Actor Dennis Quaid and wife Kimberly sued a leading blood-thinner manufacturer Tuesday, saying the labeling and design of the product led to a massive overdose of their newborn twins last month at Cedars-Sinai Medical Center.
The Quaids' babies, Thomas Boone and Zoe Grace, twice were given 1,000 times the intended dosage of heparin on Nov. 18 at the Los Angeles hospital.
At 11:30 a.m. and again at 5:30 p.m., nurses mistakenly administered heparin with a concentration of 10,000 units per milliliter instead of 10 units per milliliter, the family's attorney said. Another child also was given the wrong dose of the medication, often used as a flush to prevent blood clots around intravenous catheter sites.
All three children have since been released from the hospital, which said they suffered no adverse health effects.
Detailing the incidents for the first time Tuesday, Cedars-Sinai cited at least three separate safety lapses that led to the overdoses.
In a prepared statement, the hospital said a pharmacy technician took the heparin from the pharmacy's supply without having a second technician verify the drug's concentration, as hospital policy requires. Then, when the heparin was delivered to a satellite pharmacy that serves the pediatrics unit, a different technician there did not verify the concentration, as required.
Finally, the nurses who administered the heparin to the patients violated policy by neglecting to verify that it was the correct medication and dose beforehand, the hospital said.
The staffers involved were relieved of duty during the investigation and "appropriate disciplinary actions are being taken," the hospital said.
Heparin is one of the most frequently used -- and misused -- drugs in the nation, according to U.S. Pharmacopeia, which operates a medication error and adverse drug reaction reporting program.
Between 2001 and 2006, more than 16,000 heparin errors were blamed on incorrect dosing, according to data the group prepared for The Times. Nearly 650 patients were harmed, including 12 who may have died, the group said.
All told, at least 1.5 million Americans a year are injured after being given the wrong medication or the incorrect dose, according to the Institute of Medicine, part of the National Academies of Science.
