No one expects to leave the hospital worse than they arrived, yet this happens when basic safety protocols are ignored. What are “Never Events” in Healthcare? They are shocking, avoidable medical mistakes that lead to permanent injury, long-term complications, or patient death, and they should never happen in a functioning health care system.
At Lipton Law, we help families hold healthcare providers accountable for these failures. As a trusted Southfield, Michigan Medical Malpractice Lawyer, our firm fights for individuals harmed by never events across the state. If you or a loved one suffered from one of these preventable incidents, call (248) 557-1688 or contact us online for a free consultation.
What is a “Never Event” in Healthcare
The term “never event” refers to a shocking and entirely preventable medical mistake that results in death or serious harm. The National Quality Forum, a nonprofit organization that develops healthcare performance measures used by hospitals, regulators, and insurers across the United States, categorizes these incidents as serious reportable events. Its primary goal is to improve safety and accountability across the healthcare system by reducing avoidable errors.
Examples of never events include performing wrong-site surgery, operating on the wrong patient, or discharging a mentally impaired individual without adequate support. In some situations, when medication or a medical device is not used as intended, patient death may occur.
Most never events stem from a communication breakdown, missed safety checks, or lack of clinical oversight. These incidents expose broader failures in hospital systems and cause irreversible harm to patients and families relying on safe care.
Never Events vs. Sentinel Events
Both never events and sentinel events involve unexpected outcomes that result in death or serious harm, but they are different. A sentinel event is a broader classification that includes any unanticipated incident causing serious injury or loss of life. These events can happen even when healthcare providers follow appropriate procedures.
By contrast, a never event is a type of sentinel event that is largely preventable. It reflects a breakdown in the hospital’s systems or safety checks, such as performing surgery on the wrong patient or administering the wrong drug.
Because never events are reportable events, hospitals are required to document them, investigate the cause, and take steps to protect future patients. Both types raise urgent patient safety concerns, but never events signal errors that should never have reached the patient in the first place.
Types of Hospital Never Events
Never events are categorized based on the type of systemic failure that caused them. The National Quality Forum groups these incidents into areas hospitals are required to track, investigate, and report. These categories include surgical and procedural errors, product or device events, medication errors, care management events, environmental events, and other dangerous safety breakdowns. Each reflects a threat to patient safety and typically results from poor communication, improper training, or a failure to follow a facility’s event policy.
These are not isolated lapses. Each type of never event points to a breakdown within a hospital’s core safety systems, failures that can lead to death or serious harm. Whether the issue stems from a misplaced surgical tool, an equipment malfunction, or an error in medication labeling, these incidents are symptoms of a broader problem in how the healthcare facility operates.
Never Events in Surgery
Surgical never events are among the most dangerous and preventable failures in a healthcare setting. These incidents include operating on the wrong patient, performing surgery on the wrong body part, or completing the wrong procedure altogether. Errors such as surgery performed on the wrong body part or patient can occur when OR teams skip essential steps like confirming identity, marking the correct location, or reviewing the procedure.
Other serious mistakes that can cause permanent harm include leaving a foreign object inside the patient or misidentifying the patient due to mislabeled records. These events often point to failures in communication, poor coordination, or breakdowns in protocol. You may be asking, “Can you sue for surgery complications in Michigan?” The answer may be yes if the harm was preventable and tied to negligence.
Never Events with Medical Products
Never product or device events occur when medical equipment, drugs, or supplies are used in a way that causes preventable harm. These never events include administering contaminated drugs, delivering the wrong gas during surgery or respiratory treatment, or injecting medication into a line designated for another purpose. Each of these actions can lead to significant injury or, in the most severe cases, when an individual suffers a never event in a healthcare facility, patient death.
Medical product mistakes often result from poor labeling, staff training, or skipped safety checks. If an individual is exposed to or ingests harmful materials or toxic substances, patient death may occur. These incidents are avoidable when hospitals follow strict quality control procedures, properly maintain equipment, and verify medications before they reach the patient.
Never Events in Care Management and Patient Protection
How care is managed is as important as the procedures performed. Care management events include administering the wrong drug, failing to monitor a low-risk pregnancy, or overlooking critical lab results. These errors can delay diagnosis, worsen a condition, or cause serious complications.
Patient protection events involve failures that expose vulnerable patients to largely preventable harm. Common examples include releasing someone at risk of attempted suicide without a safety plan or allowing patient elopement from a secured unit. These incidents may also involve discharging a person who lacks the mental or physical ability to care for themselves safely. An unsafe discharge from a hospital in Michigan can lead to serious consequences and may be grounds for legal action if proper protocols were not followed.
These never events are often linked to communication failures, fragmented care, or poor discharge planning. When departments are uncoordinated or safety checks are missed, the risk to the patient and the licensed healthcare provider increases significantly. These situations can result in lasting patient harm and are entirely avoidable with structured oversight and accountability.
Never Events in a Healthcare Facility
A safe environment is a basic expectation in any healthcare facility, but when it’s not maintained, the result can be dangerous or even fatal. Environmental events may involve electric shock, burns incurred from malfunctioning equipment, or exposure to hazardous conditions. These types of never events often occur when hospitals fail to maintain infrastructure, monitor equipment, or follow basic safety procedures.
