Errors in local pharmacies

Proposed Laws Increasing Ratio of Pharmacy Technicians to Pharmacists Could Adversely Impact Patient Safety

March 5, 2014 | Lebowitz & Mzhen

Pharmacies often rely on a team of medical professionals to meet the demands of customers. These teams consist of pharmacists, who must meet educational and licensing requirements in all U.S. states and the District of Columbia; and pharmacy technicians, who are not always subject to such strict credentialing requirements. Some states set a maximum ratio of pharmacists to pharmacy technicians, while others simply require that the pharmacist have adequate support from staff and technology to perform their professional duties. Pending legislation that would increase the number of technicians that can work under a pharmacist has raised concerns about patient safety.

To obtain a pharmacy license, an individual must obtain a degree from an accredited pharmacy school, pass several examinations, and maintain continuing education requirements. Many states do not require as many credentials to work as a pharmacy technician. Maryland requires a person to have a high school diploma or equivalent, complete a 160-hour training program or obtain certification from a national pharmacy organization, and complete annual continuing education. Supervision of pharmacy technicians by licensed pharmacists is critically important to patient safety.

According to a report by Tampa’s WFTS on pending legislation in Florida, errors occur in an estimated 0.09 percent of all prescriptions filled in the United States. While this seems like a small number, the Kaiser Family Foundation estimates, based on data from 2011, that doctors write more than 59 million prescriptions per year in Maryland alone. That means that more than 53,100 pharmacy errors may occur per year in this state. Most of these errors do not cause any harm, but injuries from pharmacy misfills can be severe.

Washington DC News Investigation Finds Multiple Medication Errors at National Pharmacy Chain

February 27, 2014 | Lebowitz & Mzhen

In a report on its investigation of the national pharmacy chain CVS/pharmacy, Washington DC’s NBC affiliate, News 4, claims to have found numerous alleged medication errors and other problems. Consumers reported receiving the wrong prescription and, in at least one case, meeting with indifference from employees. A former CVS pharmacist with more than thirty years at the company filed a whistleblower lawsuit last year, alleging in part that the company fired him in retaliation for reporting his concerns about an increasing rate of medication errors due to staff reductions. CVS has denied the allegations against it and publicly stated its commitment to protecting patients’ health and safety.

Washington’s News 4 reported a woman’s claim that CVS made a mistake when refilling her prescription for potassium citrate, which she took for her kidneys. She noticed that the pills did not look familiar, and saw that the pharmacy had given her a bottle of potassium chloride instead of citrate. The pills look similar and have similar names, but they have very different uses. Potassium chloride is used to treat hypokalemia, or low blood potassium, and can cause serious, even fatal, complications for some kidney patients. The woman claimed that when she notified the pharmacy manager of the mistake, he responded “Well, potassium is potassium.”
The report also looked at automatic refills, a service offered by CVS and other pharmacies. This allows the pharmacy to refill a prescription at regular intervals, so that the patient does not have to call and request a refill. Problems may occur, however, if the pharmacy refills prescriptions that the patient does not want or need. An elderly patient told the news team that he ended up with more Lidoderm patches, which contain an extremely strong painkiller, than he wanted, based on the auto refill system. This could lead to confusion for some patients, who might not realize that they are receiving medications they did not request.

Pharmacy Allegedly Dispenses Adult’s Prescription to Child with the Same Name, Resulting in Near-Fatal Drug Reaction

February 20, 2014 | Lebowitz & Mzhen

The family of a five-year old boy in the Chicago area is claiming that a case of mistaken identity resulted in the boy receiving the wrong medication and suffering a near-fatal reaction with possible long-term health effects. They have filed a negligence lawsuit in Cook County Circuit Court seeking $50,000 in damages. Pharmacies and the medical professionals they employ owe a duty of care to consumers to verify not only the type and dosage of medication dispensed, but also that the correct patient receives the correct medication.

