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[Iatrogenic methadone poisoning]

W Rabl1, T Sigrist, K Sutter

  • 1Gerichtsmedizinisches Institut, Kantonsspital St. Gallen.

Schweizerische Rundschau Fur Medizin Praxis = Revue Suisse De Medecine Praxis
|February 23, 1993
PubMed
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A methadone overdose error occurred due to a concentration change from 0.1% to 1.0% not being recognized. This led to one fatality and severe intoxication in another patient, highlighting critical medication safety needs.

Area of Science:

  • Pharmacology
  • Clinical Toxicology
  • Patient Safety

Background:

  • Methadone is a synthetic opioid used for pain management and opioid addiction treatment.
  • Accurate dosing is critical due to methadone's narrow therapeutic index.
  • Medication errors can have severe consequences, including fatalities.

Observation:

  • Two young individuals undergoing treatment received a 10-fold overdose of methadone.
  • The overdose resulted from medical personnel's unawareness of a stock solution concentration change from 0.1% to 1.0%.
  • One patient died, while the other experienced severe intoxication but survived.

Findings:

  • Failure to recognize altered methadone concentration led to a critical medication error.
  • Lack of clear labeling and communication regarding pharmaceutical stock solutions contributed to the incident.

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  • The event underscores the vulnerability of treatment protocols to undetected changes in drug concentration.

    • Implications:

    • Enhanced labeling of pharmaceutical stock solutions is crucial for preventing dosing errors.
    • Improved communication channels between pharmacies and medical staff are necessary.
    • Reinforced training on medication concentration verification is essential for healthcare providers to ensure patient safety.