Examples include broken or improperly used heating devices, faulty electrical systems, or unsecured areas that allow for physical assault involving a patient or staff member. Contaminated HVAC systems and sterilization failures can also contribute to hospital-acquired infections, which put patients at risk of further illness and complications.
All of these are considered reportable patient safety incidents. Without oversight and clearly enforced safety protocols, patients and staff are exposed to conditions that increase the likelihood of death or serious harm. Every healthcare setting must take these risks seriously and act proactively to prevent them. A hospital injury lawyer in Michigan can help you understand your legal rights if you or a loved one suffered harm due to unsafe hospital conditions.
How to Prevent Never Events in Hospitals
Preventing never events requires more than checklists. It takes leadership, clear protocols, and a hospital-wide commitment to safety. Staff must feel empowered to pause a procedure if something seems off, and every department must treat patient safety as a shared responsibility.
Hospitals that reduce reportable events implement strong verification steps, real-time checklists, internal audits, and confidential reporting systems. Compliance with national benchmarks and Medicaid Services guidelines supports system-wide improvement.
A proactive events policy, combined with regular training on patient identification, medication labeling, and procedural accuracy, helps improve patient safety and reduce preventable errors in high-risk areas.
Assessing Patient Safety
Assessing patient safety requires ongoing attention to every stage of the care process. Facilities should regularly review past sentinel events, monitor serious reportable events, and track patterns of patient harm. These reviews help identify weaknesses before they lead to a never event.
Practical assessment goes beyond clinical metrics. It requires input from every level of the organization, including physicians, nurses, pharmacists, and administrative staff. When safety is treated as a system-wide responsibility, hospitals are better equipped to correct procedural failures and protect future patients.
Increasing Documentation
Clear and consistent documentation is one of the most effective ways to prevent costly medical errors. Accurate medical records reduce the risk of administering the wrong drug, using the wrong route, or preparing the wrong person for surgery. Proper charting also helps avoid the wrong preparation of medication by allowing staff to confirm allergies, dosages, and patient instructions in real time.
Complete documentation limits miscommunication between departments and across shifts. When records are accurate and accessible, providers can quickly trace the origin of a patient safety incident, making it easier to conduct root cause analysis and implement corrective action. Strong documentation supports both patient care and legal accountability.
Improving Hospital Training
Ongoing training equips healthcare providers with the tools to prevent never events. This includes recognizing risk factors, confirming proper medication dosing, and following verification protocols before surgery or procedures. Routine refreshers help teams respond to emergency alerts, follow up on test results, and reduce repeated management events.
Special focus should be placed on caring for patients with cognitive or physical impairments who are more vulnerable to elopement, physical assault, or missed care. In hospitals where continuous learning is prioritized, providers are more likely to take action when safety concerns arise. Strong staff education leads to better outcomes and fewer reportable events, making training a critical part of patient protection.
Increasing Awareness for Patient Safety Events
Increasing awareness of patient safety events helps hospitals improve care and gives the public better insight into where to seek treatment. Tools like the Leapfrog Hospital Survey provide transparency into hospital performance by highlighting safety metrics, including rates of medical errors, serious injury, and serious reportable events.
Public data empowers patients and encourages hospitals to strengthen safety policies and reduce risk. National agencies track outcomes like hospital-acquired infections, preventable deaths, and potential criminal events, such as abuse or misconduct within the health care system. This visibility promotes accountability and drives long-term improvements in patient safety.
Can You Take Legal Action for a Never Event in Michigan?
Yes. If a never event caused significant injury, serious disability, or patient death, you may have legal grounds to pursue compensation. Michigan law allows individuals and families to seek damages when a healthcare organization causes preventable harm by failing to meet the standard of care. In the most severe cases, such as a preventable loss of life, wrongful death claims may also apply.
Liability may arise in situations involving the wrong dose, failure to monitor a low-risk pregnancy, or discharging a suicidal patient without safeguards. Other harmful events, like the use of the wrong donor sperm or egg during fertility treatment, giving medication via the wrong route, or missing a terminal diagnosis, can result in life-altering consequences.
Victims of never events may be eligible to recover compensation for medical expenses, lost income, pain and suffering, and emotional distress. These cases are severe, and they require knowledgeable legal support focused on accountability and results.
How Medical Malpractice Lawyers Can Prove Negligence in Never Events
At Lipton Law, our lawyers investigate every medical malpractice case with help from in-house nurses who understand how hospital systems work. To prove negligence in a never-event case, we typically:
- Review detailed medical records to identify reportable patient safety incidents
- Analyze the facility’s internal events policy for compliance failures
- Track patterns of medication errors or ignored safety alerts
- Investigate whether the incident qualifies under serious reportable adverse events
- Identify the involvement of any other licensed healthcare provider
These steps allow us to build a clear, detailed case and help victims recover the compensation they need for recovery and long-term care.
Call the Southfield, MI Medical Negligence Attorneys at Lipton Law Today
If you or someone you love has suffered patient harm because of a never event, don’t wait to seek help. Contact Lipton Law for experienced legal help backed by a full team of Southfield, MI, medical negligence attorneys and nurses who handle these cases daily. We know how to uncover failures in patient care, identify the responsible parties, and hold healthcare providers accountable for their actions that lead to serious injury, loss, or healthcare facility death.
Call (248) 557-1688 to schedule a free consultation or contact us online today.