Preventing medication errors with neuromuscular blocking agents: Recommendations of the united states pharmacopeia advisory panel on medication errors

umerous reports of serious injuries, including fatalities, from the misuse of neuromuscular blocking agents have been received through the United States Pharmacopeia (USP) Medication Errors Reporting (MER) Program. Because MER is a voluntary reporting program, the true incidence of actual errors resulting from misuse of neuromuscular blocking agents is not known. The severity of these events prompted the USP Advisory Panel on Medication Errors to develop recommendations for labeling and packaging standards to be published in the United States Pharmacopeia-National Formulary, potentially alleviating this serious health concern.