Sequential drug verification errors resulting in wrong drug administration during caesarean section.

An intravenous bolus of phentolamine was inadvertently given to a parturient during an emergency caesarean section following delivery of her infant when the intention had been to give an intravenous bolus of 5 IU Syntocinon. Root cause analysis identified a series of errors originating in the hospital pharmacy when one drug package was mistakenly issued in place of another. Subsequent checks failed to detect the original mistake. The final and most important check immediately before intravenous administration was also at fault. This case highlights a systems failure that permitted issue, transportation and administration of the wrong drug to a parturient. Robust measures to ensure avoidance of drug administration errors should be evaluated and introduced where possible.

The relationship of childhood physical and sexual abuse to adult illness behavior.

A sample of 275 undergraduate subjects reported (i) their history of sexual and physical abuse in childhood and (ii) their health care utilization, somatization, and hypochondriasis as an adult. Physical and sexual abuse were recalled by largely separate groups, physical abuse predominating in males and sexual abuse in females. Both types of abuse were followed by a greater number of hospital admissions and surgical procedures in adulthood. Although sexual, and especially physical, abuse were associated with recall of emotionally disturbed parenting, this could not explain their influence on health care utilization because this was unrelated to parenting. Similarly, although abuse was followed by greater somatization and hypochondriasis, these also were unrelated to health care utilization. Physical and sexual abuse in childhood are risk factors, independent of their association with poor parenting, in the development of separate aspects of adult illness behavior.