Covid era and beyond: Can human life be endangered due to error of judgment?

By Dr R Kumar*
A whopping 138 million patients witness harm and 2.6 million deaths are caused due to medical errors every year in the developing nations like India. It constitutes the third leading cause of death. Even in US, every minute five people die due to medical errors and the cost is over $30 billion annually.
One of the leading causes of medication errors is communication barrier. Nearly 75% of medication errors have been attributed to distraction caused to the doctor. Majority of distortions may originate from poor writing, misunderstood symbols, use of abbreviations, or improper translation. Illegible writing has plagued doctors for decades.
To further complicate practitioner’s responsibility, there are thousands of health supplements, herbs, potions, and lotions used by the public regularly to treat their health problems. Added to this is the high risk of communication gap in doctor-patient interaction. Typical errors include the healthcare provider writing the wrong medication, wrong route or dose, or the wrong frequency.
Other modes of mistakes are: omission, wrong time, unauthorized drug, improper dose, wrong dose prescription/wrong dose preparation, administration errors including the incorrect route of administration, giving the drug to the wrong patient, extra dose or wrong rate, Monitoring error such as failing to take into account patient liver and renal function, failing to document allergy or potential for drug interaction. Error in lab tests can often put the prescription on the wrong path. Self prescription is rampant and often dangerous.

Future of corona vaccine

Positive corona report of a Haryana minister after 15 days of taking a shot of vaccine with fanfare has raised many questions. Is the vaccine safe? Is it effective? Should the country spend crores on the product? Will the people be enthused to take the injection? Will the vulnerable population of old and sick people be able to bear the rigors of the modulated pathogen or succumb to its toxic effects?
Does it uphold the warning of Dr Michael Yeadon (former chief scientist at Pfizer), who said, “There is absolutely no need for vaccines to extinguish the pandemic. You do not vaccinate people who aren’t at risk from a disease. You also don’t set about planning to vaccinate millions of fit and healthy people with a vaccine that hasn’t been extensively tested on human subjects.”

Haryana Minister Anil Vij

Even Pfizer Chairman Albert Bourla expressed apprehension at NBC’s ‘dateline’ that more studies need to be conducted to ascertain whether a person who has been administered vaccine can spread the virus. Rand Paul says that surviving about of Covid-19 confers greater protection, and poses fewer risks, than getting vaccinated. While one may not prefer to get infected with corona, vaccine entails hazards as a preventive remedy, which has generated euphoria and hope all over the globe.
What has not been hyped as yet is hazards and risk of medication mistakes that takes away millions of lives, all over the globe especially in developing countries like India. This is a wakeup call for ‘medicine minded’ people, who think medicine and health are synonymous.

Medication in Covid era, beyond

Prescribing and demanding fistful of medicines has been a bane of today’s medical treatment in the hospitals as well as clinics, which got accentuated with the advent of Covid. Since there is no specific drug, hit and trial became the order of the day. Starting with antibiotics and anti-viral and going to plasma and expensive new drugs that were initially labeled as panacea and subsequently given up as placebos.
A lot of effort and cost was wasted on the suspected or Corona detected patients. Whereas about 95% did not require medications, many became victims of drug toxicity and medication errors. Our concern here is not limited to Covid saga; it embraces the pre and post Covid period as well. The blame of medication mistake is not on the hospitals alone, the consumers are also found to be equally wanting.
Taking the patient to the hospitals in the last stages, when treatment may be of no avail is biggest cause of disappointment. Administering aggressive and most expensive treatment to the patient, when survival is excluded only increases the financial distress of the family, before the body- bag is taken home with hue and cry of medical negligence.
The problem is that some people don’t take their medications properly. While Indian patients are far less responsible or capable, even in US close to half of all patients don’t take their medications as prescribed by their physicians, according to a study published in ‘Medicine’. 

Common medication mistakes

1. Indian patients are low and complacent on following the advice on dosage regime, but are acutely concerned with hot and cold, water or milk, with food or without food. Poverty and ignorance coupled with apathy often lead to cessation of treatment altogether or missing dosage.
2. Suspecting doctors’ intention and capability is another flaw. Will researching your drugs on the internet do more harm than good?
3. Food can interfere with the way drugs are absorbed and with the extent and rate at which these drugs get into the bloodstream, or else taking medicine empty stomach can cause irritation or vomiting.

Dr R Kumar

4. Storing Medication improperly is another issue. Keep them at room temperature, where they'll remain dry, and away from direct sunlight.
5. Some drugs clearly should be taken before bed-time, such as those intended to help you sleep. Long-acting insulin and some statins should also be taken at bedtime.
6. Alcohol can affect the way your body metabolizes drugs and can lead to increased side effects like nausea, vomiting, sedation, light-headedness, and even death e g in case of metronidazole.
7. If patient is old, infirm, forgetful, negligent or in a serious state, let a trained home-nursing attendant be employed.
8. While prescribing tetracycline, the patient should be warned about sun exposure, or when taking ibuprofen, the patient should be told to take the medication with food.
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*Formerly with the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh; President, Society for Promotion of Ethical and Affordable Healthcare