Medical Expert Witness On Medication Errors Part 2

In Preventable Medical Errors, medical expert witness Perry Hookman, M.D., writes that cancer outpatient medication errors may be more common than previously thought.

Adverse Drug Events [ADEs]

In a study by Hern├índez and Vargas (Adverse Drug Events in Ambulatory Care. NEJM.2003;349:303-305), of four primary care practices, the authors found that one-quarter of outpatients had adverse drug events during a three-month period. Of these events, 13% were serious, 39% were either ameliorable or preventable, and 6% were serious and preventable or ameliorable. Ameliorable adverse drug events were attributed to poor communication: the physician’s failure to respond to symptoms reported by the patient or the patient’s failure to report symptoms to the physician.

The Institute of Medicine (IOM)’s report on the quality of patient care entitled To Err Is Human has drawn national attention to the occurrence, clinical consequences, and cost of adverse drug events in hospitals, which is estimated at $2 billion annually in the United States.1Leape et al.2 studied adverse drug events by reviewing solicited self-reports and conducting daily chart reviews and found that 44% of these events occurred after the prescription order was written (i.e., during the medication delivery and administration processes). Drug therapy cannot be successful unless, and until, both the prescribing and medication delivery processes are conducted correctly.