Anaesthetists, errors in drug administration and the law

Abstract

Aim: To document the problem of drug administration error in anaesthesia in New Zealand, with regard to: prevalence (in context of the total number of drugs that might be administered during an anaesthetist's career); preventative strategies; and anaesthetists' perceptions concerning the medicolegal environment prevailing in New Zealand.

Methods: A questionnaire was posted to a random sample of 75 New Zealand anaesthetists. Drug administrations per anaesthetic were counted on a random sample of anaesthetic records at Green Lane Hospital. Ten anaesthetists were asked the number of anaesthetics administered per year.

Results: Eighty-nine percent of 66 respondents reported at least one error of drug administration, and 12.5% had actually harmed patients. There was no relationship between any preventative strategy and frequency of error. All respondents were concerned about the possibility of manslaughter charges arising from a drug error; 57% thought the medicolegal environment in New Zealand impacted adversely on their practice; 83% thought it might impede the reporting of errors. There seems to be no definitive strategy for the elimination of drug error.

Conclusion: Error is inherent in drug administration in anaesthesia, as it is in any complex human endeavour; therefore it is illogical to treat it as necessarily criminal. Instead, effort and resources should be aimed at rational initiatives to reduce this worrying problem.