HTA publishes quarterly closed incidents data

This quarter we have closed 83 as reported to the HTA.  Licensed establishments need to report that an incident has taken place and provide a follow-up investigation report within two months for review. 

When an incident occurs, we aim to support establishments in their review of the incident and the actions taken to help mitigate the risk of a similar incident occurring in future.  

HTA licensed establishments in the Post-Mortem, Human Application and Organ Donation and Transplantation sector are required to report incidents to the HTA as part of their licensing requirements.  In the post-mortem sector we call these HTARIs and those in the Human Application and Organ Donation and Transplantation sectors are called Serious Adverse Events or Reactions (SAEARs). 

The latest data can be found here: Disclosing information on incidents | Human Tissue Authority (hta.gov.uk) 

Organ Donation and Transplantation reporting 

The system of reporting and investigating SAEARs is managed by NHSBT on our behalf. You can find out more here: Serious Adverse Event or Reaction (SAEARs) | Human Tissue Authority (hta.gov.uk) 

Human Application Reporting 

Establishments are required to notify us of serious adverse events (SAEs) or serious adverse reactions (SARs) within 24 hours of discovery.  You can find out more about the process here: Human application serious adverse event and reaction (SAEARs) reporting | Human Tissue Authority (hta.gov.uk) 

Post-Mortem sector reporting 

Notifications must be submitted to us within five working days of the incident occurring or being discovered. Establishments must not delay reporting to the HTA, they should not wait for any internal review or investigation.  You can find out more about how HTARIs are managed here: Post Mortem HTA Reportable Incidents (HTARIs) | Human Tissue Authority 

 

Incidents in the Post-Mortem Sector 

We have reviewed information received from HTARI notifications and investigation follow-up reports to identify and share what can be learned about how things go wrong and what can be done to mitigate the risks of incidents occurring.  The data collected confirms HTA received notification of 66 incidents of release of the wrong body since April 2017. We have updated our lessons learned page about release of the wrong body, you can find out more here: Release of the wrong body incidents in the Post Mortem sector | Human Tissue Authority (hta.gov.uk)