Pharmacy Errors and Children

FDA Panel Looks to Prevent Drug Error by Changing Children’s Acetaminophen Product Labels

May 27, 2011 | Lebowitz & Mzhen

In recent pharmacy error injury news that our Hartford County, Maryland attorneys have been following, a panel advising the U.S. Food and Drug Administration (FDA) has recommended that dosing instructions for children’s acetaminophen be based primarily on a child’s weight and not age, and be changed to include children under two years—to reduce the risk of medication error.

According to the Wall Street Journal (WSJ), a majority of dosing information for over-the-counter (OTC) children’s medicine containing acetaminophen have instructions based on age, with only some information on dosing by weight, causing confusion in dosing that could lead to error or injury. Acetaminophen is the most commonly used OTC medication to lower fevers in children and relieve pain, with the best-known brand being Children’s Tylenol.

The federal advisory panel has recently recommended that all acetaminophen products should contain a standard label with updated weight tables to reflect average weight increase among children over the past 20 years.

According to the FDA reports from 2000 to 2010, there were 14 fatalities and 74 non-fatal adverse events that were related to acetaminophen drug errors in infants and children from the age of 13 and younger. Some of the medication error fatalities were due to incorrect usage of the more-concentrated infant drops that were meant for older children, but used on infants.

The FDA panel reportedly recommended a single infant and children’s medication formula in 2009 that is slated for release this summer. The panel also recommends that the FDA should consider a single concentration of acetaminophen in solid forms, to avoid possible drug errors or overdoses with children.. The panel also voted to add dosage instructions for children from six months to two years onto liquid products. Currently on acetaminophen formulations for children, the dosing information is for children from 2-12 years old, with instructions to contact your doctor for children under 2 years.

Lack of Medication Adherence Can Cause Serious Medication Reactions and Injury

May 16, 2011 | Lebowitz & Mzhen

The Institute of Medicine, reports that every year, 1.5 million people are injured by medication-related events. According to an article in the Wall Street Journal (WSJ), that our Baltimore medication error injury attorneys have been following, a recent report from the Agency for Healthcare Research and Quality (AHRQ), found that the number of patients treated in hospitals across the country for illnesses and personal injuries from incorrectly taking medications like sedatives, blood thinners, corticosteroids and other drugs, increased over 50% from 2004 to 2008.

The report also found that over 800,000 U.S. patients were also treated in emergency rooms across the country in medication-related events, stemming from the incorrect usage of antibiotics, insulin, painkillers, and cardiovascular and other drugs. The WSJ looked at some of these individual drugs, to examine how they can cause personal harm or injury if taken incorrectly. According to the report:

• Antibiotics can cause an allergic reaction if taken incorrectly, and can also fail to properly fight infections. Also, when taking antibiotics, patients are generally cautioned to limit sun exposure, as it can cause extreme sunburns.
• Painkillers can cause breathings problems or even death if taken with alcohol or other sedatives or painkillers. OTC products that contain the ingredient acetaminophen can harm the liver if taken with a combination of opioid-acetaminophen drugs.
• Antidepressants and tranquilizers, if taken incorrectly, can lead to panic attacks and suicidal tendencies or actions.
• If taken erroneously, corticosteroids prescribed for asthma, arthritis, transplant patients, ulcerative colitis, and other conditions, can worsen other health conditions, like high blood pressure, blood sugar problems, ulcers, and diabetes, and can also lead to withdrawal if a patient stops taking them suddenly.
• Insulin, if not taken as prescribed, can both increase or reduce a patient’s blood-sugar levels, leading to shock and other health complications.
• If a patient fails to take blood thinners correctly, a high dose that is too high can cause bruising, excessive bleeding, whereas a dose that is too low can cause clotting. Effectiveness of the drug can also be threatened when interacting with other medications.
• Blood pressure drugs can also, if the medication is taken erroneously, cause a spike in blood pressure, and an overdose can cause chest pain, dizziness, shortness of breath, a fast or abnormally slow heartbeat, and can also cause coma.
• Cancer drugs, when taken in error, can cause fever, nausea and vomiting, shortness of breath, diarrhea, cause confusion and fatigue, and when an overdose is taken, can even cause death.

