# AI misinterprets a medication list by translating 'Tylenol #3' as acetaminophen 300 mg with codeine 30 mg without flagging the codeine component for pediatric patients under 12

- **ID:** `medical/medication-list-interpretation`
- **Domain:** medical
- **Category:** data_error
- **Error Code:** `MED_LIST_INTERP_COD`
- **Verification:** ai_generated
- **Fix Rate:** 78%

## Root Cause

'Tylenol #3' is a brand name for acetaminophen 300 mg + codeine 30 mg; AI fails to recognize the codeine component and its FDA black box warning for children under 12 years after tonsillectomy or for any child under 18 with respiratory risk.

## Workarounds

1. **Parse 'Tylenol #3' as a fixed combination: acetaminophen 300 mg + codeine 30 mg. Flag for pediatric patients under 12 years: 'Codeine is contraindicated in children under 12 years due to risk of respiratory depression.' Example: if patient is 8 years old, do not recommend this medication.** (90% success)
   ```
   Parse 'Tylenol #3' as a fixed combination: acetaminophen 300 mg + codeine 30 mg. Flag for pediatric patients under 12 years: 'Codeine is contraindicated in children under 12 years due to risk of respiratory depression.' Example: if patient is 8 years old, do not recommend this medication.
   ```
2. **Use a medication database lookup (e.g., RxNorm, DrugBank) to resolve brand names into active ingredients with warnings. For any codeine-containing product, automatically check patient age and surgical history.** (85% success)
   ```
   Use a medication database lookup (e.g., RxNorm, DrugBank) to resolve brand names into active ingredients with warnings. For any codeine-containing product, automatically check patient age and surgical history.
   ```

## Dead Ends

- **** — The '#3' suffix specifically indicates codeine 30 mg per tablet; interpreting it as quantity leads to missing the opioid component. (90% fail)
- **** — Codeine is a prodrug metabolized to morphine; ultra-rapid metabolizers (CYP2D6) can have fatal respiratory depression. FDA warns against all codeine use in children under 12. (95% fail)
- **** — Omits the opioid component entirely, leading to under-treatment of pain or missed drug interaction warnings. (85% fail)