The complexity of decision-making and diversity of tasks in pediatric practice can lead to medical errors. To confirm the hypothesis that physicians' emotions influence the occurrence of medical errors, we analyzed medical adverse event reports to assess the effect of emotional factors on pediatrician decision-making and medical errors. Methods: This study involved case analyses of reports of pediatrician-related medical adverse events drawn from a Japanese national medical database. We

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... 310 adverse medical event reports involving pediatrician errors recorded over a 6-year period. Reports involving decision-making errors were extracted and analyzed by the patient's age, doctor's experience, severity of the adverse event, event circumstances, timing of errors by decision-making stage, and the presence of emotional factors. Results: We found decision-making errors in 58.6% of the examined medical adverse events reports. Most errors occurred in the situation awareness and decision stages. Overall, 53.2% of cases involving decision-making errors showed emotional involvement in the adverse event occurrence. The three emotional factors that most affected errors were trust, optimism, and distraction. Conclusions: Over half of the cases of errors in the decision-making process had an emotional component. The finding that trust influenced medical errors suggests that even positive emotions may affect errors. More awareness of the emotional aspects of clinical decision-making and research approaches that address emotion will help to reduce medical errors and improve patient safety.