Subject: Serious Untowards Incidents
- The number all Serious Untoward Incidents (SUIs) reported within your NHS trust which occured during 2016 (Jan-Dec), and the details of what occured.
Of those SUIs, how many resulted in a patient death.
3. Of those SUIs, how many were found to be the consequence of staff fatigue or lack of sleep.
|Wrong Lens implant|
|Neonates – inadvertent overdose of morphine|
|Wrong Site anaesthetic block|
|Response to rapid deterioration|
|C Diff acquisition||Patient died|
|Administration of Wrong Route Medication|
|Wrong results reviewed leading to unnecessary surgery|
|Wrong Site Aspiration|
|C.Diff acquisition||Patient died|
|Failure of equipment for lens measurement|
|Medication Error – Fentanyl|
|Fall – found on floor|
|None of the investigations noted staff fatigue or lack of sleep as the root cause.|