The child reportedly had a routine checkup with a physician in January 2012. The doctor discussed allergy medication with the boy’s parents, but did not write a prescription at that time. A Walgreens pharmacy allegedly called the family two days later to tell them that their prescription was ready. Believing it to be the allergy medication they had discussed with the doctor, the boy’s mother picked the prescription up and began giving it to him according to the instructions on the bottle.

The lawsuit, filed in January 2014, states that the boy slept for almost two full days after taking the medication. When the child woke up, he exhibited unusual symptoms. His neck flared, leading his parents to call 9-1-1, but it soon subsided. The boy later fainted, so his parents took him to the doctor, who told them to go immediately to the hospital. The prescription that they thought was for allergies, they learned, was actually haloperidol, an antipsychotic medication intended for an adult with the same name as the child.

Compounding Pharmacy and Drug Maker at Center of Contamination Lawsuit

December 12, 2013 | Lebowitz & Mzhen

A California man and his wife recently filed a lawsuit against the drug maker Genentech, a compounding pharmacy, and the doctors responsible for injecting contaminated medicine into his eye that caused him to become blind.

The lawsuit makes several different sorts of arguments regarding culpability of the various defendants for the resulting injury and damage suffered by the plaintiff.

The complaint states that he became blind in one eye when an eye doctor injected Genentech’s drug Avastin, which was contaminated with streptococcus, in order to treat his macular degeneration. The drug is primarily intended for use in the treatment of cancer, but it can be used to treat eye conditions, in so-called off label use.

District Court Denies Pharmacy’s Motion in Fertility Medication Error Case

November 27, 2013 | Lebowitz & Mzhen

The U.S. District Court for the District of South Carolina recently handed ruled on a motion to dismiss, filed by Walgreens in a negligence lawsuit regarding improperly dispensed fertility medication.

In the case,

Caesar v. Walgreen Co., Dist. Court, D. South Carolina (2013), the plaintiffs allege that Walgreens improperly filled her prescription at three times the proper dosage. The couple was in the process of attempting to conceive a child through the process of in vitro fertilization (“IVF”). Following some testing regarding her levels of thyroid stimulating hormone (“TSH”), she was prescribed 50 mcg of levothyroxine in order to lower her TSH levels to an optimum number for conception.

However, instead of being given the 50 mcg, Walgreens provided her with a dosage of 150 mcg, which caused her TSH levels to drop dramatically to 0.006, far below the optimal levels of 1 and 2 for conception and implantation. She had filled her initial prescription and subsequent refills at the same Walgreens for a period of three months.

Intentional Pharmacy Error Causes Woman to Unknowingly Take Abortion Medication

October 2, 2013 | Lebowitz & Mzhen

In probably one of the most egregious incidents that have occurred in pharmacy error news lately, a young woman was intentionally given the incorrect prescription medication in order to induce a miscarriage.

The 27 year old Florida woman was apparently deceived by her boyfriend who colluded with a local pharmacy employee, and she is now suing the pharmacy that provided the medication.

According to the woman’s lawsuit, she reportedly thought that she was receiving amoxicillin, which had allegedly been prescribed by her boyfriend’s father, an obstetrician who’d confirmed her pregnancy. Instead, however, she was given misoprostol, a stomach ulcer medicine that can cause abortion and birth defects. According to her recently filed negligence lawsuit, just a few days later, the woman had a miscarriage.

Woman Told to Take 4 Pills Instead of 1 in Anti-Anxiety Med Error

September 20, 2013 | Lebowitz & Mzhen

A woman who was given a prescription for medication to help ease her anxiety before a dental appointment now has good reason to be skeptical of pharmacies.

The woman was given a prescription by her dentist to take prior to a dental appointment for 0.25 milligrams of Triazolam. When she picked up her medication from a local pharmacy, she assumed that the instructions on the label were accurate, and after paying for the medicine, was not consulted by a pharmacist. The label instructed the woman to take four pills an hour before treatment.

