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These medication errors have occurred in health care facilities at least once. They will happen again-perhaps where you work. Through education and alertness of personnel and procedural safeguards, they can be avoided. You should consider publishing accounts of errors in your newsletters and/or presenting them at your inservice training programs. Your assistance is required to continue this feature. The reports described here were received through the Institute for Safe Medication Practices (ISMP) Medication Errors Reporting Program. Any reports published by ISMP will be anonymous. Comments are also invited; the writers' names will be published if desired. ISMP may be contacted at the address shown below. Errors, close calls, or hazardous conditions may be reported directly to ISMP through the ISMP Web site (, by calling 800-FAIL-SAFE, or via e-mail at . ISMP guarantees the confidentiality and security of the information received and respects reporters' wishes as to the level of detail included in publications. [ABSTRACT FROM AUTHOR]

The article presents an analysis of reports gathered by the Institute for Safe Medication Practices Medication Errors Reporting Program regarding medication errors attributed to the use of pen injectors in the United States. Pen injectors, which were primarily intended to facilitate easy and accurate self-administration of subcutaneous drugs, can now be found in hospitals and other health care settings for patient medication administration.

The article presents comments on a revised format of package insert of prescription drugs announced by the U.S. Food and Drug Administration and will take effect on June 30, 2006. There have been significant growth in the length and complexity of the product information insert since the 1980s. The revised formatting guidelines were designed to provide health professionals with clear and concise prescribing information and to reduce the number of adverse reactions resulting from medication errors. One of the proposed changes is the addition of the initial product-approval date.