Underreporting of fatal cases to a regional poison control center

• Published in: The Western journal of medicine Vol. 162; no. 6; pp. 505 - 509
• Main Authors: Blanc, P D, Kearney, T E, Olson, K R
• Format: Journal Article
• Language: English
• Published: United States BMJ Publishing Group LTD 01.06.1995
• Subjects: Adult; Catchment Area (Health); Coroners and Medical Examiners; Disease Notification; Drug Overdose - mortality; Drug Overdose - prevention & control; Drug Prescriptions - statistics & numerical data; Emergency Service, Hospital - statistics & numerical data; Female; Hospital Mortality; Humans; Hypnotics and Sedatives - poisoning; Male; Narcotics - poisoning; Nonprescription Drugs - poisoning; Poison Control Centers - statistics & numerical data; Poisoning - mortality; Poisoning - prevention & control; Population Surveillance; Regional Medical Programs - statistics & numerical data; Retrospective Studies; San Francisco - epidemiology; Street Drugs - poisoning; San Francisco
• ISSN: 0093-0415; 1476-2978

We assessed fatal drug overdose and poisoning case surveillance by a regional poison control center, comparing it with medical examiner determinations of death by poisoning over the same 2-year period and from the same catchment area. We studied 358 fatal cases of poisoning or drug overdose reported by a medical examiner and 10 fatal cases of poisoning or drug overdose reported by a poison control center, analyzing demographics and other case-associated factors with with possible successful poison control center case surveillance. Of the medical examiner cases, 245 (68%) were prehospital deaths. Of the remaining 113 emergency department or hospital cases, only 5 (4.4%) were also reported to the poison control center. Compared with cases involving illicit drugs, other narcotics, and sedative drugs, those that involved other prescription drugs (relative odds, 30.6; 95% confidence interval, 2.7 to 351) and over-the-counter products and other substances (odds ratio, 18.9; 95% confidence interval, 1.4 to 257) were significantly more likely to be reported to the poison control center. Most fatal cases of poisoning and drug overdose are not detected through poison control center surveillance. For prevention and treatment, health planners and policy makers should recognize the implications of case underreporting.