Health-care-related harm: harm, cause and mode

Three parts of one event

Health care related harm has three parts: the harm, what caused it, and how it happened.

Harm, cause, mode

The three-part model. The harm: the resulting condition, from almost any chapter. The cause, or source of harm. And the mode or mechanism: the main way the cause led to the harm.

• Harm · Any chapter · The condition that resulted. It may come from almost any chapter, plus special injury or harm categories.
• Cause · Source · The external cause: a substance, a procedure, a device or another cause.
• Mode · How · The main way the cause led to the harm. Modes are specific to the cause type.

Each cause has its own modes

Each type of cause has its own modes. For a substance: overdose, underdose, the wrong substance, or harm despite correct dosing. For a procedure, for example, unintentional perforation of an organ. For a device, dislodgement or malfunction. Other causes include mismatched blood.

• Substance · Dosing · Overdose, underdose, incorrect substance, or harm arising despite correct administration.
• Procedure · Perforation · For example unintentional perforation of an organ during a procedure.
• Device · Failure · For example dislodgement or malfunction.

Always a mode

One rule. A mode is coded alongside the cause in every case. If no mode is apparent, select the unspecified mode code for the type of cause.

• Rule · Mode coded · A mode is coded alongside the cause in every case.
• When unclear · Unspecified · If no mode is apparent, select the code for mode of injury or harm unspecified.

Check yourself

Pause and think. Which is a mode for a device cause? The answer: Dislodgement or malfunction. Each type of cause has its own modes. For a device: dislodgement or malfunction. For a substance: overdose, underdose, wrong substance, or harm despite correct dosing.

• Dislodgement or malfunction
• Overdose
• Mismatched blood
• Underdose

Keep these in mind

Harm, cause and mode: three parts. Modes belong to cause types. And always code a mode, even if unspecified.

• Harm, cause and mode: three parts
• Modes belong to cause types
• Always code a mode, even unspecified