RT Journal Article
SR Electronic
T1 Deaths following methotrexate overdoses by medical staff.
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 2009
OP 2011
VO 32
IS 10
A1 Sinicina, Inga
A1 Mayr, Barbara
A1 Mall, Gita
A1 Keil, Wolfgang
YR 2005
UL http://www.jrheum.org/content/32/10/2009.abstract
AB Methotrexate (MTX) is an effective disease modifying antirheumatic drug (DMARD) with a relatively safe profile, and it is widely used to treat neoplastic diseases and dermatologic and rheumatologic disorders. As indications for use of MTX increase, more accidental overdoses are noted to occur. Typical problems include deficiencies in labeling, instructions, or packaging, as well as erroneous use. We describe 5 fatal cases of repeated oral overdose of MTX prescribed by physicians in the treatment of rheumatoid arthritis to focus attention on the design of the underlying system and the organizational practices as sources of problems.