The following are excerpts from the newsletter
- Art imitates life! Error
portrayal really happened
- The year 2000 at a glance: ISMP's medication safety "Cheers"
- Safety Briefs
- USP holds press conference to release the "Summary of
1999 Information Submitted to MedMARx; A National Database
for Hospital Medication Error Reporting."
- A managed care pharmacist was asked to review an appeal
for CLOMID (clomiphene), which was rejected by an HMO's
standard pharmacy benefit program. In reviewing the case
with an appeals nurse, it was learned that the medication
was being prescribed to treat premenstrual dysphoric disorder.
After further review and discussion with the prescribing
nurse practitioner, it was discovered that the intended
medication was actually SARAFEM (fluoxetine) which was
misheard as SEROPHENE (clomiphene) when the prescription
was ordered by phone.
- According to the latest JC Sentinel Event Alert (November
30, 2000), surveyors from the Joint Commission on Accreditation
of Healthcare Organizations (JC) will begin to inquire
about health care organizations' use of infusion pumps
without free-flow protection.
- Mead Johnson Nutritionals has been promoting SUBDUE,
a ready-to-use, flavored, peptide-based elemental liquid
formula for the dietary management of patients with impaired
gastrointestinal function. In one hospital the prescriber's
handwriting made "Subdue" look like "sotalol" and "8oz"
look like "80 mg." Sotalol is BETAPACE, which is a beta-blocker