Annals of Internal Medicine is published by the American College of Physicians-American Society of Internal Medicine (ACP-ASIM), an organization of more than 115,000 internal medicine physicians and medical students. The following highlights are not intended to substitute for articles as sources of information. For an embargoed fax of an article, call 1-800-523-1546, ext. 2656 or 215-351-2656.
In the first of an eight-article series on medical errors, two patient safety experts describe the 17 errors that allowed one patient to receive an invasive procedure intended for another patient (Academia and Clinic, p. 826). Each article in the series diagnoses the problems in the medical system and in individual decision-making that led to a serious error or adverse medical outcome for a patient (Editorial, p. 850).
A 1999 Institute of Medicine (IOM) report, based on reviews of hospital medical records, estimated that 44,000 Americans die each year of medical errors. In a new study, researchers reviewed 500 of the records used in the IOM report and found that two changes in the record review process markedly reduced the rates of negligent events: increasing the number of reviewers from one to three, and requiring reviewers to be highly confident that the event being examined was due to negligence (Brief Communication, p. 812). Thus, the authors say, institutions and health systems interested in reducing medical errors will need more reliable measurements than reviewing medical records, such as direct observation of patient care.
Cocaine raises body temperature, which makes users more susceptible to fatal cocaine overdose. Researchers discovered why cocaine raises body temperature (Article, p. 785). They found that a low dose of cocaine impaired the body's ability to dissipate heat through sweating and flushing. It also impaired the ability to sense a rise in body temperature, so that a person would be less likely to take action to reduce body temperature by removing clothing or turning on a fan.