seriously
Your Condition Gets Unexpectedly Worse
Some discomfort after treatment is normal, but a sharp or unexpected decline isn't. If you're being treated for pneumonia and develop severe shortness of breath and a rising fever, or your pain after surgery suddenly worsens rather than improving, contact your care team immediately. Seek emergency care for severe or rapidly worsening symptoms.
New, Unexplained Symptoms Appear
New symptoms after a procedure or medication change may signal a side effect, infection, or injury. For example, new numbness or weakness in your foot after knee surgery should be evaluated promptly.
Providers Give Conflicting Information
If your surgeon and primary care doctor give you different instructions, ask both to explain and reconcile them. Conflicting information can be a sign of a communication breakdown, and following the wrong instructions can cause harm.
Explanations Are Vague or Missing
You should understand your diagnosis, treatment plan, risks, and next steps. If questions are repeatedly brushed off or answers don't make sense, keep asking and request written information.
You Feel Dismissed
Your symptoms matter. If persistent pain or other concerns are repeatedly dismissed as "normal" without an examination or explanation, request a more thorough evaluation or a second opinion.
Care Is Delayed Without Explanation
Long, unexplained delays in test results, referrals, or procedures can allow conditions to worsen. Ask when you should expect results and follow up if you don't hear back.
Your Medication Looks Wrong
If a pill looks different from usual, the dose or instructions differ from what you were told, or you're prescribed something you're allergic to, stop and ask your pharmacist or prescriber before taking it. Carry an up-to-date list of medications, supplements, and allergies.
How to Assess an Unexpected Result
Revisit What You Were Told
Look back at your informed consent discussion and documents. Before most significant procedures and treatments, providers should explain the expected benefits, significant risks, alternatives, and what could happen without treatment. If the outcome falls within the risks you were told about, it may be a recognized complication. If it falls outside what was discussed, or a significant risk was never disclosed, ask why.
Ask Whether It Was Preventable
The key distinction between a complication and an error is preventability. A severe allergic reaction to a drug you'd never taken before can be an unavoidable complication. Giving that same drug to a patient whose record clearly lists the allergy would be an error. Ask your provider directly whether the outcome was expected, what may have caused it, and whether anything could have prevented it.
Weigh the Severity and Course
Step-by-Step: What to Do If You Suspect an Error
Step 1: Protect Your Health First
Get appropriate care for your current condition. If symptoms are severe or worsening, seek urgent or emergency care. Answers can wait; your health can't.
Step 2: Gather Information
Request copies of your medical records, including physician and nursing notes, test results, imaging reports, medication lists, operative reports, and discharge instructions. Under federal law, you generally have the right to access your records within 30 days of your request. Write down a timeline of events, including dates, names of providers, what you were told, and how your symptoms changed. Save prescription labels, discharge papers, bills, and insurance statements.
Step 3: Talk to Your Care Team
Request a meeting with the doctor or team involved. Explain what happened and why you're concerned, and ask specific questions: What do you think caused this? Was this an expected risk? What happens next? Bring a trusted family member or friend to take notes.
Many hospitals now use communication-and-resolution approaches, in which providers investigate adverse events, disclose what happened to patients, and work toward resolution. Many states also have laws that allow providers to express sympathy without that statement being treated as an admission of fault, which can make open conversations easier. A clear explanation may resolve your concern – or confirm that further steps are needed.
Step 4: Get a Second Opinion
Ask an independent specialist, ideally one not affiliated with your original providers, to review your records and evaluate your current condition. A second opinion can identify issues that were missed, confirm a diagnosis, or reassure you that the outcome was an unavoidable complication.
Step 5: Use Patient Advocates and Hospital Leadership
Most hospitals have patient relations departments or patient advocates who can help you get answers and navigate the system. Hospitals that participate in Medicare are required to have a formal grievance process. If you aren't satisfied, you can escalate your concerns in writing to hospital administration.
