Adverse events in gynaecology at King Edward VIII Hospital, Durban, South Africa

Summary

Audit of the quality of gynaecological care is essential so that errors due to medical interventions can be reduced to the bare minimum. The aim of this study was to determine the incidence and nature of adverse gynaecological events. The clinical records of all women admitted with gynaecological conditions over 9 months were assessed for adverse events, defined as an injury caused by medical management rather than the underlying disease. Adverse events occurred in 11.7% of admissions and 52% were avoidable. The majority of adverse events were minor (disability lasting less than 6 months). Mortality accounted for 17.7% of adverse events and 2.1% of all admissions. The death rate was higher in the elective admissions. The frequency of adverse events increased with age, the presence of co-existing illnesses, and severity of the illness on admission. Therapeutic mishaps (n = 67; 8%) were the most common type of adverse event. Lessons learnt from audit should reduce adverse events considerably.