[Responsibility due to medication errors in France: a study based on SHAM insurance data].
OBJECTIVE
The safe medication practices at the hospital constitute a major public health problem. Drug supply chain is a complex process, potentially source of errors and damages for the patient. SHAM insurances are the biggest French provider of medical liability insurances and a relevant source of data on the health care complications.


METHODS
The main objective of the study was to analyze the type and cause of medication errors declared to SHAM and having led to a conviction by a court. We did a retrospective study on insurance claims provided by SHAM insurances with a medication error and leading to a condemnation over a 6-year period (between 2005 and 2010).


RESULTS
Thirty-one cases were analysed, 21 for scheduled activity and 10 for emergency activity. Consequences of claims were mostly serious (12 deaths, 14 serious complications, 5 simple complications). The types of medication errors were a drug monitoring error (11 cases), an administration error (5 cases), an overdose (6 cases), an allergy (4 cases), a contraindication (3 cases) and an omission (2 cases). Intravenous route of administration was involved in 19 of 31 cases (61%). The causes identified by the court expert were an error related to service organization (11), an error related to medical practice (11) or nursing practice (13). Only one claim was due to the hospital pharmacy.


CONCLUSIONS
The claim related to drug supply chain is infrequent but potentially serious. These data should help strengthen quality approach in risk management.
Service d'anesthésie réanimation, centre hospitalier Princesse Grace, avenue Pasteur, 98000 Monaco, Monaco. Electronic address: alexandretheissen@hotmail.com.
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A
Theissen
Réanimation médico-chirurgicale, hôpital Saint-Roch, CHU de Nice, rue Pierre-Dévoluy, 06000 Nice, France.
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JC
Orban
SHAM assurances, 18, rue Édouard-Rochet, 69372 Lyon cedex 08, France.
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F
Fuz
Service d'anesthésie réanimation, centre hospitalier Princesse Grace, avenue Pasteur, 98000 Monaco, Monaco.
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JP
Guerin
SHAM assurances, 18, rue Édouard-Rochet, 69372 Lyon cedex 08, France.
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P
Flavin
Service d'anesthésie réanimation, centre hospitalier Princesse Grace, avenue Pasteur, 98000 Monaco, Monaco.
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S
Albertini
Pharmacie, centre hospitalier Princesse Grace, 98000 Monaco, Monaco.
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S
Maricic
Direction qualité gestion des risques, centre hospitalier Princesse Grace, 98000 Monaco, Monaco.
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D
Saquet
Service d'anesthésie et chirurgie ambulatoire, centre hospitalier Princesse Grace, 98000 Monaco, Monaco.
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P
Niccolai
D004342:Drug Hypersensitivity; D016903:Drug Monitoring; D062787:Drug Overdose; D005602:France; D006801:Humans; D007345:Insurance Claim Review; D007351:Insurance, Liability / Q000706:statistics & numerical data*; D008508:Medication Errors; D010607:Pharmacy Service, Hospital / Q000706:statistics & numerical data; D012189:Retrospective Studies
Administration error; Claim; Erreur de prescription; Erreur d’administration; Erreur médicamenteuse; Gestion des risques; Medication error; Prescribing error; Risk management; Sinistralité