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MONDAY, July 28 (HealthDay News) -- Preventing medical errors that occur during or after surgery could save lives and almost $1.5 billion a year, according to U.S. Agency for Healthcare Research and Quality (AHRQ) study.

The researchers analyzed data on more than 161,000 patients in employer-based health plans who underwent surgery between 2001 and 2002.

The study found that insurers paid an additional $28,218 (52 percent more) and an additional $19,480 (48 percent more) for each surgery patient who suffered acute respiratory failure or post-operative infections, respectively, compared to patients who didn't suffer those complications.

Among the other findings:

• Nursing care associated with medical errors, including pressure ulcers and hip fractures, cost an additional $12,196 (33 percent more) per patient.
• Metabolic problems, such as kidney failure or uncontrolled blood sugar, linked to medical errors cost an additional $11,797 (32 percent more) per patient.
• Blood clots or other vascular or pulmonary problems associated with medical errors cost an additional $7,838 (25 percent more) per patient.
• Wound opening tied to medical errors cost an additional $1,426 (6 percent more) per patient.

In addition, the study found that one out of every 10 patients who died within 90 days of surgery did so due to a preventable error, and one-third of the deaths occurred after the initial hospital discharge.

The study was published in the July 28 issue of the journal Health Services Research.

"Like the physical and emotional harm caused by medical errors, the financial consequences don't stop at the hospital door. Eliminating medical errors and their after-effects must continue to be top priority for our health care system," AHRQ director Dr. Carolyn M. Clancy said in an agency news release.

More information

The American Academy of Family Physicians tells patients how they can protect themselves from medical errors  .

MONDAY, July 28 (HealthDay News) -- Researchers have discovered a soaring increase in the number of fatal medication errors that occur in people's homes.

The report incidentally follows the death earlier this year of Heath Ledger, the 28-year-old actor who died from an accidental overdose of prescription drugs in his apartment in New York City.

"[There was] large-scale evidence that the death rate from prescription errors was going up very fast, but I didn't know until this paper that they were going up extremely fast in particular circumstances, namely at home and when alcohol and/or street drugs are involved," said study author David P. Phillips, a professor of sociology at the University of California at San Diego.

"I also didn't know from this paper that the number of years of potential life lost from potential medication errors are greater than the number of years of potential life lost from all accidents combined, including falls and drowning," he said.

According to background information in the paper, published in the July 28 issue of the Archives of Internal Medicine, there has recently been a dramatic shift in fatal overdoses away from inpatient settings to outpatient settings. More and more medications are taken outside of the hospital or clinic, with far less oversight from health-care professionals, the researchers said.

At the same time, more medications that once were available only by prescription are now bought over-the-counter, and more people are taking more than one medication.

All of this makes it easier for individuals to combine medications with alcohol and/or street drugs. But despite this shift, few if any studies have looked at drug errors outside clinical settings.

Almost 50 million death certificates were filed in the United States between Jan. 1, 1983, and Dec. 31, 2004, 224,355 of them involving fatal medication errors (FMEs). After examining all of these documents, the authors discovered that the overall death rate from fatal medical errors increased by 360.5 percent during that time period.

The surge in FMEs differed by type. FMEs occurring at home and combined with alcohol and/or street drugs increased the most, by 3,196 percent. FMEs not happening at home and not involving alcohol and/or street drugs showed the smallest increase, at 5 percent.

Meanwhile, at-home FMEs not involving alcohol and/or street drugs increased by 564 percent, while at-home FMEs involving alcohol or street drugs increased by 555 percent.

Overall, the increase in FMEs was particularly pronounced among people aged 40 to 59, where the increase was 890.8 percent.

Dr. Andrew Kolodny, chairman of psychiatry at Maimonides Medical Center in New York City, believes most of the deaths can be attributed to misuse of prescription opioid pain medications and that, in turn, is probably due to wider prescribing by doctors of such drugs.

"Prescribing practices have changed to the point where physicians are much more liberal, largely through marketing," Kolodny said. "We've trained a whole generation of physicians to believe that if you prescribe opioids to patients who have legitimate pain that there's little or no risk of addiction or misuse. I think we have to provide physicians and the public with better education about the true risks of some of these medications."

For his part, Phillips agreed that the focus of concern has shifted to the outpatient arena.

"People should no longer just focus on medication errors in clinical settings and caused by clinical staff," Phillips said. "There's a whole new world out there that needs to be investigated, that is to say, fatal medication errors occurring at home and not in clinical settings, and apparently influenced by patients and not by staff."

Another expert agreed.

"Most of the information we have about medication errors and their effect take place within the hospital setting," noted Lisa Killam-Worrall, director of drug information and assistant professor of pharmacy practice at Texas A&M Health Science Center Irma Lerma Rangel College of Pharmacy.

But she said there's a real challenge in finding out exactly what substances people might be taking along with their prescription medications.

"As pharmacists, we always try to counsel people when medications could interact with alcohol or other medications, but there aren't that many studies looking at interactions with street drugs," Killam-Worrall said. "We normally don't ask people, 'Are you using street drugs and which ones are you using?' We normally try to ask people, "What other medications are you taking, prescription, over-the-counter, herbal supplements?' But usually with illicit drug use, you're not going to garner a lot of information."

