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Medical error disclosure — USMLE Step 2 CK MCQ

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HardEthics, patient safety, quality improvementMedical error disclosureUSMLE Step 2 CK

A physician accidentally enters a tenfold insulin dose. The dose reaches the patient, who develops symptomatic hypoglycemia that is promptly treated and resolves without lasting injury. The patient does not yet know why the event occurred. After ensuring immediate clinical stability, what should the physician do?

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Reveal the answer and explanation

Correct answer: B — Promptly disclose the error, apologize, explain known consequences and prevention steps, and submit a safety report

The medication error reached the patient and caused harm, even though the hypoglycemia resolved. The physician should disclose the event promptly and compassionately, explain what is known about what happened and its actual and potential consequences, express regret or apologize, describe the clinical response and follow-up, and explain steps being taken to reduce recurrence. The record must remain accurate, and the event should be reported through the institution's patient-safety system for analysis and systems improvement. Disclosure is not contingent on permanent injury, a complaint, or litigation. Concealment undermines autonomy and trust and prevents informed follow-up. Prematurely blaming an individual ignores possible ordering, interface, verification, staffing, or communication contributors. Patient care and transparent communication come first; liability concerns should be handled through appropriate institutional channels without delaying ethically required disclosure.

Reference: American Medical Association Code of Medical Ethics. Opinion 8.6: Promoting Patient Safety. https://code-medical-ethics.ama-assn.org/ethics-opinions/promoting-patient-safety