Analysis of Medication-Related Deaths in Denmark

Objective. To investigate the circumstances associated with medication-related deaths. Design and Setting. This retrospective study investigated closed claims concerning medication-related deaths from 1996 to 2008 registered by the Danish Patient Insurance Association (DPIA). Results. A total of 80 were patients registered as having died because of an adverse event or error associated with a medication, and 37 of these cases were considered to have been preventable. The circumstances of the 37 deaths are described in detail in this report. Orthopaedic surgery, anaesthesiology, and internal medicine were the specialties involved in the majority of the deaths. Incorrect dosing was the cause of 17 deaths, and the use of the wrong drug caused 11 deaths. The administration of a drug despite a known allergy/intolerance or contraindication caused 6 deaths. Other 5 deaths were caused by anticoagulation medications. Methotrexate given daily by mistake caused 2 deaths. Conclusion. This study describes the circumstances of 37 preventable deaths caused by medication. Drug administration despite a known allergy, opioids, sedative, anticonvulsive medicine, and incorrect dosing and incorrect use of anticoagulants are the most important areas to be addressed in the development of future patient safety measures to reduce patient deaths caused by or related to medications. 1. Introduction In Denmark, patients may file a claim if their medical treatment results in an injury or an unexpected side effect. The independent Danish Patient Insurance Association (DPIA) considers these claims. The DPIA operates on a no-blame no-fault basis and does not take any legal action beyond assessing damages. As a result, patients may file a claim with the DPIA free of charge with the sole purpose of seeking financial compensation. Thus, the injured patient is spared the expense of legal fees and the trouble of going to court. In general, financial compensation may be granted under any one of the following criteria: (1) an experienced specialist would have acted differently, whereby the injury could have been avoided; (2) defects in or failure of the technical equipment was of major concern with respect to the incident; (3) the injury could have been avoided by using alternative treatments, techniques, or methods if these were considered to be equally safe and to potentially offer the same benefits; and (4) the injury was rare, serious, and more extensive than what the patient should be expected to endure. Claims granted based on criterion (1) are associated with events considered possibly