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In Reply: In response to Drs Schiowitz, Blank, and Carr, many terms, including "adverse events," "medical errors," "medical injuries," "iatrogenic conditions," "health care associated risk," etc, have been introduced to describe unintended injuries to patients and errors in the process of health care.¹ The lack of common terminology and taxonomy remains an obstacle to national efforts in improving patient safety. In response, the Institute of Medicine has recently recommended that "the federal government should move expeditiously to identify a core set of well-integrated, nonredundant clinical terminologies for clinical care, quality improvement, and patient safety reporting."²

Deciding on proper terminology to describe our research findings was one of the biggest challenges for our study. Although we were painfully aware that the term was not agreeable to all, we used the term "medical injuries" to describe the 18 types of events identified by the PSIs developed by the Agency for Healthcare Research . . . [Full Text of this Article]

Chunliu Zhan, MD, PhD
Center for Quality Improvement and Patient Safety
Agency for Healthcare Research and Quality
Rockville, Md

Marlene R. Miller, MD, MSc
Quality and Safety Initiatives
Johns Hopkins Childrens Center
Baltimore, Md