A medication error, as defined by the National Coordinating Council for Medication Error Reporting and Prevention (NCCMERP), is any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in control of the health care professional, patient or consumer. Medication errors are frequent and have the potential to do great harm to patients. They can occur in and out of the hospital.
The Institute of Medicine reported in 1999 that 44,000 to 98,000 people die in US hospitals as a result of medical errors. Medication errors are the largest component of medical errors. Medication errors are estimated to account for at least 7,000 annual deaths. Medication errors are preventable events and are distinct and separate from adverse drug reactions which may be unavoidable. Most medication errors are not detected and from those that are detected only a few are reported. Type of medication errors include:
Improper dose (overdose, underdose, extra dose)
Wrong route of administration
Wrong strength or concentration
Medication errors can occur at all stages of the medication process including prescribing, preparing, dispensing, administering and monitoring. Physicians, nurses, pharmacists and hospital all have a responsibility to prevent medication errors. Most common causes of medication errors are human factors followed by communication problems, handwriting errors, transcription errors and interpretation errors. The greater number of medications prescribed to a patient, the greater the risk of medication errors.
A careful investigation usually can determine where the medication error occurred and who was responsible for it. Causes of medication errors include:
Communication (oral or written miscommunication)
Name confusion (proprietary names that sound or look alike)
Labeling (similar or misleading container labels)
Human factors (performance or knowledge deficits)
Packaging or design (inappropriate package or device design)
Dosage error (wrongly prescribed or wrongly transcribed)
Medication errors that result in an adverse drug event (ADE) occur most often during the ordering stage of the medication process. Most of these adverse drug event (ADE) errors are preventable. Many pharmacies have installed medical logic alerts to detect unsafe medication orders.
Unfortunately, many computer systems miss unsafe orders and alerts are often overridden because they occur frequently with questionable or unclear significance. Some studies have shown that up to 80% of drug-allergy alerts were overrode of which 6% led to adverse drug event (ADE).
Harmful medication errors are over three times more likely to occur in the perioperative period than at other stages of the process. Children and elderly patients are particularly at a greater risk for such errors. Most medication errors during the perioperative period occur in the:
Operating room (OR)
Postanesthesia care unit (PACU)
Postoperative surgical floor
If you or your loved one have been injured as a result of a medication error Dr. Borten and the Boston area medical malpractice attorneys at Gorovitz & Borten can help you assert your rights and get the compensation you deserve.
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