UNDERREPORTING OF FATAL CASES TO A REGIONAL POISON CONTROL CENTER

We assessed fatal drug overdose and poisoning case surveillance by a r egional poison control center, comparing it with medical examiner dete rminations of death by poisoning over the same 2-year period and from the same catchment area. We studied 358 fatal cases of poisoning or dr ug overdose reported by a medical examiner and 10 fatal cases of poiso ning or drug overdose reported by a poison control center, analyzing d emographics and other case-associated factors with possible successful poison control center case surveillance. Of the medical examiner case s, 245 (68%) were prehospital deaths. Of the remaining 113 emergency d epartment or hospital cases, only 5 (4.4%) were also reported to the p oison control center. Compared with cases involving illicit drugs, oth er narcotics, and sedative drugs, those that involved other prescripti on drugs (relative odds, 30.6; 95% confidence interval, 2.7 to 351) an d over-the-counter products and other substances (odds ratio, 18.9; 95 % confidence interval, 1.4 to 257) were significantly more likely to b e reported to the poison control center. Most fatal cases of poisoning and drug overdose are not detected through poison control center surv eillance. For prevention and treatment, health planners and policy mak ers should recognize the implications of case underreporting.