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What causes medical device adverse incidents? Analysis using a classification of incident causes

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If you have a question about this talk, please contact Thomas Jun.

Aim: Dr Amoore is invited for discussion on patient safety and medical device. He kindly agreed to share his experience in the analysis of medical device incidents as the kickoff of the discussion. Anyone interested in only his talk is also welcome. Please contact Saba (sh467@eng.cam.ac.uk) if you need more details.

Abstract: Medical device incidents are typically multi-factorial in origin, stemming from the interaction between device, operator and patient within the clinical environment. The clinical environment consists of the physical environment where the healthcare takes place, the infrastructure and support systems (including maintenance) that ensure the efficacy and safety of the environment. This suggests that the causes of medical device incidents can logically be divided into the four main groups of device, operator, patient and infrastructure. Incidents caused by poor human factors design are classified as an aspect of device failures. Often overlooked, but nevertheless a significant cause of adverse events, is lack of equipment, an element of Infrastructure failure. The talk explores adverse incidents from these perspectives, whilst recognising that incidents arise from a combination of latent and trigger factors.

This talk is part of the Engineering Design Centre series.

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