The Most Common Medication Errors

Medical Author: Melissa Conrad Stoppler, MD
Medical Editor: Jay W. Marks, MD

Approximately 1.3 million people are injured annually in the United States following so-called "medication errors". The National Coordinating Council for Medication Error Reporting and Prevention defines a medication error as "any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer...related to professional practice, health care products, procedures, and systems, including prescribing; order communication; product labeling, packaging, and nomenclature; compounding; dispensing; distribution; administration; education; monitoring; and use."

The U.S. Food and Drug Administration (FDA) currently reviews medication error reports that come from drug manufacturers and through MedWatch, the agency's safety information and adverse event reporting program. The agency also receives reports about medication errors from the Institute for Safe Medication Practices (ISMP) and the U.S. Pharmacopeia.

What kinds of errors are most common?

In a study by the FDA that evaluated reports of fatal medication errors from 1993 to 1998, the most common error involving medications was related to administration of an improper dose of medicine, accounting for 41% of fatal medication errors. Giving the wrong drug and using the wrong route of administration each accounted for 16% of the errors. Almost half of the fatal medication errors occurred in people over the age of 60. Older people may be at greatest risk for medication errors because they often take multiple prescription medications.

How can you help prevent medication errors?

When your doctor gives you a prescription, ask him or her to tell you the name of the drug, the correct dosage, and what the drug is used for. Be sure you understand the directions for any medications you may be taking including the correct dosage, storage requirements, and any special instructions.

In the hospital, ask (or have a relative or friend ask) the name and purpose of each drug you are given.

Be sure to tell your doctor the names of all the prescription and non-prescription drugs, dietary supplements, and herbal preparations you are taking every time he or she writes you a new prescription. This will help to prevent another type of medication problem, undesirable and potentially serious interactions among medications.

Finally, never be afraid to ask questions. If the name of the drug on your prescription looks different than you expected, if the directions appear different than you thought, or if the pills or medication itself looks different, tell your doctor or pharmacist right away. Asking questions if you have any suspicions at all is a free and easy way to ensure that you don't become the victim of a medication error.

References:

U.S. Food and Drug Administration, "Medication error reports."

U.S. Food and Drug Administration. "Strategies to reduce medication errors."