Breaking Bad News: How to Disclose an Adverse Event

Talking with patients after an adverse event is never easy. In the July issue of AAOS Now, AAOS Medical Liability Committee members Thomas Fleeter, MD, and Robert Slater, MD, started a conversation with Lee McMullin, CPHRM, senior risk management and patient safety specialist for Cooperative of American Physicians, a physician-owned and governed, California-based medical malpractice liability cooperative. The conversation continued in an AAOS Now podcast (downloadable from, and concludes here.

Dr. Slater: When it’s necessary to discuss an adverse event or complication with a patient, who should do the talking? Should there be a “team approach,” or does the physician require a witness?

Mr. McMullin: When a major event occurs in a hospital acute care setting, the facility’s risk manager may have the appropriate skill set to do that. But not every facility risk manager has that skill set. The surgeon or provider who is primarily involved in the event is the best person to make that disclosure, but sometimes they’re so emotionally disturbed by the situation that they need a surrogate.

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