Norwegian Board of Health Supervision
Supervision of health and social services


Annual Report 2004 for MedEvent (Meldesentralen – the Reporting System for Adverse Events in Specialized Health Services)

Short summary of Report from the Norwegian Board of Health 5/2006

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For 2004, 2 056 adverse events were registered (registered per 1 December 2005). Such events involve a duty to report to the Norwegian Board of Health in the counties, in accordance with the Specialized Health Services Act, section 3-3. The number of reports of injuries to patients has increased by 51 per cent during the period 2001 to 2004.
 
About one third of the reports were reports of serious injury to patients, and over half were reports of events that could have led to serious injury.
 
176 reports of unnatural death were registered. In 40 per cent of these reports, the death occurred when providing health care, and in 41 per cent, the death occurred as a result of self-inflicted injury.
 
One-quarter of reports of events were related to incorrect use of medicinal products.
 
It is registered in 43 per cent of reports that the patient was informed about the event. It is registered in only ten per cent of reports that the patient was informed about the Norwegian System for Compensation for Injuries to Patients.
 
The Norwegian Board of Health regards the increase in the number of reports as a positive development. However, many events that should be reported, are still not reported. Openness about adverse events, injuries and near misses, and systematic use of information about such events, form the basis for satisfactory work with improving safety. This presupposes a positive attitude to reporting. It is also important for leadership to focus on systematic safety-improvement work.
 
Data from MedEvent must be interpreted with caution, because of sources of error. However, despite the limitations of the data, we believe that the reports provide useful information that can be used in safety-improvement work and in supervision of specialized health services.
 
 
Updated 29 March 2006