Advances in Patient Safety

Improper Prescriptions and Optimization of Medications

July 31, 2022 | Lebowitz & Mzhen

Medication is by far the most common method for the treatment of diseases, with between 75% to 80% of physician office and hospital outpatient clinic visits involving medication therapy. Annually, about 275,000 people die each year, and roughly $528 billion in medicine is wasted due to poorly managed medications. Doctors, pharmacists, and other health care professionals have a responsibility to protect patients and ensure that every prescription is safe, effective, and appropriate for each patient. A recent article in the Pharmacy Times, authored by the executive director of The Get the Medications Right Institute, highlights some of the major barriers to appropriate prescriptions. Issues range from a lack of transparency to inadequate commitment to team-based care and benefit plan design integration by care providers. These problems can compound, ultimately resulting in dangerous results for patients.

According to the article, one of the consistent themes when it comes to the failure of medical professionals to optimize medications or prescribe the proper medicine is the current siloed approach to treatment. With different treatment providers unable or unwilling to communicate with each other in the current health care environment, cost-saving and comprehensive care are significantly more difficult to achieve.

What Are Steps to Prevent Improper Prescriptions?

The piece outlines five straightforward questions that health care providers, patients, and pharmacists can utilize to prevent improper prescriptions and optimize the impact of medication when it comes to health care. Briefly stated, the steps are to ensure the correct medication, allow patients to ask questions, ensure the proper dose, provide patients with a timeline for taking the medication and explain how patients will know the medication is working.

COVID-19 Vaccines Being Distributed in Maryland

December 24, 2020 | Lebowitz & Mzhen

Maryland is receiving nearly 200,000 vaccine doses that will go to front-line hospital workers, first responders, and long-term care facility residents and staff in the state. Some Maryland pharmacies are receiving shipments of the vaccine to administer to nursing home residents and staff through the CDC’s Pharmacy Partnership for Long-Term Care Program.

To date, two vaccines have received approval from the Food and Drug Administration for emergency use: Pfizer-BioNTech’s COVID-19 vaccine and Moderna’s COVID-19 vaccine. Both are now being distributed in Maryland. Both Pfizer-BioNTech’s and Moderna’s vaccines have been shown to be about 95% effective in preventing symptoms and decreasing severe COVID-19 infection.

The two approved vaccines require two doses of the vaccine. Pfizer’s is administered three weeks apart, and Moderna’s is administered four weeks apart. Both vaccines have shown some minor-to-moderate side effects, including pain, fatigue, headaches, chills, and joint pain. Both approved vaccines are mRNA vaccines, which means that those vaccines work by teaching one’s body to create an immune response to the virus without getting sick with the virus and without putting a weakened or inactivated virus in people’s bodies. The mRNA vaccines do not use the live virus that causes COVID-19, and someone who gets vaccinated cannot get infected with COVID-19 from the vaccination.

How Will Automation in Maryland Pharmacies Affect Medication Errors?

December 17, 2020 | Lebowitz & Mzhen

Each year, between 7,000 and 9,000 people die in the United States because of a medication error. Many more experience adverse reactions that are not reported. Maryland medication error victims often suffer from physical pain as well as psychological pain because of the error. The problem of medication errors, which are often due to human error, has pushed many pharmacies to begin implemented pharmacy automation. Pharmacy automation is a process that includes the handling and distribution of medications in pharmacies and hospitals.

Automation can include counting medicines as well as maintaining and updating patient information. The global pharmacy automation market is expected to continue to grow. The reasons for which growth is expected include a shift towards digitization and a rise in investment in healthcare development in certain countries, leading to an increase in opportunities for growth. Some see automation as a way to avoid medication errors, although it may also bring about risks and new opportunities for errors to be made.

If someone is injured due to a medication error, they may be able to file a negligence claim against the pharmacist, doctor, or other provider, in order to hold them responsible for the error and seek financial compensation. In a Maryland medication error negligence case, a victim generally has to show that the defendant owed the victim a duty, the defendant failed to meet the standard of care required, the victim was injured because of the defendant’s negligent conduct, and the defendant’s conduct caused the victim injuries. A medication error victim has to prove it was more probable than not that the injury the victim suffered was caused by the healthcare professional’s negligent conduct. In the tragic event of a death caused by a medication error, certain members of the decedent’s family may be able to pursue a wrongful death claim against the responsible parties.

