October 2003 Bulletin

Breaking News

2004 Nominating Committee selected

The 2004 Nominating Committee has been selected. The Board has appointed S. Terry Canale, MD, as chair of the 2004 Nominating Committee and the elected members of the 2004 Nominating Committee are: Jerome M. Cotler, MD (Penn.), Robert N. Hensinger, MD (Mich.), Joseph M. Lane, MD (N.Y.), Bernard F. Morrey, MD (Minn.), Scott J. Mubarak, MD (Calif.) and Andrew J. Weiland, MD (N.Y.); the alternate is Richard D. Coutts, MD (Calif.). The committee will make recommendations for members to serve on the AAOS Board of Directors and for nominees to serve on the American Board of Orthopaedic Surgery. Nominations will be announced at the 2004 Annual Meeting.

FDA issues MedWatch Alert on Roxanol (morphine sulfate) concentrated oral solution

MedWatch, the U.S. Food and Drug Administration (FDA) safety information and adverse event reporting program, announced that Elan Biopharmaceuticals has issued a “Dear Healthcare Professional” letter reporting serious adverse events and deaths resulting from accidental overdose of high concentration morphine sulfate oral solutions. In most of these cases, morphine oral solutions ordered in milligrams (mg) were mistakenly interchanged for milliliters (mL) of the product, resulting in 20-fold overdoses. Prescribers and dispensers should be aware that concentrations of morphine sulfate are available from various manufacturers with the concentration expressed in mg/tablespoon.

To assure that the patient receives the proper dose of morphine sulfate oral solution, prescriptions for morphine sulfate oral solution should include:

  1. the concentration of morphine sulfate oral solution to be dispensed AND
  2. the intended dose of morphine in milligrams (mg) with the corresponding volume in milliliters (mL or cc) written out in the directions.

It is important that the prescription is filled with the proper concentration of morphine sulfate oral solution to prevent potential medication errors. AAOS Members who have further questions or would like additional information should contact Elan’s Medical Information Services Department at 1-888-638-7605. Read the letter from Elan Biopharmaceuticals.

Orthopaedics Overseas opens new site in Costa Rica

Orthopaedics Overseas (OO) has announced the initiation of a new training site in San Jose, Costa Rica. The program provides training to local physicians, residents and medical students in general orthopaedics as well as subspecialty training in pediatrics, joint replacements, spine and hand surgery. Volunteers are being sought for assignments of three weeks in duration and must be board-certified or eligible to participate.

OO is also recruiting volunteers to serve in Bhutan, Cambodia, Ethiopia, Kenya, Peru, Philippines, St. Lucia, South Africa, Tanzania, Tobago, Uganda and Vietnam. Hand surgery specialists are needed at several OO sites as well as in Honduras and Peru. Orthopaedics Overseas is the founding division of Health Volunteers Overseas (HVO), an organization founded in 1986 to improve global health through education. For more information about opportunities in orthopaedic training, please contact the office by telephone at (202) 296-0928 or e-mail or visit the Web site

Hospital errors have 'devastating' impact on health care system

Almost 32,600 deaths, $9.3 billion in excess charges and 2.4 million extra hospital days are caused each year by medical injuries during hospitalization, according to a study from the Agency for Healthcare Research and Quality (AHRQ), a division of the U.S. Department of Health and Human Services. The study’s authors say their findings, published in the October 8, 2003, issue of the Journal of the American Medical Association, represent “only the tip of the iceberg,” given the number of conditions examined. The study analyzes the costs associated with each of 18 complications or “patient safety indicators” identified by AHRQ as sometimes caused by medical errors. Information was culled from administrative data at 994 hospitals in 28 states during 2000, a sample of about 20 percent of the nation’s hospitals. Sepsis was the most serious complication, adding costs of $57,727, causing hospital stays almost 11 days longer than normal and adding a 22 percent increased risk of death after surgery, the study finds. The researchers estimate as many as 3,000 people die each year from such blood infections. The reopening of surgical incisions was the second most serious event, causing an estimated 405 deaths annually.

Physician shortage predicted: 15 percent increase needed

A study by the Center for Workforce Studies at the State University of New York, Albany, is predicting a doctor shortage over the next 20 years. According to the study, the U.S. may need an additional 85,000 to 96,000 physicians, which would probably require the opening of four or five new medical schools. Acting on the study, the Council on Graduate Medical Education, a Congressional advisory group, has endorsed proposals to increase the number of medical school graduates by 3,000 over the next 12 years and increase the number of doctors entering residency programs to 27,000 in 2015. The group also endorsed a recommendation to end the goal of a 50-50 mix of primary care and specialist physicians in residency programs, a move that could expand the number of specialist slots available. The shortage is already being felt in some states; the Wisconsin Hospital Association has organized a task force to examine an emerging shortage of physicians in that state.

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