Medical malpractice ︱ A patient in the public hospital was repeatedly prescribed two insulins before being exposed three days later

The Hospital Authority publishes the latest issue of "Drug Safety", which mentions two cases of repeated prescriptions and prescriptions of unnecessary drugs. In one case, the patient was prescribed two insulins after being admitted to the hospital, and was only discovered 3 days later , That is, repeated three doses of insulin.

In another case, the patient originally needed to take a platelet aggregation inhibitor, but because of blood stains in his urine, the doctor thought that the drug should be suspended, but the nurse misunderstood the English abbreviation written by the doctor and finally continued to prescribe the drug.

The HA’s "Drug Safety" journal shared two cases, including repeated prescriptions and prescriptions for unnecessary drugs.

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Two cases have been published in the "Drug Safety" journal of the Hospital Authority, including repeated prescriptions and prescriptions for unnecessary drugs.

The first case involved an outpatient who needed insulin. The patient himself had been using "Mixtard 30" and then agreed to switch to another insulin "Ryzodeg70/30". The doctor prescribed it through the outpatient drug prescription system. Ryzodeg" also noted this change in the clinical record.

However, one month later, the patient was admitted to the orthopedics ward. According to the drug record on hand, the doctor also prescribed "Mixtard" and "Ryzodeg" to the patient.

Three days later, it was discovered that the patient had been repeatedly prescribed drugs.

In other words, the patient received two insulins for 3 consecutive days.

In the second case, the patient himself had to take a platelet aggregation inhibitor "Plavix (clopidogrel)" for life, but his urine showed blood stains and was admitted to the ward. After evaluation by an on-duty doctor, the prescription should be suspended. Plavix" until the patient’s attending doctor examines the case the next day.

After checking, the attending doctor wrote "continue W/H Plavix today" in the clinical record, which meant that the prescription of "Plavix" ("continue withhold Plavix today") was continued today, but the nurse interpreted it as continuing the prescription of "Plavix today" "("Continue with Plavix today"), as a result, the patient was prescribed "Plavix" in the afternoon, and it was only discovered 2 hours later.

The Hospital Authority reminded that when switching drugs, words such as "suspend" should be used in the prescription system, and abbreviations should be avoided when manually prescribing drugs.

The journal also reminds medical staff to correctly record vaccine information in the clinical medical management system to assist in collecting relevant data for monitoring purposes. The journal reminds medical staff to use "COVID-19 (CORONAVCAC)" or "COVID-19 (COMIRNATY ( BNT162B2))” instead of “COVID19 VACCINE”, “BIONTECH”, “CORONAVAC”, “SINOVAC” and other words.

Medical accident | Three private hospitals prescribed wrong drugs within two months. Three patients involved are in stable condition. Medical accidents. Drug sensitive patients get prescriptions. Pharmacists of similar drugs: The blood pressure drops sharply. Medical accidents. The reason is unknown