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In medical negligence litigation, one must understand exactly what went wrong, and when, before one may litigate a case. It is this microscopic attention that requires lawyers to dissect a case in minute detail that would inspire envy in a forensic pathologist. Unfortunately, the fact is that few physicians want to engage in such analysis. Once we understand the who, what, where, and when, however, 'why' becomes much more clear, thus leading to answers as to how future accidents and miscalculations can be prevented.
There are two points at which intervention can be made to influence a patient outcome: before and after a sentinel event. A pre-emptive intervention ' the ounce of prevention ' is, naturally, better than the pound of cure. It is always much more difficult putting Humpty-Dumpty back together again. Still, analyzing why an error occurred is a major source for institutions and individuals in deciding how to prevent future problems.
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