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Reporting a Medication Error

What Do We Do With Your Report?

At ISMP, we review incident reports submitted by consumers and healthcare professionals and look for ways to prevent harmful errors. For example, we may approach a manufacturer to suggest that the label of a product be changed, we may suggest safer ways for healthcare professionals to handle medications, or we may remind consumers of things they can do to avoid making mistakes with medications.

ISMP will:

  • Review your report
  • Look for system problems that could cause errors to happen
  • Prepare recommendations that are designed to prevent mistakes with medication
  • Send recommendations about medication safety to healthcare professionals and consumers
  • Notify the manufacturer if it is a product issue
  • Advocate throughout the healthcare system to promote changes to improve medication safety
  • Provide consumer-focused information and tips about medication safety on the ConsumerMedSafety.org website
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ISMP will not:

  • Investigate a complaint on your behalf with an organization or healthcare professional that is responsible for an error
  • Investigate the actions of individual practitioners
  • Report (for disciplinary purposes) the incident to professional authorities responsible for regulating the practice of healthcare professionals
  • Release or publish any information that could identify the reporter of an incident, a patient, a healthcare professional, or an organization involved in an incident

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More Safety Articles

Taking Your Medicine Correctly After Discharge from the Hospital

If you or a family member has been hospitalized, the first few days after returning home can be confusing. You may have prescriptions to fill for new medicines. You may need to restart some medicines or stop others that you were taking before your hospitalization. Or you may need to take these medicines in different doses, or at different times. These changes may cause you to make a mistake as you try to figure out what medicines to take or how to take them now that you are home.

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Patient Readmitted to Hospital After Taking Only Liquid Part of Medicine

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Who Keeps the Box?

The pharmacy label on your prescription medicine has important information. It identifies you as the person who will be taking the medicine and tells you how to use your medicine properly and safely. Adding a label to medicines such as tubes of creams, small bottles of liquids or eye drops, and inhalers can be difficult. In these cases, the label is sometimes placed on the outer carton or package that contains the medicine.

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Doggy Drops in Your Child's Ear?

Who would ever make that mistake? Well, people do. A father told the babysitter to put his son's ear drops in his right ear before bed, and the careful babysitter did just that. She found ear drops labeled "put two drops in right ear" in the medicine cabinet, and instilled the ear drops into the child's right ear. But the family's dog also had a bottle of ear drops, which were the drops the babysitter used. The son's ear drops were in the refrigerator. Luckily, the child was not harmed by the dog's ear drops.

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