Procedural safety observation (Surgical site verification) in Ultrasound
Occurred: 2025-03-07T09:53 UTC · Reported: 2025-03-11T13:53 UTC
Clinical Narrative & Synthesized Abstract
Synthesized Abstract: At 09:53 UTC in Ultrasound, a minor safety event occurred involving surgical site verification. The incident was assigned preliminary risk score 15 in the Low band.
In Ultrasound at 09:53, surgical team conducting safety checklist noted a variance relating to surgical site verification. Formal pause was executed.
Risk Evaluation & Score Breakdown
Deterministic multi-term risk score from 1 to 100 derived from clinical harm, recurrence, and reporting lag.
Top Similar Incidents in Radiology
Semantic similarity calculated across category, location, and clinical narrative keywords.
Procedural safety observation (Surgical site verification) in Ultrasound
Procedural safety observation (Surgical site verification) in Ultrasound
Procedural safety observation (Surgical site verification) in Ultrasound
Root Cause Analysis & Safeguards Workspace
Explore 5 Whys causal pathways, 6-bone fishbone decomposition, and barrier analysis safeguards.
Corrective & Preventive Actions (1)
Implement systemic safeguard against surgical & invasive procedures: standardized protocol enforcement and hardware interlock.
Parties Involved (2)
Masked by default per governance protocolHandover & Action Notes (2)
Root cause debrief conducted with morning nursing team. Focus on verbal order readback adherence.
Root cause debrief conducted with morning nursing team. Focus on verbal order readback adherence.