Hospitals move to prevent mix-ups

By MARTIN JOHNSTON health reporter

The labelling of a widely used anti-nausea drug will be changed to reduce the risk of staff giving patients a powerful anaesthetic supplied in a virtually identical bottle.

Christchurch Hospital has replaced the injected anti-nausea drug with more expensive medicines, at an expected cost of $500,000 this year.

It has also started putting red stickers on the fast-acting and potentially fatal anaesthetic, and several Auckland hospitals are keeping bottles of it in a special container.

Drug company AstraZeneca supplies the medicines in virtually identical ampoules, each containing 2ml.

The anti-nausea drug, metoclopramide, now carries brick-red writing. The anaesthetic, suxamethonium, is labelled in bright pink.

After pressure from anaesthetists, AstraZeneca has decided to change the anti-nausea drug's writing to black, at its own cost, to differentiate it more clearly.

But AstraZeneca commercial manager Stuart Barnett said last night that existing stocks, expected to last four to six weeks, would remain brick-red since they complied with Government regulations and re-labelling them would cost too much.

"These products have been available in New Zealand for some time and used by different hospitals around the country without any issues of potential confusion being raised with us.

"We've not received any complaints or inquiries about the confusion or inadvertent administration of metoclopramide or suxamethonium here or in Australia."

The College of Anaesthetists welcomed the change to differently coloured labels.

Spokesman Dr Vaughan Laurenson, a Christchurch Hospital anaesthetist, said that in the past the hospital had avoided mix-ups by ensuring that the ampoules were different.

But hospitals were now required to buy their metoclopramide from Astra under contracts for a variety of drugs from various suppliers negotiated by Pharmac which came into effect in January.

The contracts save the Government about $10 million a year.

Dr Laurenson said Pharmac had recognised the potential for confusion between the Astra drugs and initially warned staff to be careful, but that was insufficient.