What are the three lies? Click here to refresh your memory: http://www.webcom.com/jrudolph/joke_3lies.html
For this entry, we'll stick with the clean ones:
I'm from the government and I'm here to help.
I gave at the office.
The check is in the mail.
To those, how about adding: It's just a shot; it won't kill you.
You probably heard the story -- three babies died because they got the
adult dose of a blood thinner instead of the baby dose. Here's
the first couple of paragraphs in the story posted on AOL:
Fatal Drug Mix-Up Exposes Hospital Flaws
By TOM DAVIES, AP
INDIANAPOLIS (Sept. 23) - Early
last Saturday, nurses at an Indianapolis hospital went to the drug
cabinet in the newborn intensive care unit to get blood-thinner for
several premature babies.
The nurses didn't realize a
pharmacy technician had mistakenly stocked the cabinet with vials
containing a dose 1,000 times stronger than what the babies were
supposed to receive. And they apparently didn't notice that the label
said "heparin," not "hep-lock," and that it was dark blue instead of
"The nurses didn't realize. . ." because they didn't take the time to
check. They ASSUMED something, without confirming their assumption.
They trusted the pharmacy tech. Big mistake.
A pharmacy tech, one of those jobs you can get from those schools that
advertise on TV, is not going to be a genius. Why he or she is allowed
to restock medicines that can kill people without having some kind of
supervision is beyond me.
Why the nurses aren't required to double check the medications the tech
leaves for them is also beyond me. There should be a rigorous protocol
for confirming medications. Check the label, check the dose, sign off
with a supervisor.
I thought the writer was rather restrained in his observation that the
labels not only have different names, but they have different shades of
blue. That's two red flags they should have noticed.
Frankly, I think the manufacturer was a little casual with their labeling and product forms.
First of all, don't have names that are so similar. Heparin and
Hep-Lock look too much alike for our reading challenged workers these
days. Make them different so there wouldn't be confusion.
Second, print NOT FOR INFANTS in large letters along with ADULTS ONLY, too. So there wouldn't be confusion.
Third, coloring one blood thinner blue and the other SOMETHING ELSE
might have saved three little kids. At least prevented confusion.
Third, putting the baby version in a much smaller vial would have put up a red flag, too. And prevented confusion.
I don't work in a hospital and even I could come up with solutions to
prevent future mistakes. Don't the hospitals and phramaceutical companies
already have people who do stuff like this?
I understand that the families are suing Abbott Labs for not labeling
the two products in such a way that ANYBODY could tell the difference.
Blaming the manufacturer for not fixing the problem reminds me of when
we switched to cash registers that can tell the cashier what the change
should be, because most cashiers aren't smart enough to learn how to
make change. The education and intelligence of our workers is so poor the machines have to do their thinking for them.
So far we don't have the equivalent of the cash register that
figures out the change in our hospitals. The people who are dispensing
drugs that can kill you have to be
accountable on some level. Job loss is probably all they'll get.
I know I wouldn't want any of those nurses or that tech working in my
hospital. Of course, they probably belong to a union so they may just
get slap on the wrist and a stern warning.
Despite their mistakes, they don't have money to pay for the pain and suffering the parents are going through.
And the drug companies do.