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Invited Critique
Oct 2012

Posttraumatic Venous Thromboembolism as a “Never Event”: Comment on “Improved Prophylaxis and Decreased Rates of Preventable Harm With the Use of a Mandatory Computerized Clinical Decision Support Tool for Prophylaxis for Venous Thromboembolism in Trauma”

Author Affiliations

Author Affiliation: Department of Surgery, Massachusetts General Hospital, Boston.

Arch Surg. 2012;147(10):908. doi:10.1001/2013.jamasurg.150

Dr Haut and colleagues1 have made significant contributions to the field of venous thromboembolism (VTE). Previously, they have taught us that (as expected) the more you look for it, the more you find it. This fact works against institutions that have well-designed protocols of routine surveillance because they may be penalized for identifying a “never event.” Those institutions that lack stringent protocols may show better statistics and may enjoy related financial benefits from payors, a paradox that in many ways illustrates the effects of controversial health policy mandates.