More than 20,000 cases of adverse medical events have been reported in our country over the past eight years, while more than 1,000 cases have reached the courts and received final rulings. The majority of these rulings vindicate those who filed claims after a medical error caused significant physical or psychological harm to themselves or their loved ones — and in some cases, the error even led to death.

It has not been long since the death of a patient due to a mistaken blood transfusion at Tzaneio Hospital, while another erroneous transfusion was reported at the General Hospital of Rethymno involving a patient in the ICU — with the Minister of Health saying he learned about it on television… In September, the Wrong blood type was administered to a patient at the Euroclinic, prompting a prosecutor’s intervention, while only days later it became known that a 28-year-old pregnant woman died of anaphylactic shock after receiving an antibiotic. Recently, nurses at Attikon Hospital administered the wrong medication to a patient, causing a severe allergic reaction. These are only some of the incidents reported by the media, but more or less everyone has heard of a medical-error case within their own social circle that never made the news.

“Adverse events,” lawsuits, and insurance

For about eight years now, the Patient Safety Observatory has operated within the Laboratory of Health Economics and Management at the University of Piraeus. There, more than 1,000 court decisions related to such incidents have been collected and analyzed, along with more than 20,000 “adverse events,” as described by Professor Athanasios Vozikis, head of the laboratory—incidents that could have caused, or did cause, harm to one or more patients during care in public or private healthcare facilities.

Medical errors in Greece exceed 6,000 annually. Naturally, not all are equally serious, and not all end up in court. Some are even concealed from patients or attributed to the natural course of the illness. On the other hand, patients often do not wish to engage in lengthy legal battles. Still, according to an earlier University of Piraeus study, the average compensation awarded in finalized cases reaches €300,000. This is one reason why thousands of doctors have taken out liability insurance, and some private clinics require it as a condition. Annual payouts for medical errors amount to tens of millions of euros, whether through court judgments (usually after five or more years) or out-of-court settlements. Lawyers involved in such cases also point to difficulties in finding colleagues willing to testify or serve as expert witnesses against accused doctors.

Exhausted healthcare personnel

Recent findings from the World Health Organization revealed that one in three doctors and nurses in Europe suffers from depression — a factor that appears to contribute to medical errors. Nearly half say they are considering leaving the profession. The study confirms the immense pressure on the healthcare system, not so much in terms of infrastructure, but in the human resources that support it.

The pandemic undeniably made matters worse. Applause on balconies may have been a symbolic, communicative gesture of moral support, but it does not erase exhaustion, relentless shifts, inadequate training, understaffing, and the pressure on those responsible for our health.

Medication errors most common

The most recent relevant cross-sectional study in Greece was conducted by researchers at the Universities of Patras, Thessaly, and Ioannina, and published in the international scientific journal AIMS Public Health. The study included 514 nurses from four major public hospitals in Athens, Piraeus, Larissa, and Thessaloniki. The findings are revealing.

In the anonymous survey, 64.4% admitted they had made a medication error in the past year. Of these, 62.1% never reported the error due to fear of disciplinary or legal repercussions.

The study also showed that the most common mistakes involved incorrect medication, while about 30% agreed that errors occur most frequently during afternoon shifts, when staffing is lower and procedures are performed by inexperienced staff or assistants lacking proper supervision.

Additional statistics shed light on the rise of medical errors: 65% of nurses report psychological manipulation (gaslighting) by superiors; 66% report burnout; and 50% are considering changing professions.

Gynecology/obstetrics ranks first

Liability for medical and nursing personnel falls into three categories:
– Civil liability, which involves monetary compensation claimed from practitioners and often the clinics as well;
– Criminal liability, which may involve imprisonment if an act falls under the criminal code;
– Disciplinary liability, concerning professional duties (e.g., removal from the medical association).

Large studies over the last decade show that gynecology/obstetrics ranks first in serious medical errors that lead patients and doctors to court, followed by general surgery, anesthesiology, emergency medicine, and radiology.

In recent years, the field of aesthetic medicine has also entered the picture. Most errors occur during diagnosis (including delayed diagnosis) and treatment.

No official record in Greece

Errors can occur during prevention, diagnosis, treatment, or even rehabilitation. Greece has no official registry of such cases, which is why experts from various fields have increasingly called for a standardized procedure leading to a central database for monitoring errors, under the responsibility of the National Organization for Quality Assurance in Health (ODIPY).

However, the World Health Organization does not include medical error in the International Classification of Diseases (ICD) as a pathological condition leading to death. As a result, death certificates issued in Greece never list “medical error” as a cause of death.