Step 6: Report to External Organizations
If internal channels don't resolve the issue, outside organizations can review concerns. You can file a complaint with your state health department, which oversees licensed facilities, or with your state medical board or other licensing board for individual providers. Hospitals accredited by The Joint Commission can be reported to that organization. Medicare beneficiaries can contact their Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) about quality-of-care concerns. Serious problems with medications or medical devices can be reported to the FDA through MedWatch.
Step 7: Know When to Talk to an Attorney
If you've suffered serious or lasting harm, consult a medical malpractice attorney sooner rather than later. Legal action is not right for every situation, but filing deadlines vary by state and can be short – especially for claims involving government facilities. A consultation can help you understand your options while you pursue other avenues for answers.
How to Reduce Your Risk of Medical Errors
Be Prepared
Bring a list of symptoms, questions, medications, supplements, and allergies to every appointment. Update your list whenever anything changes.
Ask Clear Questions
Ask what your diagnosis is, what else it could be, what tests are needed, and what symptoms should prompt you to call back or seek emergency care. If you don't understand something, ask the provider to explain it differently.
Verify Everything
Confirm the name, dose, and purpose of every new medication. Before surgery, confirm the procedure and surgical site with your care team.
Bring an Advocate
For hospital stays, surgery, or complicated appointments, bring someone who can listen, take notes, and speak up when you can't.
Follow Up
Don't assume no news is good news. Ask when you'll receive test results, use patient portals, and follow up if you don't hear back.
Get Second Opinions on Major Decisions
For serious diagnoses or major treatments, a second opinion is a sensible way to confirm the best path forward.
Common Mistakes Patients Make
Common mistakes include ignoring new or worsening symptoms, assuming every bad outcome is someone's fault, assuming every bad outcome is unavoidable, failing to request records, waiting too long to raise concerns, and delaying legal advice after serious harm until deadlines have passed.
Disclaimer: This article is for educational purposes only and does not constitute medical or legal advice. Consult a physician or qualified healthcare provider about your symptoms and treatment, and a licensed attorney about legal questions. If you have severe or rapidly worsening symptoms, call 911 or seek emergency care immediately.
FAQ
What's the difference between a complication and a medical error?
A complication is an adverse outcome that occurs despite appropriate care. An error is a failure in the care process, and errors that cause harm are generally considered preventable.
Is every medical error malpractice?
No. Malpractice is a legal concept that generally requires a breach of the standard of care that causes significant harm. Many errors don't meet that threshold.
What should I ask my doctor after an unexpected result?
Ask what caused it, whether it was a known risk, whether it could have been prevented, and what the next steps are for your care.
Where can I report a medical error?
You can use the hospital's grievance process, your state health department or licensing board, The Joint Commission for accredited hospitals, a BFCC-QIO for Medicare beneficiaries, or FDA MedWatch for medication and device problems.
How quickly should I act if I think an error caused serious harm?
Get medical care right away, request your records, and consult an attorney promptly, since legal deadlines can be short.
The Bottom Line
Not every unexpected result is an error, and not every error is malpractice – but every unexpected result deserves a clear explanation. Watch for red flags, protect your health first, gather your records, ask direct questions, get a second opinion when needed, and use internal and external channels to get answers. Staying engaged in your care is one of the most effective ways to prevent errors and catch them early when they happen.
📚 Sources
Agency for Healthcare Research and Quality – Patient Safety Network: https://psnet.ahrq.gov/
Agency for Healthcare Research and Quality – Communication and Optimal Resolution (CANDOR): https://www.ahrq.gov/patient-safety/settings/hospital/candor/index.html
U.S. Department of Health and Human Services – Individuals' Right to Access Their Health Information: https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/access/index.html
The Joint Commission – Report a Patient Safety Concern: https://www.jointcommission.org/resources/patient-safety-topics/report-a-patient-safety-concern-or-complaint/
Centers for Medicare & Medicaid Services – Quality Improvement Organizations: https://www.cms.gov/medicare/quality/quality-improvement-organizations
U.S. Food and Drug Administration – MedWatch: https://www.fda.gov/safety/medwatch-fda-safety-information-and-adverse-event-reporting-program