The woman reports losing memory just after her dental appointment began. She does not recall a friend driving her home or the rest of the evening. She credits her boyfriend having stayed over for the relatively uneventful rest of the day. The woman’s friend said she had seemed “completely normal,” which concerned the woman to think what could have happened under the circumstances. According to pharmacy experts, amnesia is a well known side effect of an overdose of the drug Triazolam. Other serious side effects include cardiac arrest, coma and seizures.

Lawmakers Reverse Decision to Shut Down Pharmacy Blamed for Causing Heart Attack

July 18, 2013 | Lebowitz & Mzhen

Massachusetts lawmakers, and specifically the state’s Board of Registration in Pharmacy, have been under increased scrutiny following the deadly meningitis outbreak that occurred last year.

Prior to the outbreak, the regulators changed course regarding a decision to shut down a Massachusetts pharmacy whose medication error sent a teenager to the emergency room with a heart attack. While they claim to still be investigating, they have yet to take disciplinary action against the responsible pharmacy.

According to state records, in July of 2011 Royal Palm Specialty Pharmacy reportedly accidentally gave a patient thyroid medication that was 1,000 times too concentrated. This devastating error required hospitalization for serious heart complications. The board reportedly only found out about the error after the boy’s mother called to complain, four months later.

According to state documents, instead of supplying 10 microgram capsules of the relevant thyroid medication, the pharmacy apparently provided capsules containing 10,000 micrograms.

After taking the drug, the teenager had to be taken to an emergency room four times and hospitalized twice in August 2011 for heart problems. The symptoms still plague the young man, as he reportedly continues to experience generalized weakness and heart palpitations.

Investigators found that the pharmacy did not report the overdose to the state board, even though they are required to report any errors that lead to death or serious injury within 15 days. A pharmacist for the company says that she did not report the error, because she did not know the extent of the harm to the young man, as she could not get in touch with his mother. The pharmacist has since been reprimanded by the state for the error.

Man Given Opposite of Intended Medication Sues Pharmacy

July 2, 2013 | Lebowitz & Mzhen

A man who went into a pharmacy in order to get pills to keep him awake throughout the day allegedly ended up suffering serious consequences when he was instead given sleeping pills.

The 61 year old man alleges that the mistake caused him to get into minor car accidents, and led to his arrest for driving under the influence of a controlled substance. Luckily for the man, prosecutors later dropped the misdemeanor charges when they decided that he probably was not aware of what he had been taking.

The pharmacy reportedly told police that they had given the man someone else’s prescription. However, the pharmacist also claimed that he told the man that they were sleeping pills, and were only to be taken before bed.

However, the victim in the case maintains that he was given no such warnings, and that he had in fact been instructed to take the medication in the morning. His suit claims that after taking the first pill, that afternoon he began to run some errands, and became drowsy and incoherent. He then pulled his vehicle onto a sidewalk, then backed into another vehicle, before driving to a family member’s home and crashing into their garage door.

“Check Your Pills” Essay Tells of Woman’s Personal Debilitating Pharmacy Error Injury

June 3, 2013 | Lebowitz & Mzhen

An essay contest sponsored by the Daughters of the American Revolution spurred an entry by a woman left severely disabled by her life threatening pharmacy error injury.

A pharmacy error led to the woman accidentally being given a blood thinner, instead of her diabetes medication (subscription required to view).

The error led to intense pain, and eventually prevented her from being able to walk. She was barely able to even talk on the night she called for help. After spending four days in the Intensive Care Unit, and a further two weeks in the hospital, it took months of physical therapy and other treatment to recover from her physical injuries, including brain damage.

The woman’s essay stresses the need for individuals to check their medications and trust their instincts when it comes to prescriptions.

“I knew my pills were different, had a different shape. I should have questioned them,” she said. The reason she didn’t was because when she asked on a prior occasion, she was told by a different pharmacy that they changed manufacturers often, in order to get the lowest medication cost. Therefore, she assumed that this was the case in this instance.

The takeaway message is that even a small and accidental error can have long-lasting, and in some cases deadly, results. It is because of individuals like this woman who share their stories, that the message to check your medications is getting increased publicity.