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What to do when things go wrong
  1. Daniel McKenzie
  1. Cardiology, Royal United Hospitals Bath NHS Foundation Trust, Bath BA1 3NG, Bath and North East Somer, UK
  1. Correspondence to Dr Daniel McKenzie, Cardiology, Royal United Hospitals Bath NHS Foundation Trust, Bath, BA1 3NG, Avon, UK; dan.mckenzie{at}

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Hippocrates’ famous decree, ‘First do no harm’, was an honourable but impossible aspiration.

Hippocrates practised medicine at a time when human dissection was forbidden in Greece. Undoubtedly, the resulting lack of knowledge on disease processes would have led to unintentional patient harm. In medicine, all physicians will inevitably fail to uphold the eponymous oath which many swear to, and this has contributed to the difficult relationship we have with medical error.

Healthcare is an inherently risky activity and cardiology is particularly dangerous due to the conditions that our patients present with and the procedures that we undertake to diagnose and treat them. It is a very uncomfortable situation when things go wrong, but accepting that occasionally they will and having the skills to manage them when they do are both vitally important.

Imagine what you would want to happen if you were a patient or the relative of a patient that had been harmed in the hospital. Most people want to know three basic things:

  1. What happened?

  2. What can be done to deal with …

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  • Contributors DMcK wrote this article after being invited to by Dr Sarah Hudson, BMJ Heart Section Editor, Cardiology in Focus.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, conduct, reporting or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.

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