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Moments in Surgical History |

Harvey Cushing's Open and Thorough Documentation of Surgical Mishaps at the Dawn of Neurologic Surgery

Katherine Latimer, BS; Courtney Pendleton, BS; Alessandro Olivi, MD; Aaron A. Cohen-Gadol, MD, MSc; Henry Brem, MD; Alfredo Quiñones-Hinojosa, MD
Arch Surg. 2011;146(2):226-232. doi:10.1001/archsurg.2010.319.
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The recognition of surgical mishaps and their correction in subsequent cases was critical in the evolution of the discipline of neurosurgery during its infancy. The Johns Hopkins Hospital surgical records from 1896 to 1912 were reviewed, and 30 cases documenting the self-reported surgical errors of Harvey Cushing, MD, were selected for further analysis. We demonstrate that alongside pioneering profound advancements in medical care, Cushing openly acknowledged and described significant instances of human error, mistakes in judgment and technique, and equipment and supply oversights, regardless of whether these events affected patient outcome. Mistakes were analyzed and recorded to be drawn on as lessons to improve future care. This review defines the attitude toward documenting and reporting medical errors present at the founding of the field of neurosurgery as one of forthright acknowledgment in the pursuit of innovation.

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Dr Harvey Cushing's original note in the file of a human error case stating, “Unquestionably overlying an Endothelioma a condn [abbreviation for condition ] unrecognized in 1910 by me. H.C.”

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