2021-10-08

Sentinel Event and Serious Untoward Event


The Sentinel Event (SE) Policy was implemented in 2007, while the element of Serious Untoward Event (SUE) was incorporated later in 2010. After implementation of the Sentinel and Serious Untoward Event Policy (The Policy) in 2010, the Policy was updated in July 2015 (Annex I) with inclusion of supplementary notes on definitions and qualification criteria of SE as well as new Chinese translations of SE and SUE. [Note 1]

[Note 2]

10 years ago in 2010

A total of 81 SUEs were reported from 1 January 2010 to 30 September 2010. A breakdown of reported SUEs revealed that 72 cases (88.9%) were due to medication error and 9 cases (11.1%) patient misidentification. [Note 2]

  

Yearly trend


[Note 1]

SUEs from Medication Error

In year 2010, The commonly reported SUEs due to medication error, 
  • with a total of 26 (36.1%) cases, were related to the prescription or administration of “Known Drug Allergy” (KDA) drugs
  • medication error involving “dangerous drugs” (21 cases; 29.2%)
  • “hypoglycaemic agents” (7 cases; 9.7%)
  • “anticoagulants” (6 cases; 8.3%)
  • “vasopressors” (4 cases; 5.6%) and 
  • other medications (8 cases; 11.1%) [Note 2]
In year 2020,
[Note 1]

Dr. Pierre Chan

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