Drug-related problems and adverse drug events: negligence, litigation and prevention.

Since the inclusion of medical profession under Consumer Protection Act, Indian doctors are facing malpractice suits. The incidence of adverse events (AEs) is 3.4-3.7, of adverse drug events (ADEs) is 2.4-6.5 and of adverse drug reactions (ADRs) is 6.7 per 100 hospital admissions. The complications of drug-related problems (DRPs) include therapeutic failure (TF) in 23% and new medical problems (NMPs) in 10% and could lead to serious permanent disability and death in majority (42%). The incidence of negligence in serious ADEs and death is 34% and 51%, respectively. Proportion of preventable ADEs is 28-50%. Errors occur most often in prescribing (39-56%) and result in malpractice claims in 13-25% of cases. Rational prescribing, improved therapeutic knowledge through re-training and effective use of computers in prescribing could prevent errors and reduce economic consequences for patients, doctors and hospitals.