A mistake I made as an intern more than 20 years ago still haunts me. It’s one that doctors continue to make today, even though a simple solution — affordable EpiPens for emergency departments — could make these errors a thing of the past. One night during my first year as a full-fledged physician, I took a call in the middle of the night. A young man being treated for cancer was having a severe allergic reaction to a blood transfusion. The nurse and I grabbed a vial of epinephrine from the crash cart. For someone having a potentially deadly anaphylactic reaction, a small dose of epinephrine (0.3 milligrams) can help reverse the rash, wheezing, swelling of the throat, and other symptoms. It should be injected into the muscle or under the skin so it doesn’t get into the bloodstream too fast, which can dangerously stress the heart. By comparison, a larger dose (1 milligram) is injected into the bloodstream to try to restart the heart when the heart stops during a “code blue.” In the stress of the moment, I failed to see that the vial was an extra concentrated form of epinephrine, delivering 1 milligram per milliliter of fluid. It’s like concentrated laundry detergent, sold to save on volume — and money. One vial of this type of epinephrine costs just $4. The drug is also packaged in a more dilute form, which delivers just one-tenth of a milligram per milliliter of fluid. It is up to [...]