Category: Editorials
Patient Safety, Insulin Pumps, and Cognitive Dysfunction
Earlier today, I consulted on a patient in the hospital who was there because of recurrent hypoglycemia. It was an interesting problem. The patient was an 85-year-old man, with a 39-year history of insulin dependent diabetes, who had been on an external insulin pump for twenty-five years. During the past two years, he had been […]
Propylthiouracil (PTU) Hepatotoxicity and Graves’ Disease Therapy
Scott A. Rivkees, M.D. Yale Pediatric Thyroid Center Yale University School of Medicine New Haven, CT Donald R. Mattison MD, CAPT, Obstetric and Pediatric Pharmacology Branch Eunice Kennedy Shriver National Institute of Child Health and Human Development National Institutes of Health Bethesda MD David S. Cooper, M.D. Division of Endocrinology and Metabolism The Johns Hopkins […]
Safety in the ICU – Is Bedside Glucose Testing Safe For Our Patients?
In my recent editorial on the NICE-SUGAR study, I raised the question as to whether the methods commonly used to measure glucose levels at the bedside may be the source of error that may pose a hazard to the patient. A very important article by Scott, Bruns, Boyd, and Sacks, just published on-line in Clinical […]
Preliminary Report of the NICE-SUGAR study: Hypoglycemia and what it may mean for patient safety
The optimal treatment for the hyperglycemic patient in an ICU setting has been hotly debated for many years. On one side are those who propose that normoglycemia is the goal of treatment of hyperglycemia, and on the other side those who propose that the case has not yet been proven – that the risk of […]
Editorial on FDA alert on confusion between propylthiouracil (PTU) and purinethol (mercaptopurine)
The FDA has just released an important alert from the Institute for Safe Medication Practices (ISMP) of yet another example of errors in drug administration due to confusion between two very different agents, a drug used to treat hyperthyroidism, PTU, and an agent used in oncology, purinethol (mercaptopurine). The report delineates not just how the […]
Patient Safety in Diabetes Care and Intensive Glycemic Therapy
In June 2008, the results of both the ADVANCE and ACCORD studies became public. The results were published in the New England Journal of Medicine (NEJM) on June 12, 2008, presented at the American Diabetes Association (ADA) meeting, and widely discussed in the public media as well. The two trials, ADVANCE and ACCORD, are clearly […]
Insulin Pens and Safety
The Institute for Safe Medication Practices (ISMP) released an article recently that highlighted potential safety problems that are being seen in hospitals when they switch the delivery of insulin subcutaneously from insulin that is drawn from multiple-dose vials to insulin pens. The details of the ISMP Medication Safety Alert were included in an FDA Patient […]
Joint Commission Safety Alert regarding Health Information Technology
On December 11, 2008, the Joint Commission released a sentinel event alert regarding implementation of health information technology (HIT) and converging technologies – the interrelationship between medical devices and information technology. This very thoughtful document highlights the many ways that poorly designed or implemented HIT products can lead to medical errors and serious problems in […]