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DISCUSSING 'BEYOND BLAME'
Below are excerpts from comments made by experts participating in a panel discussion on medication errors and adverse drug events at the Dec. 9, 1997 premiere of Bridge Medical's award-winning documentary, "Beyond Blame," at an ASHP meeting in Atlanta.


Doni Haas
Director of Risk Management, Martin Memorial Health Systems
"When we decided to come forward, we came forward... out of a belief that we had a responsibility... to the family to try to prevent the death of another child."

 



"If any of you have happen to you what happened to me, that phone call [to a doctor] would be really, really easy. I don't care whose toes I step on when I make a phone call now to get something clarified, because it's not worth a life."

 



Dennis Dunn
Hospital Pharmacist


Sylvia Bartel
Director of Pharmacy,
Dana Farber Cancer Institute


"It's very important to keep management involved. It has to come from the top. We would not have been successful if we didn't have the support both from the executive level and from the board."

 



"I think you need to bring it out of the closet. I think that people need to look at the errors as they come up and analyze them more systematically than they have before without pointing the finger at anyone, so that you can work on the system's improvement."

 




Zane Robinson-Wolf
Dean of Nursing,
La Salle University School of Nursing



Dr. C. Everett Koop


Dr. Koop said he believes government has an obligation to point out that medication errors and adverse drug events are systems problems and occur despite the very best efforts of many people. Based on his experience, most families of patients victimized by a medication error that consider litigation do so not out of an interest in money, but because they do not want the same error to be made again. However, they often do not pursue litigation once they realize that blaming and punishing someone does not change the system.


"I think the single most important thing that can be done is to have practitioners review the labelling, the packaging, and the drug names before the companies are allowed to launch their new product."

 



Michael Cohen
President,
Institute for Safe Medication Practices



Warren Olney
KCRW, Los Angeles
Moderator


"Clearly from what we've seen and heard, it is very very clear that if you're a health care provider, your worst nightmare can come true, probably will come true. If not to you, to somebody in your institution or somebody you know."