Frequently Asked Questions

Does ISMP believe a healthcare provider involved in an error should be punished or disciplined for making a mistake?

Medication errors are rarely the result of one person making an error. There can be many factors that can contribute to an error. Blaming the person who made the mistake without getting to the root of the problem will not prevent the same mistake from being made by someone else. Reviewing incident reports and suggesting safer ways to prescribe, package, dispense, or give medication is a better way to prevent harmful errors.

When we review reports, we are looking for the problems that caused the error so that we can recommend ways to make the system safer. This is a much better way to prevent errors than punishing the person who made the mistake.

Will ISMP investigate a complaint on my behalf with an organization or healthcare professional that is responsible for an error made during my care?

ISMP cannot investigate individual complaints about a healthcare organization or healthcare professional that provided your care. ISMP will also not report the error to a professional regulatory authority (an organization responsible for disciplining healthcare professionals). Formal complaints about a particular organization or healthcare professional must be filed through the governing state in which the incident occurred. Contact your State Department of Health or State Licensing Board for more information.

Should I talk to the organization or healthcare professional that is responsible for an error in my care?


ISMP encourages you to speak with a healthcare professional if you think an error in your care has occurred. A healthcare professional can take steps to find out if you have been harmed from the mistake and can help you get treatment if necessary. Also, telling a healthcare professional about mistakes will allow them to learn how and why the mistake happened and may prevent the same mistake from happening again. If your mistake happened in the hospital and you are not sure who to talk to, many healthcare organizations have "patient representatives" or "patient advocates" who may be able to help with your concern. Ask to speak to one.

I had a side effect to a drug. Should that be reported as a medication error?


Side effects (unwanted effects that happen when drugs are used under normal conditions) are also known as "adverse drug reactions" and are not considered a medication error. Adverse drug reactions should be reported to the US Food and Drug Administration (FDA) Safety Information and Adverse Event Reporting Program (MedWatch).

Click here to report an adverse drug reaction.

Why should I report a medication error to this site?

When you submit an error report to us, we will review it carefully. We look at different things, depending on the type of error you are reporting. We also look for problems that can potentially cause harm. Our goal is to prevent errors that have occurred from happening again. Often, we can recommend ways to prevent the same error from happening to someone else. This will make healthcare safer for all.

Who should report medication errors to this site?

Patients, family members, caregivers, or any other individual who may be acting for, or in support of, a patient or client receiving healthcare. If you are reporting on behalf of someone you know, you should ask their permission to report the error and be sure that you know all the facts about the incident.

What is a medication error?

Medication errors are preventable mistakes that can happen any time medications are used. There can be an error with the medication label or package; when a doctor prescribes a medication; when a pharmacy prepares and dispenses a medication; when a nurse or caregiver give a person a medication; or even when a person takes the medicine themselves. Medication errors may involve prescription and/or over-the-counter (OTC) medications, natural health products, imported products, and devices used to administer medications. Medication errors can be caused by:

  • Incomplete patient information. For example, the healthcare professional may not know about allergies the patient has or other medications the patient is taking.
  • Miscommunication between physicians, pharmacists and other health care professionals. For example, medication orders can be communicated incorrectly because of poor handwriting or by accidentally selecting the wrong medicine on the computer screen.
  • Drug name confusion. For example, some drug names look and or sound very similar, such as tramadol and trazadone.
  • Confusing drug labeling. For example, the strength of the medication may not be clearly identified on the product label.