Can a Pharmacy’s Overreliance on Technology Put Maryland Patients at Risk?

July 4, 2019 | Lebowitz & Mzhen

As the population increases, more people are filling prescriptions. This results in an increased burden on Maryland pharmacists. Indeed, many experts believe that this increased workload is the leading cause of pharmacy errors. To help pharmacists efficiently fill prescriptions, many pharmacies rely heavily on technology, including e-prescribing, electronic databases, and software designed to bring pharmacist’s attention to potential adverse interactions.

For the most part, technology makes it possible for pharmacists to do their job. However, there is a concern that an overreliance on technology may put patients in jeopardy. According to a recent news report, all patient records were inadvertently deleted after an IT error at a university pharmacy. Evidently, the lost data included prescription and refill history and insurance information for all customers. Pharmacy staff estimate that the affected number of patients is somewhere around 50,000.

As a result of the error, the pharmacy’s databases must all be rebuilt. This requires pharmacists manually enter in all patient data, including insurance information and prescription history. Patients are being asked to call their physician and have them reorder all necessary prescriptions. For now, there have not been any reported pharmacy errors that have occurred as a result of the loss of patient data.

The Impact Technological Advancements Have on Maryland Pharmacy Errors

May 13, 2019 | Lebowitz & Mzhen

Over the past few years, local Maryland pharmacies have seen a gradual increase in the number of prescriptions that are filled each year. However, pharmacies have been slow to adjust the number of pharmacists with this increase in demand. As a result, pharmacists are dealing with increased workloads.

For quite some time, experts have agreed that as a pharmacist’s workload increases, the likelihood of an error also increases. Some believe that new technology can help pharmacists more accurately and quickly fill prescriptions. According to a recent industry news report, by using state-of-the-art technology to fill orders, pharmacists can free up nearly 90 minutes per day.

Generally, when appropriate technology is used to fill prescriptions, there seems to be a reduction in the error rate. However, some skeptics point to the learning curve that implementing new technology presents, raising a concern that patient safety may be jeopardized as pharmacists get accustomed to frequent changes in the workplace.

Are Partial-Fill Prescriptions an Answer to the Maryland Opioid Epidemic?

January 30, 2019 | Lebowitz & Mzhen

A significant number of Maryland prescription drug injuries are caused by opioid use and abuse. Over the last decade, the number of deaths that were related to opioid medications has dramatically increased from about 35,000 in 2007 to over 70,000 in 2017. In an effort to curb these stark statistics, experts began to consider why opioid abuse has become more prevalent over the past few years and what new law or policies could help decrease opioid abuse.

One idea that is starting to gain traction is the concept of partial-fill prescriptions. Under a partial-fill prescription policy, patients who are prescribed certain high-risk opioid medications are given only a few days’ worth of medication at a time. The idea behind the policy is that if patients are given fewer pills they will be less likely to take more than they need. Additionally, proponents of a partial-fill policy hope that it would reduce the number of people who sell some or all of their medication.

According to a local news report, Tennessee recently enacted a partial-fill policy under which patients would only be provided some of their medication on their first visit to the pharmacy. Patients could obtain the rest of their medication, if needed, by returning to the pharmacy once they run out of medication. Under the new policy, pharmacies are responsible for inputting patient data into a state-wide database.

New Technology Aims to Address the Danger of Prescription Errors in Maryland and throughout the United States

November 15, 2018 | Lebowitz & Mzhen

Prescription errors are all too common in the United States. Pharmacists and doctors are human, and like everyone else they make mistakes. Unfortunately, these errors can have devastating effects on Maryland patients. In the event of a prescription error, a patient or family member may be able to bring a claim to recover compensation for the patient’s injuries and to hold the person or entity responsible.

A patient or family member may be able to bring a medical malpractice claim, or another claim against the responsible medical professional. In a medical malpractice case, a plaintiff must show that the defendant failed to meet the requisite standard of care, or the standard the medical professional should have met in the same or similar situation.

