Table 1

 Preventability criteria

Preventable: any identifiable actions or missed actions that would have prevented the death
MisdiagnosisFinal mortality diagnosis significantly differing from ED disposition diagnosis in clinical medical care
Delayed diagnosisDelay in making the correct diagnosis and providing timely medical care with potential contribution to early mortality
Inappropriate medical managementOther actions or missed actions that would result in the unexpected death of the patient
Non-preventable: the mortality event was unavoidable by any means of the currently available standard of care.