Drugs must be tested before they are marketed, but side effects are not always detected in clinical trials. As patients take more and more drugs, drug interactions require greater attention. Mistakes are possible at many points in the process from the writing of a prescription to drug administration. One study, widely cited in news reports, estimated that 100,000 people die each year from adverse drug reactions. Although other estimates are lower, there is agreement that the number affected is significant.
Experts believe that better information is key to progress on patient safety.
A recent report from the Institute of Medicine suggests that only a small percentage of adverse drug events and other mishaps are reported through internal hospital channels. A number of states require hospitals to report certain categories of adverse events to state agencies, but underreporting is believed to be significant at this level as well. An effective system will have to address barriers to reporting. Factors frequently cited include fears concerning damage to reputation, disciplinary action, liability for damages in a civil lawsuit, and in rare cases, criminal liability. In addition, in a voluntary system, or a mandatory system without effective enforcement, those who consistently report adverse events and errors may appear less safe than non-reporting colleagues and competitors.