Top 10 Sentinel Events Reviewed in First Half of 2013

Wrong-patient, wrong-site or wrong-procedure surgery was the most frequent sentinel event category reviewed by The Joint Commission in the first half of 2013.

The Joint Commission has reviewed a total of 446 sentinel events so far in 2013. In 2012, it reviewed a total of 901. Here are the top 10 sentinel events reviewed by The Joint Commission from January to June 2013 based on the number of events:


Wrong-patient, wrong-site, wrong-procedure — 60
Unintended retention of a foreign body — 56
Delay in treatment — 56
Fall — 48
Other unanticipated event (includes unexpected additional care/extended care, and psychological impact) — 40
Op/post-op complication — 37
Suicide — 35
Criminal event — 26
Medication error — 20
Perinatal death/injury — 15

These events are also the top 10 reviewed sentinel events in 2012, but in a different order.

The Joint Commission noted that most sentinel event reports are voluntary and represent only a small percentage of actual events. "Therefore these data are not an epidemiologic data set and no conclusions should be drawn about the actual relative frequency of events or trends in events over time," it wrote.

More Articles on The Joint Commission:

Joint Commission: Addendum to Creutzfeldt-Jakob Disease Sentinel Event Alert
5 Hardest Joint Commission Ambulatory Care Standards

OSHA, Joint Commission Renew Alliance for Worker Safety

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