News in brief - Feb. 21, 2011

Sound-alikes, unusual dosages contribute to painkiller mix-ups - Physician organizations file appeal in nurse anesthesia case

Sound-alikes, unusual dosages contribute to painkiller mix-ups

A study of more than 2,000 "near miss" medication errors involving analgesics at the Albany Medical Center in New York found a rate of 2.87 prescribing mistakes per 1,000 orders among adults and nearly 6 per 1,000 pediatric drug orders.

The leading causes of the mistakes were sound-alike drug names, unusual dosage regimens, modified dosage forms and drugs that could be administered in more than one way or are used on a 24-hour schedule, said the study in January's Journal of Pain (www.ncbi.nlm.nih.gov/pubmed/21187270).

Though most mistakes involved the most popular painkillers, less frequently prescribed analgesics such as buprenorphine and benzocaine had the highest error rates. Doctors -- less familiar with these drugs -- were more likely to make prescribing mistakes, the study said.

Nearly a quarter of the mistakes would have had potentially serious consequences, the study said. Researchers suggested that hospitals should limit the number of similar analgesics available in their formulary and have pharmacists review drug orders.

Physician organizations file appeal in nurse anesthesia case

The California Medical Assn. and the California Society of Anesthesiologists are appealing a decision by a lower court allowing unsupervised nurse anesthetists to administer anesthesia.

In June 2009, Arnold Schwarzenegger, then governor, exempted the state from federal regulations requiring physician supervision of nurse anesthetists who administer anesthesia to patients during surgery. In 2010, the CMA and CSA attempted to block the rule with a lawsuit, but the San Francisco Superior Court sided with the state.

The two organizations filed an appeal on Jan. 31 with the State of California 1st Appellate District Division. They say anesthetists should be allowed to administer anesthesia only under the supervision of physicians. Patients face safety risks and decreased quality care under the existing rule, they said.

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