In reply
We concur with Dr Falliers that corticosteroid-related adverse events are very important clinically. Our analysis of medication-related malpractice claims included 4 claims (or 3% of all claims) involving corticosteroids. These claims consisted of 2 patients with osteonecrosis, 1 claim associated with adrenal insufficiency due to corticosteroid withdrawal, and 1 claim associated with the development of a cushingoid syndrome in a child following a 20-fold overdose of a long-acting glucocorticoid injection.
While providing additional perspective, malpractice claims represent a very small portion of the problem of serious and often preventable adverse drug events.1 While we cannot determine if the number of corticosteroid-related malpractice claims in our study is consistent with the experience in other parts of the country, we share Dr Falliers' concern regarding preventable adverse drug events due to corticosteroid prescribing.
Corticosteroids, especially long-term and high-dose therapy, may result in significant morbidity including osteonecrosis.2 Recent advances in the . . . [Full Text of this Article]
