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Red flags

• An unexpected death or serious deterioration after an intervention or medication is an adverse event until proven otherwise — ask 'could this have been caused by the treatment rather than the disease', stabilise the patient, preserve the evidence, and notify the senior clinician before anything else.
• An apology (an expression of regret) is NOT an admission of legal liability under Australian civil liability legislation and under the Australian Open Disclosure Framework — withholding an apology for fear of litigation breaches the ethical and (in many jurisdictions) legal duty of candour and paradoxically increases the risk and value of a claim.
• A death attributable to an adverse event or medical procedure is reportable to the coroner — do NOT complete the ordinary death certificate or release the body for cremation; the duty is to report, to preserve the record and any equipment, and to let the coronial process run.
• Wrong-site surgery, wrong-patient surgery, wrong-procedure surgery, retained foreign object, and incompatible blood transfusion are never events — they trigger a mandatory sentinel event review, an external report to the ACSQHC, and a full root cause analysis regardless of the clinical outcome.
• Practising while intoxicated, sexual misconduct in connection with practice, impairment placing the public at risk, and a significant departure from accepted professional standards are AHPRA notifiable conduct — a treating practitioner who forms a reasonable belief must notify AHPRA; the threshold is public protection, not peer disapproval, and mandatory notification is distinct from the internal incident report.
• Insulin written with a U for units (4U read as 44), a trailing zero (5.0 versus 5), or a missing leading zero (.5 versus 0.5) are documented causes of tenfold and greater insulin overdose — write units in full, never use a trailing zero, and always use a leading zero; these are non-negotiable prescribing standards.
• The second victim — the clinician involved in the adverse event — commonly suffers acute distress, loss of confidence, intrusive thoughts, and, in severe cases, suicidal ideation; failing to support the second victim drives concealment, burnout, and attrition, and is itself a patient-safety risk.
• A punitive blame culture causes clinicians to conceal errors, prevents the latent conditions from being surfaced and fixed, and guarantees that the same error recurs in a different clinician — the durable fix is a just culture that distinguishes human error (console), at-risk behaviour (coach), and reckless behaviour (punish).