Anaesthetists, errors in drug administration and the law.

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.