The IOM report, which was requested by Congress in 2003, concluded that drug mistakes in hospitals are so common that any given patient will experience a medical error every day he or she stays there.
"Everyone in the health care system knows this is a major problem, but there's been very little action, and it's generally remained on the back burner," says IOM panel member Charles B. Inlander.
The report cites common errors like doctors writing prescriptions that could negatively interact with the drugs a patient is already taking, pharmacists filling prescriptions for medications of the wrong strength, and nurses either dispensing the wrong medicine altogether, or wrong doses of the right medicines in intravenous drips.
The report's authors suggest possible solutions, such as requiring hospitals to have a standardized bar-code system to ensure correct medications and dosages. However, drug companies and drug vendors have created six different systems that require different bar-code readers to work, so such a system has not been effective so far.
Though the focus of the study was not to determine the FDA's role in medical errors, the report made it clear that IOM experts believe the FDA and pharmaceutical companies have not effectively made drug packaging error-proof, or made drug information accessible to the public.
The report also found that hospitals and long-term care facilities do not report medical errors to patients unless the errors result in death or injury -- a policy the IOM says must change, as past studies have found that drug errors cause at least 400,000 preventable deaths every year in hospitals, as well as more than 800,000 such deaths in nursing homes and 530,000 preventable deaths among Medicare recipients in outpatient clinics.