Preventable Operating Room Medication Errors May Result in Additional $5.3B in Medical Costs Per Year in U.S.

Medication errors during surgery cost the U.S. healthcare system $5.3 billion every year, and the majority of the errors are preventable, according to the findings of a new study.

Researchers from several Ivy-league universities found that up to 10% of all medications used in U.S. operating rooms result in a medical error, according to findings published in the September 2023 issue of the Journal of Patient Safety.

A team of researchers from Harvard, Yale, and Brown Universities conducted a search of PubMed research focusing on medication errors in the operating room. They examined the likelihood that a medication errors would result in harm to the patient during surgery or downstream, later after surgery.

These included injuries such as surgical site infections or acute kidney injury. The researchers then estimated the additional cost of care for each potential downstream patient harm event.

The researchers indicate there are more than 19.8 million surgical procedures occurring in the United States every year. Roughly 4 to 9% of all medications administered in the operating room lead to a medication error that can cause patient harm, they determined.

Nearly 20% of medication errors were related to untreated postoperative pain, which was the error reported most often. Medication documentation errors accounted for 8%, as did errors linked to possible bacterial contamination due to the use of expired syringes.

Prolonged hemodynamic swings accounted for 7.6% of errors, and syringe swaps during surgery accounted for nearly 6% of all the errors that occurred.

Other errors included delayed or missed antibiotics, residual neuromuscular blockade, oxygen saturation under 90% due to a medication error, untreated new-onset intraoperative cardiac arrhythmia, hypotension with the inability to get a blood pressure reading, and untreated bradycardia.

Medication Error Costs

Overall, the researchers estimated that the annual total cost for medication errors during surgery was $5.3 billion. That estimate does not include the cost of medical malpractice lawsuits.

The U.S. alone accounts for 11% of the $46.7 billion annual total global cost of medication errors, as estimated by the World Health Organization.

Operating room medication errors linked to missed antibiotics that resulted in infections or sepsis were the costliest errors, accounting for $1.47 billion annually. Hemodynamic swings were second, costing about $1.3 billion.

Those medication errors that occurred during surgery led to an additional cost of about $55,000 per surgery on average, the researchers determined. This raises the overall cost of all surgeries performed in the U.S. by about $270 each year, the estimated.

The researchers concluded that more research is needed to focus on identifying how medication errors in the operating room occur and how to prevent them, in order to reduce the number of deaths, injuries and increased health care costs. These could include the use of electronic medication checks and clinical support software, they determined.