Qual Saf Health Care 16:213-215 doi:10.1136/qshc.2006.019810
  • Error management

Patients use an internet technology to report when things go wrong

  1. John H Wasson1,
  2. Todd A MacKenzie2,
  3. Michael Hall3
  1. 1Dartmouth Medical School, Hanover, New Hampshire, USA
  2. 2Norris Cotton Cancer Center, One Medical Center Drive, Hanover, New Hampshire, USA
  3. 3Hall Stewart, Manchester, New Hampshire, USA (posthumous)
  1. Correspondence to:
 Dr J H Wasson
 Dartmouth Medical School, Hanover, New Hampshire 03755, USA; john.h.wasson{at}
  • Accepted 30 January 2007


Background: As patients directly experience harm from adverse events, investigators have proposed patient-report to complement professional reporting of adverse events.

Objective: To investigate how an automated health assessment system can be used to identify adverse events.

Design and setting: Internet survey responses from April 2003 to April 2005 involving communities and clinical practices across the USA.

Patients: 44 860 adults aged 19–69 years.

Outcome: Patient perceptions of adverse events experienced during the previous year. Independent legal review was also used to estimate how many patient-reports were serious enough to be potentially compensable.

Results: Although patient reports of possible adverse events was low (1.4%), the percentage of adverse events was eight times higher for patients with the greatest burden of illness than for those with the least (3.4% vs 0.4%). Two expert malpractice attorneys agreed that 9% of the adverse events seemed to be serious.

Conclusions: Patients will use internet technology to report their perceptions of health-related adverse events. Some of the patient-reported events reported will be serious.


  • Competing interests: The results are based on the use of an internet technology Although the website is freely available without advertising or support from any commercial entities, it does cover its costs through a nominal fee for custom use by some subscribers. Under a license agreement with the trustees of Dartmouth College, the corresponding author has developed and distributed the website for the collection of data in this report. In this respect, the corresponding author has a conflict of interest. The authors have no other potential conflicts of interest.

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