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Article |

The Double Iatrogenic Hazard

Raphael Adar, MD
JAMA. 1987;257(16):2164. doi:10.1001/jama.1987.03390160050012.
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To the Editor.—  Three case reports1-3 on iatrogenic injuries in a single recent issue may be coincidental, but they certainly catch the eye of a longtime iatrogenic-complication watcher like myself. While iatrogenic mishaps are often unusual, even piquant, the "message" of a single case report, though important, is usually limited. A systematic study of iatrogenic afflictions is, however, more instructive, and recent clinical literature does indeed try to define predisposing factors, possible mechanisms, and general safeguards.From a long interest in iatrogenic problems in surgical patients,4,5 we have made some observations that cannot always be documented in a scientific manner, yet may be important in the attempt to cut down on the incidence of iatrogenic complications. For instance, we have noticed that an error in judgment or an unindicated procedure appear more likely to lead to an iatrogenic complication, and there is a tendency for this to happen


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