Hospital mix-ups harm children

Estimates of drug error rate increase

CHICAGO -- Medicine mix-ups, accidental overdoses and drug reactions harm about one out of 15 hospitalized children, according to the first scientific test of a new detection method.

That number is far higher than earlier estimates, bolstering worries that have been heightened by well-publicized cases like the accidental drug overdose administered to actor Dennis Quaid's newborn twins in November.

"These data and the Dennis Quaid episode are telling us that ... these kinds of errors and experiencing harm as a result of your health care is much more common than people believe," said Dr. Charles Homer of the National Initiative for Children's Healthcare Quality. His group helped develop the detection method used in the study.

THE NUMBERS: Researchers found a rate of 11 drug-related harmful events for every 100 children who were patients at a dozen hospitals. Adjusting for children who experienced more than one drug error, the estimate suggests that 7.3 percent of hospitalized children, or about 540,000 each year, suffer from drug treatment mistakes.

Earlier estimates that relied on hospital staffers to report such problems found less than 4 percent of the problems detected in the new study.

HOW IT WORKS: The new monitoring method is a list of 15 "triggers" on young patients' charts that suggest possible drug-related harm. It includes use of specific antidotes for drug overdoses, suspicious side effects and certain lab tests.

Among triggers on the list is use of the drug naloxone, an antidote for an overdose of morphine and related painkillers; use of vitamin K, an antidote for an overdose of the blood thinner Coumadin; use of a blood test that detects insulin overdoses; and a lab test that identifies blood-clotting problems that can come from an overdose of the blood thinner heparin and other drugs.

ABOUT THE STUDY: The researchers reviewed randomly selected medical charts for 960 children treated at 12 freestanding children's hospitals nationwide in 2002. The study is being released today in the April issue of the journal Pediatrics.