WOMEN who have epidurals to ease the pain of childbirth risk potentially fatal hospital blunders, it has emerged.

More than 200 errors with epidurals in 12 months have been detected and the National Patient Safety Agency (NPSA) has now issued a warning to doctors and midwives over the drugs.

The painkiller is supposed to be administered at the base of the spine, but some women have had it accidentally injected into veins in their arms, triggering heart attacks. The safety agency says three women died as a result of such mistakes before it began monitoring.

The blunders are occurring because staff are confusing bags containing the epidural with other drugs.

About one fifth of pregnant women are given epidurals for pain relief during labour.

Most also have intravenous drips to speed up contractions and maintain blood pressure. The watchdog says maternity ward staff are muddling the two drugs because the packaging is similar.

Professor David Cousins, head of safe medication practice at the watchdog, said: “Following three deaths and numerous other patient safety incidents with epidural infusions, the NPSA is undertaking a consultation on fast-track recommendations to prevent wrong-route errors. Thanks to staff reporting incidents, the NPSA has been able to take action to address this important issue.”

The problem emerged after the watchdog introduced new systems for doctors and nurses to report mistakes or “near-misses”.

The most serious incidents have involved the drug bupivacaine, a local anaesthetic used in epidurals, being administered into the veins.

Other errors have included administering too powerful a dose or using the wrong equipment to inject the drug. Epidurals are often given initially by doctors, and then “topped up” by midwives during labour.

Dr Maggie Blott, a consultant obstetrician at Royal Victoria Infirmary, Newcastle upon Tyne, said: “Two hundred mistakes in 12 months is an extremely large figure and very worrying.

“There are systems in place for double-checking drugs before they are given to patients. This suggests midwives are not getting the right training.”

The safety agency is preparing to publish its annual report into medical errors in National Health Service hospitals, clinics and GP surgeries in England.

New figures released by Andy Burnham, a health minister, ahead of the report’s publication, show that between November 2003 and the end of last month there were 2,575 mistakes involving surgery or anaesthesia.

In 75% of cases the mistakes were harmless; in 17% they caused “low harm”, in 7% of cases they caused “moderate harm”, and in 35 individual cases they caused severe harm.

In six cases the patients died.

The Crown Prosecution Service is considering whether to bring charges against Great Western hospital in Swindon, Wiltshire, after it admitted a fatal blunder with an epidural.

Mayra Cabrera, 30, a theatre nurse, died within an hour of giving birth to her son at the Great Western when staff accidentally injected the drug into her arm in May 2004.

Burnham said: “The government is concerned about NHS patients affected by adverse events and that is why it established the NPSA in July 2001 and asked it to set up a national reporting and learning system for patient safety incidents.

“This system is now in place across the NHS. All trusts have been connected and reporting to the system from late 2005.”

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