First paragraph (this article has no abstract)

For patients, surgical complications are analogous to "friendly fire" in wartime. Both scenarios imply that harm is unintentionally done by somebody whose aim was to help. One would assume that any patient admitted to a hospital to undergo a surgical procedure should expect to be better off after the intervention than before. However, while we, as surgeons, strive to achieve excellent results and ideal patient outcomes, we fail this noble task more often than we appreciate [1]. Interestingly, adverse events resulting from surgical interventions are more frequently related to mistakes and failures before and after surgery than during the operative procedure itself [2]. A recently published analysis of the American College of Surgeons' closed claims study revealed that at total of 97% of all events leading to medicolegal claims involved a delay in diagnosis, a failure to diagnose, a delay in treatment, or a failure to treat [2]. Technical errors resulting in surgical complications represent only about half of all events leading to a claim [2]. Furthermore, out of 258 medicolegal claims related to errors leading to surgical patient injuries, about 25% were attributed to a breakdown in communication before, during, or after surgery [3].