Health Insight March 2001: Costly mistakes
An 18-year-old patient died at the Queen's Medical Centre in Nottingham a month after a cancer drug was wrongly injected into his spine instead of a vein. The drug vincristine is highly toxic and carries a warning which states that it is fatal if injected into the spine. The medical centre suspended two junior doctors after the incident and an internal investigation was launched. Nottinghamshire police have been asked by the coroner to investigate. The death came just twenty-four hours after an inquest into the death of a 23-year-old, who had been paralysed for eight years after a doctor in Leicester made a similar error. Since 1985 there have been thirteen such mistakes in UK hospitals.
In a dreadful reversal of fate, a 74-year-old Brighton man died recently after being injected with local anaesthetic into a vein, rather than the spine. He was undergoing routine major surgery at the Royal Sussex County Hospital. The doctor concerned, an experienced consultant anaesthetist, has been suspended while an internal hospital investigation takes place. The Royal College of Anaesthetists has also launched an independent inquiry. An editorial in the BMJ has called for new systems and changes in the design of equipment that would make it impossible for such an error to occur.
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