Never Never Land?

There's this new thing in healthcare called "never events." These are events occurring in a healthcare facility whose resultant costs won't be covered by Medicare and Medicaid (surely to be followed by the insurance companies). These events include 

• death/disability surrounding surgery (wrong patient or body part, things left in the body after surgery, incorrect procedure)
• death/disability associated with incorrect/misuse/malfunction of equipment, medications, blood products
  
• assault within a healthcare facility
• abduction

Makes sense, right? Some of them, however, are much less clear and have the bedside community concerned. For example, the following are now considered "never events:"

• patient suicide
• death/disability associated with patient elopement (disappearance)
• maternal death/disability associated with labor or delivery on a low-risk pregnancy
• death associated with a fall 
• death/disability associated with use of restraints or bedrails 
• death/disability associated with hypoglycemia
• perioperative death in a normal health patient
  

I'm not saying they're ok to happen, but I do think there are instances where things happen anyway. We don't know enough about the body to guarantee surgery/delivery with a "normal" patient will not result in death (you sign consent for a reason!). Patients have free will and will do things against policy and orders (ie: get out of bed, do illegal drugs in the hospital, leave briefly to meet up with the dealer/shoot up). Not all areas of a hospital provide one-to-one care. I'm not alone in feeling that some "never events" are unrealistic in the healthcare setting.

This was an interesting post. Scary isn't it?