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Updated: Oct 15, 2025

Diffuse Reflectance Spectroscopy: Getting the Capillary Refill Test Under One's Thumb
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The Risks of Reflexive Refilling.

Olivia R McCarty1, Margaret Pertzborn2, Paul A Bergl3

  • 1Medical College of Wisconsin, Milwaukee, Wisconsin.

WMJ : Official Publication of the State Medical Society of Wisconsin
|October 28, 2021
PubMed
Summary
This summary is machine-generated.

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Electronic health records and prescribing systems can lead to medication errors. This case highlights how medication reconciliation is crucial for patient safety, especially with automated prescription refills.

Area of Science:

  • Medical Informatics
  • Clinical Pharmacy
  • Patient Safety

Background:

  • Electronic health records (EHRs) and electronic prescribing have improved medication management.
  • However, automation bias in EHRs and electronic prescribing can lead to errors.
  • Overreliance on automated medication lists poses risks.

Observation:

  • A 69-year-old man presented with severe symptoms including weakness, weight loss, and bicytopenia.
  • Initial evaluation focused on malnutrition and malabsorption.
  • A pharmacist identified long-term oral linezolid use as the likely cause.

Findings:

  • Discontinuation of linezolid led to rapid symptom resolution and normalization of lab values.
  • Linezolid's known side effects include myelosuppression and gastrointestinal issues.

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Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex
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Objective Nociceptive Assessment in Ventilated ICU Patients: A Feasibility Study Using Pupillometry and the Nociceptive Flexion Reflex
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  • Reflexive medication refilling contributed to prolonged, unnecessary linezolid use.

    • Implications:

    • Medication reconciliation is essential for accurate diagnosis and treatment.
    • Vigilance is needed to prevent errors from automated electronic prescribing.
    • Patient and caregiver education on medications is critical for safety.