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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

Make Sure You Get the Right Mix… Ask Questions if Your Medicine Is a Powder

Some medicines, including many prescribed for children, come in a powder form. Water must be added to the powder so the medicine can be easily measured and taken. The ratio of water to powder must be precise, so that the prescribed amount of the final liquid mixture provides the correct dose of medicine per milliliter (mL). It is best for the pharmacist to add water right before the medicine is picked up. Once mixed, the medicine often needs to be refrigerated to stay potent. But if the pharmacist forgets to add the water, or if the wrong amount of water is added at home, a serious dosing error can occur.

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The “Granny Syndrome”: Accidental Poisonings in Children

Most people recognize that accidental poisonings in children are a daily occurrence in the US. But you may be surprised to learn one common source of these poisonings: grandparents’ medications! A scientific study conducted at the Long Island Poison Center1 found that about two of every 10 medicine poisonings in children involved grandparents’ medications. Most of these poisonings, caused by what the study participants called the “Granny Syndrome,” involved grandparents’ medicines that had been left on a table or countertop, on low shelves, or in grandmothers’ purses.

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National Patient Safety Awareness Week

Patient safety awareness week

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Sleep Aid Medicine Patches Should Not Be Used on Children

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