The findings also have policy implications in terms of patient care , Phillips added.

"Asking patients to be part of the quality-control team is not something you can just automatically do," he said. "It's true that keeping shorter times in hospitals saves money, but it apparently loses lives, and a way to try to ameliorate that would be to spend more time in educating the patient about the risks of taking these powerful medicines and the risks, particularly, of taking these powerful medicines in conjunction with alcohol and/or street drugs."

More information

The U.S. Food and Drug Administration has more on medication errors.

FRIDAY, July 25 (HealthDay News) -- Individuals bent on beating drug tests need only turn to the Internet to find dozens of products that claim to help them do so, scientists have found.

Researchers at the University of Texas at Houston Medical School plan to present a detailed list of drug-test cheating options, along with sophisticated counter-measure tests that can be done by laboratory scientists, at the American Association for Clinical Chemistry's annual meeting, Monday, in Washington, D.C.

"People have been trying to cheat on drug tests for decades," said Alan H.B. Wu, director of chemistry and toxicology at the University of California, San Francisco, who was not involved in the research. "The general population is unconcerned, because they're clean and don't need to worry about that. But, if you're addicted to opiates or painkillers, your job is dependent on clean urine, and these people go to great lengths to try to pass that test."

"These [Internet] companies prey on that mentality with products that enable them to cheat, and laboratories, on the other hand, employ countermeasures to try to detect that practice," Wu added.

Drug testing basically started in the 1980s, after President Ronald Reagan issued a mandate ordering federal agencies to have drug-free work places. The federal government and many other employers now have mandatory drug testing. Today, some 20 million employees are screened annually in the United States for illicit drugs, and maybe 1 percent to 2 percent of samples come out positive, Wu said.

Time-tested ways to cheat on drug tests include using someone else's urine, adding drain cleaner, disinfectant or even water, vinegar or hand soap to the urine sample, or drinking herbal tea. Some people have even tried to smuggle drug-free urine hidden in their armpits or inject drug-free urine into their bladders, the researchers said.

As a result, Wu said, "urine detection sites started taking away any source of water, putting bluing agents in the toilet bowls themselves, so methods [of cheating] have gotten more sophisticated."

The researchers cited some examples of the quick fixes that can be found on more than 1,000 Web sites, products such as "Ready Clean Drug Detox Drink" and "Urine Luck." There are even advertisements for synthetic bottled urine.

In addition, they said, Internet sites sell a fairly inexpensive variety of fluids or pills to flush out the system. And then there are products, with names like Stealth, that can be added to the urine sample after it is collected.

But for each measure, there's often a countermeasure, according to lead author Amitava Dasgupta, a professor of pathology and laboratory medicine at the University of Texas-Houston Medical School, who outlines a host of them in his presentation.

The toxicology arsenal ranges from recipes for detecting nitrites in urine to spot color tests and test strips that show doctored urine.

Dasgupta said, in a prepared statement, that only 2 percent of folks try cheating on drug tests. But, he added "There are always a few bad apples, and if you don't catch them, they can spoil a workplace."

"It's a minority that succeed, but it's certainly not zero," Wu added. "We don't know how many are successful, because if we knew that, they wouldn't be successful."

More information

Visit the National Institute on Drug Abuse for more on substance abuse.

FRIDAY, July 25 (HealthDay News) -- If you've made a sudden trip to the emergency room and are now heading home, take a moment to think about something besides all that poking and prodding: Are you sure you know what just happened and what comes next?

There are approximately 115 million people who visit ERs annually in the United States, statistics suggest. But new research finds that more than 75 percent of emergency room patients leave the hospital not knowing what's wrong with them or what they should do about it.

While it's not clear why patients are missing important details about their health, the chaotic nature of emergency rooms could have something to do with it, said the study's lead author, Dr. Kirsten Engel, a former University of Michigan emergency medicine fellow who now teaches at Northwestern University.

"It's a difficult, loud, confusing place, and there's a lot of activity going on," Engel said. "It's also a place where people by necessity come in during situations where they're not feeling well, they're anxious and upset."

In 2003 and 2004, researchers from the University of Michigan and Northwestern University interviewed 140 emergency room patients in two Michigan hospitals. The study findings were expected to be published in an upcoming issue of Annals of Emergency Medicine and were released online ahead of print.

The researchers asked the patients about four subjects: their diagnosis, their care in the ER, what would happen next, and when they should return. Then the researchers compared the answers to information in the patients' charts.

Seventy-eight percent of the patients gave incorrect information, and more than half got something wrong in at least two of the four subject areas. More than a third misunderstood what their post-ER care entailed.

Meanwhile, only 20 percent of patients who had incorrect information believed they might not be clear on things.

The study didn't look at why the gaps exist or how they might affect health.

Doctors may be part of the problem, Engel said. "We are pressured by many other issues, and that leads us at times to not necessarily review the information in ways that the patient can understand or we present it in a way that's too rapid at the wrong time for a patient," he said.

More information

Learn about what happens in an emergency room from kidshealth.org  .