Data Snapshot: Iatrogenic Burn Injuries

Pa Patient Saf Advis 2009 Mar;6(1):36.

Data Snapshot

A recent article in the Wall Street Journal¹ led Pennsylvania Patient Safety Authority analysts to query the PA-PSRS database for burn reports submitted in 2007.* The search was designed to yield reports of actual or proximal harm to the patient by burns, singes, or sparks occurring in the healthcare facility that reported the burn. Reports involving events before the patient received care at the reporting facility were not considered. Also excluded were reports of events involving cigarettes, candles, and other flammable items not usually found in a healthcare setting.

There were 224 reports of burns, two-thirds of which were thermal in nature. More than half the submitted burns were reported to have been caused by instruments or devices used in procedures, including cautery units, light sources, and cords for these devices. Nine percent of the reported burns were attributed to therapeutic heat sources, such as heating pads or hot packs; a further 5% were reported following magnetic resonance imaging procedures. Almost 14% of reported burns were attributed to food preparation or distribution. These reports include hot liquid spills and handling hot containers.

Table. Causes and Types of Burns Submitted to PA-PSRS in 2007
Cause	Chemical	Electrical	Mechanical	Radiation	Thermal	Unknown/Unstated	Total	% Of Total
Procedural instrument/device	0	14	5	0	98	0	117	52.2%
Cautery device		6			53		59
Device cord		1			13		14
Light source					6		6
Other instrument		7	5		26		38
Secondary to procedure	15	10	2	1	22	0	50	22.3%
Heat therapy					20		20
Magnetic resonance imaging burn		9			2		11
Solution	14						14
Other	1	1	2	1			5
Other	0	0	2	0	32	2	36	16.1%
Food					31		31
Other			2		1	2	5
Unknown/unstated			2	1		18	21	9.4%
Total	15	24	11	2	152	20	224
%	6.7%	10.7%	4.9%	0.9%	67.9%	8.9%

Overall, reports of burns account for 0.11% of all reports submitted to the Authority in 2007. Based on additional figures from the Pennsylvania Health Care Cost Containment Council, an estimated 11.9 burns occur per 100,000 admissions in Pennsylvania.²

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* 2007 was selected for comparison against data obtained from the Pennsylvania Health Care Cost Containment Council, for which 2007 was the last full year of available admission data at the time of publication.

Notes

Landro L. In just a flash, simple surgery can turn deadly Wall St J [online]. 2009 Feb 18 [cited 2009 Feb 18]. Available from Internet: http://online.wsj.com/article/SB123491688329704423.html.
Pennsylvania Health Care Cost Containment Council. Statewide report [20071-20074 online]. [cited 2009 Feb 18]. Available from Internet: http://www.phc4.org/countyprofiles/CountyProfileResults.aspx?CID=0&B=20071&E=20074.

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