Patient-controlled analgesic (PCA) infusion pumps allow patients to self-administer
opioid analgesics within the limits prescribed by a physician or other
health professional. They are frequently used to treat postoperative,
obstetric, terminally ill, and trauma patients.
As San Diego malpractice attorneys, we are increasingly concerned about the number of medical errors associated
with PCA use in hospitals in California and across the country. Since
PCA pumps are used with potent opioids, even small errors can lead to
serious patient harm. In fact, according to data from the Food and Drug
Administration, PCA-related errors are three times as likely to result
in injury or death when compared to device errors involving general-purpose
Below are some of the most common medical errors associated with PCA infusion pumps:
Improper Patient Selection
Since PCA therapy requires the patient to deliver the dose, candidates
for PCA should have the mental alertness and cognitive ability to manage
their pain and communicate their pain level to health care professionals.
However, the benefits of PCA have led some healthcare providers to extend
its use to less-than-ideal candidates (e.g., young children, confused
elderly patients), often at the expense of patient safety.
The PCA order itself can also lead to errors. For instance, reports indicate
that prescribers have made mistakes in converting oral opioid doses to
the IV route. In other cases, one opioid has been prescribed, but the
dose has been for a different drug.
Even with correct PCA orders, clinicians have been known to make mistakes
in communicating the orders, sometimes leading to serious harm to patients.
In some cases, concurrent orders for other opioids while PCA is in use
have resulted in opioid toxicity. Problems also have occurred when patients
are started on PCA therapy but have a documented allergy to the ordered
Drug Product Mix-Ups
Some opioids used for PCA have similar names and packaging, which has led
to drug selection errors. This often occurs when health professionals
fail to verify that the drug is correct before administering it to the patient.
For instance, errors have occurred when prefilled vials of meperidine and
morphine have been packaged in similar-looking boxes. In addition, morphine
is available in prefilled vials in two concentrations, but the packaging
may not allow quick differentiation of the strengths, which can also lead
PCA by Proxy
Finally, reports also indicate that PCA pump patients have received dangerous
and even lethal amounts of opioids when family members or clinicians activated
the pump’s delivery request button on the patient’s behalf
(i.e., PCA by proxy).
Pennsylvania Patient Safety Authority
If you or someone you care about has suffered serious harm due to a medication
error or other serious medical mistake, you may be entitled to compensation.
For more information, please contact
a San Diego medical malpractice attorney at the Law Offices of Robert Vaage
for a free consultation.