Errors and near-misses in radiotherapy

Author(s): Henry Lawrence

Hospital: Ipswich Hospital

Reference: RAD Magazine, 40, 471, 17-18

Excerpt: 

Errors in radiotherapy can have serious, even fatal, results. We are all well trained, intelligent people, yet still errors and near misses occur. We double check all our clinical calculations, yet still errors creep through. This article describes some errors and the underlying thought process that contributed to them.

The International Atomic Energy Agency (IAEA) has published a very informative summary of 92 errors that were brought to its attention. The cause of each of these errors is described and both the initiating event and the contributing factors are briefly discussed. Some were caused by technical failure, some were due to misunderstandings and some were due to carelessness.

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