Cancer treatment errors happen more than commonly known

In a recent review of medical charts at clinics throughout the United States many treatment mistakes were found. In the review of both adult and children treated at outpatient clinics, an abundance of errors were identified.

Kathleen E. Walsh, M.D., M.Sc. and colleagues of the University of Massachusetts reviewed approximately 1,400 charts of patients visiting four various clinics in diverse geographical areas. According to their report 7.1% of all adult visits and 18.8% of pediatric visits resulted in treatment mistakes.

There were a total of 117 errors identified and 15 of these caused actual harm to patients. An additional 64 errors had the potential to cause harm. Dr. Walsh sites the extreme complexity of cancer treatment as the reason for the large quantity of errors.

In the 1,400 cases there were more than 12,000 orders for medication.

"Orders were sometimes written for the patient's entire chemotherapy regimen for several months at the initiation of treatment, and then doses were adjusted as needed at each clinic visit," Dr. Walsh and colleagues noted. "Patients therefore had an initial set of orders and then orders might be modified on the day of the visit."

"Requiring that medication orders not be written until the day of administration, following review of laboratory results, may be a simple strategy to prevent a number of the errors that we identified in our study," they added.

Sixty percent of the errors associated with the adult cases were due to mistakes in the administering of treatment.

In the pediatric cases, 64% of the errors came from the ordering of medication. While most of these errors were minor, the more serious mistakes came in the administration of medication at home.

The oncologists who completed the study sited improved communication as the best way to avoid errors in the future.

"Improved communication between health care providers and families of patients with cancer about home medication administration may be an important first step for preventing frequent home medication errors among pediatric patients with cancer," they said.

Dr. Walsh and colleagues felt that their estimated error rate was probably lower than the actual rate of errors made in at home medication administration.

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