SCIENCE / MEDICINE : Error Rates Tallied on Prescriptions

Efforts to cut U.S. medical costs should leave in place the safety mechanisms that catch mistakes doctors make in prescribing drugs, says a researcher who documented hundreds of such errors at a New York hospital. The study in last week’s Journal of the American Medical Assn. found an average of 2 1/2 errors a day in written prescriptions at 640-bed Albany Medical Center Hospital in 1987.

Doctors at Albany wrote 289,411 prescriptions in 1987, and errors occurred in 905 of them, including 182 mistakes that could have caused severe harm or death if they had gone undetected, the researchers reported. Mistakes varied from ordering too strong a tranquilizer for the size or age of a patient to prescribing penicillin or related drug to a patient who is allergic.

But, said Timothy S. Lesar, assistant pharmacy director for clinical services and the study’s co-author, “all these errors were (detected and) averted. They never put a patient at risk.”

Researchers found higher error rates in obstetrics-gynecology and surgery-anesthesia than in other services. Error rates were higher among first-year residents and declined with successive years of training. Mistakes were highest during daytime hours, when large numbers of prescriptions were being written, and lowest during evening hours, suggesting fatigue is not a factor.