A recent study looked at the adverse complications from medications that were taken by patients, outside of a medical care facility. They may have been prescribed by a health-care practitioner, but were not administered in an office, or hospital setting.1 Iatrogenic side effects and health complaints are common in the United States and other countries, and account for many calls to poison control centers, and emergency room visits. It is estimated that iatrogenic death may be among the top 5 leading causes of death in the United States.

Iatrogenic Death Estimated Among Top 5 Leading Causes of Death in the U.S.

The current study, published in Clinical Toxicology, analyzed calls to poison control centers across the country over a 13-year time span. The analysis primarily concerned itself with medications which resulted in serious medical outcomes. The exposures all happened outside of health care facilities, and affected people of all ages; a variety of medications were encountered.

A 100% increase in serious medication errors per 100,000 people was seen between 2000 and 2012. These medication errors were seen in all age groups, aside from children under 6 years. The rate of medicine errors for children under 6 did raise early in the study, but subsequently decline, supposedly due to recommendations from the FDA regarding the use of cough and cold medications, corresponding with a decrease in their use.

The medication categories which were seen to be most likely to cause errors in use and associated with serious outcomes were:

Cardiovascular drugs (21%)

Analgesics (12%)

Hormones (11%)

Breakdown of the Categorical Findings

Within the analgesic category, most incidents were attributed to the use of acetaminophen (44%) or opioids (34%). Two-thirds of the hormone related errors had to due with insulin. Cardiovascular drugs and pain-killers combined to account for the majority of fatalities correlated with medication errors within the study (66%).

Lead Authors Advise Keeping a Written Log

The most common errors involved taking the wrong medication or incorrect dosage, which included taking a given medication twice by mistake. For children, the most common error involved taking someone else’s medication. The recommendation given by the lead authors of the study included keeping a written log, especially for children and elderly patients, whereby doses can be tracked and inadvertent double dosing can be avoided. Writing down instructions for other caregivers is also a good way to keep multiple caregivers on the same page.

Patients, Parents and Caregivers Encouraged to Ask Questions

Patients, parents and caregivers are encouraged to ask questions about medications they are responsible for administering. Ensuring that the correct dose, medication, timing, and interactions are known and understood is important in avoiding medication errors. Also, keeping medications away from children in child proof packaging at all times.


  1. Hodges NL, Spiller HA, Casavant MJ, Chounthirath T, Smith GA. Non-health care facility medication errors resulting in serious medical outcomes. Clin Toxicol (Phila). 2017;:1-8.
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Node Smith, associate editor for NDNR, is a fifth year naturopathic medical student at NUNM, where he has been instrumental in maintaining a firm connection to the philosophy and heritage of naturopathic medicine among the next generation of docs. He helped found the first multi-generational experiential retreat, which brings elders, alumni, and students together for a weekend camp out where naturopathic medicine and medical philosophy are experienced in nature. Three years ago he helped found the non-profit, Association for Naturopathic ReVitalization (ANR), for which he serves as the board chairman. ANR has a mission to inspire health practitioners to embody the naturopathic principles through experiential education. Node also has a firm belief that the next era of naturopathic medicine will see a resurgence of in-patient facilities which use fasting, earthing, hydrotherapy and homeopathy to bring people back from chronic diseases of modern living; he is involved in numerous conversations and projects to bring about this vision. 

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