Medical malpractice prescription error cases usually involve complex medical conditions and confusing medical records, and retaining an experienced attorney is essential. In a medical malpractice claim, a plaintiff must show that a defendant acted negligently or failed to take the appropriate actions. A plaintiff must prove four elements: the defendant had a legal duty, the defendant failed to perform that duty, the plaintiff suffered injuries, and causation between the defendant’s conduct and the plaintiff’s injuries.

More People Are Getting Flu Shots in Alternative Settings Across Maryland and the Rest of the US

November 8, 2018 | Lebowitz & Mzhen

A new study reports that flu vaccinations are occurring more frequently in alternative settings such as pharmacies, clinics, and work, as one news source reported. According to the study, patients between the ages of 18 and 64 had higher rates of early vaccination at clinics, pharmacies, and workplaces, helping to increase the number of flu vaccinations received before November 1st. Also, high-risk patients over 65 years of age reported even higher rates of early flu vaccinations at pharmacies and work. The study’s author found that there is an association between the setting where a vaccination is received and the timing, and that non-traditional vaccination settings help to increase the rates of flu vaccinations before November 1st, a deadline set by the Centers for Disease Control and Prevention (CDC).

According to the CDC, the 2017-2018 flu season was particularly severe, It was reported that an estimated 80,000 Americans died from the flu and its complications. These numbers included 183 pediatric deaths. It was the highest rate of death from the flu in the past four decades. The CDC recommends getting the flu vaccination as early as possible because it takes about two weeks after receiving the vaccination for the antibodies that protect against the flu to develop in the body.

Liability of Flu Shot Providers in Maryland Pharmacies and Other Alternative Settings

As more individuals in Maryland and throughout the country receive flu shots in alternative settings, providers can still be held liable for errors in dispensing the vaccine. Although many vaccinations are administered without issue, mistakes can occur, even in a routine procedure like the administration of a flu shot. For example, the incorrect dosage may be administered, a needle may be mistakenly used more than one time, side effects may not be disclosed, or the wrong vaccination may be administered. In the event of an error, some individuals may be able to bring a medical malpractice claim to recover compensation for the injuries they sustained.

The Effectiveness of a New Law Absolving Negligent Pharmacists of Criminal Liability Is Questionable

April 23, 2018 | Lebowitz & Mzhen

Medical errors, including Maryland pharmacy errors, are commonly believed to be one of the leading causes of death in the United States. However, the actual number of pharmacy errors is up for debate because, as is the case in Maryland, most states do not require pharmacists to report the vast majority of the errors that occur.

Under the laws of most states, pharmacists need only report errors that end up causing an “adverse medical event.” Essentially, this means that an error does not need to be reported unless the patient suffers some kind of harm as a result of the error. Thus, errors that are caught before the medication is delivered to the patient do not need to be reported.

It is widely believed, however, that the best way to reduce errors is to learn from common mistakes. In most professions, the industry can learn from many common errors as a whole, meaning that pharmacists in Maryland may develop a better way to prevent an error and can share that new method with other pharmacists nationwide. However, in order for that learning process to work, pharmacists must be open about the number and types of errors.

Major U.S. City Takes Steps to Reduce Pharmacy Errors

January 22, 2018 | Lebowitz & Mzhen

Maryland medical errors – including misfilled prescriptions – are one of the leading causes of death in the state and across the country. Indeed, a 2016 study by Johns Hopkins concluded that, if properly tracked, medical errors would be the third-leading cause of death in the United States. However, due to the fact that the law allows for voluntary reporting of most errors, many Maryland pharmacy errors go unreported.

According to a recent industry news report, Chicago is taking affirmative steps to combat the growing number of pharmacy errors. The city’s actions follow a report by a local paper indicating that of the 25 pharmacies surveyed, over 50% committed at least one error. The city’s attempts are premised on the longstanding and verified belief that the more prescriptions a pharmacist fills per shift, the higher is the chance that the pharmacist will make a medication error in the type, dose, or administration of a drug.

In an attempt to reduce future errors, Chicago lawmakers have proposed a number of pharmacy regulations. For example, one proposed regulation limits the total number of prescriptions a pharmacist can fill by hour to 10. Another regulation requires that pharmacists who have been working in excess of eight hours notify patients as they fill their prescription. Lawmakers have also proposed that pharmacists be required to take one 30-minute lunch break and several 15-minute breaks per eight-hour shift.