It’s sometimes just a silly mistake that proves fatal.
Around 7000 deaths according to Institute of Medicine (IOM) in July 2006 occur in USA, and the figure is not exactly known in India. Most deaths related to wrong medication are not generally reported accurately in India. Many a causes could be listed for these fatalities and the responsibilities are also almost equally shared among the patients, pharmacists, Doctors. With doctors having the lion’s share in these fatal goof ups. We have often come across doctors with handwriting that’s best understood by them. I personally knew a Doctor who was quite good and we often visited him, he also had a Drug store which his wife used to man. All the drugstores in the locality knew about it and always referred us to her store whenever they saw the Doctor’s prescription as none could after their best efforts decipher what the doctor had written. This is not that uncommon phenomenon; its world over, the Doctors are known for bad handwriting owing to various causes including tremendous work pressure, spelling mistakes and also not knowing the exact spelling. This bad handwriting in prescriptions can lead to various fatal complications, more so in presence of so many like sounding drugs that treat completely different ailments in the market. Drugs like ‘Arkamine’ used for treating blood pressure can be confused with ‘Artamine’ used for rheumatoid arthritis. Or ‘Isoprine‘ an intravenous drug to increase blood pressure can be easily confused with ‘Isoptine’ administered orally to reduce blood pressure. The chances of being administered with wrong medicine are greatly enhanced with less educated shop helps at the dispensary dispensing medicine after reading those illegible prescriptions. It is also not uncommon to administer the wrong doses for lack of proper decimal symbols which might make a dose of microgram to milligram which can be fatal especially to children. As if it was not enough, Some doctors tend to uses Latin terms and/or symbols for simple instructions like they would use od/omni die which stands for once daily or bd/tid bis in die for twice a day or a/c ante cibum that means before meals and s on. This problem of bad hand writing with doctors seems to be a world wide concern but not too many are yet overtly concerned, though some places seems to have woken u to these types of mistakes which might prove fatal. In Olympia in USA there is a law that bans a doctor from using cursive handwriting in writing prescription and a doctor is also encouraged to print the prescription instead of manually writing it. Some healthcare institutions banned use of drug abbreviations in their prescriptions and some go in for conducting special classes to improve their doctor’s handwriting. And in India too it seems the faculties discourage undergraduate doctors from using Latin terms and abbreviation of drug name. There are also other measures taken worldwide, but we are yet to see the end of illegible prescription.
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