NCL Campaign to Improve Medication Adherence and Patient Safety

May 15, 2011 | Lebowitz & Mzhen

As our attorneys reported in a recent Rockville, Maryland pharmacy misfill blog post, according to the National Consumers League (NCL), around three out of four consumers in this country admit they don’t take their prescription drug medication as directed—causing an increase in medication error and injury that has a huge impact on patients and the healthcare industry.

To combat medication error, the NCL has launched a national multi-media medication adherence campaign this month with the Agency for Healthcare Research and Quality (AHRQ), that will aim to raise patient awareness on the importance of taking medication as directed.

According to the NCL, when consumers fail to take medications as instructed by their healthcare professionals, it creates a problem that impacts not only the patient, but the caregivers, employers, researchers, health care practitioners, and tax payers as well. Nonadherence to prescribed medications can also result in injury or death.

Research presented by the league shows that one in three prescriptions never get filled, with 1/3 and 2/3 of hospital admissions linked to medication errors that stem from poor drug adherence. The total cost for nonadherence leads to a reported $300 billion a year.

The campaign will strive to enhance patient safety and improve the healthcare system, encourage health practitioners to properly and effectively communicate the importance of prescription medication adherence to patients, and raise awareness of the problem through public education and a national campaign.

CVS Pharmacy Error Leads to Amoxicillin Overdose in Child

May 6, 2011 | Lebowitz & Mzhen

In our last Washington D.C. pharmacy error injury lawyer blog, our attorneys discussed the dangerous problem of pharmacy misfills with children, and how important it is for parents to check prescriptions before leaving the pharmacy to make sure that their child has the right medication.

Other important information for parents to double check with the doctor and pharmacist is the child’s medication dosage and instructions, as a single error could lead to improper medication dosing, and possible injury.

In recent pharmacy mistake news in North Carolina, a 9-year-old child was prescribed the antibiotic amoxicillin for an ear infection. The doctor had prescribed 7 milliliters twice a day, but the CVS pharmacist who filled the prescription reportedly instructed Melissa Fink to give her daughter 7.5 teaspoons—which amounts 37 milliliters–or 5 times the recommended dosage of the doctor.

When Fink’s daughter became worse, and the bottle was nearly empty only two days of giving her the medicine, Fink’s doctor realized the medication error, and advised her to bring her child in immediately. Thankfully the antibiotic overdose did not cause major harm or injury, but according to the Carolinas Poison Center, amoxicillin overdoses can be serious and lead to dehydration or kidney failure.

Walgreens Pharmacy Misfill Leaves Toddler With Dangerous Drug

May 4, 2011 | Lebowitz & Mzhen

Our Baltimore medication error attorneys have been following a recent pharmacy misfill incident that reportedly sent a Colorado Springs mother into great shock—as she nearly gave her small child an epilepsy drug that had been accidentally given to her by the pharmacist at a local Walgreens.

According to KDRO News, Channel 13, Kathy DeRosa went to pick up her son’s Motrin flu medication from the Walgreen’s pharmacy. The prescription reportedly had her 2-year-old’s name on it, along with medication information about the drug. Upon returning home, DeRosa noticed that bottle was smaller than the usual Motrin that she previously received for her son, and after investigating the bottle, she realized that the drug give to him was Levetiracetam—a drug used for epilepsy. DeRosa immediately called the Walgreens pharmacy manager about the prescription error and they brought the correct medicine to the house, apologizing for the dangerous mistake.

Levetiracetam, the drug mistakenly given to DeRosa’s son, is reported to have many potential side effects including fever, hallucinations a drop in white blood count and breathing difficulty, and is not intended to be used for children under the age of four. DeRosa claims that had her son taken the medication he could be in the emergency room, as he has asthma.

According to DeRosa, this pharmacy misfill shows parents the importance of carefully reading the labels on their children’s prescription bottles before leaving the pharmacy, and to check for potential prescription error. Had it not been for the change in bottle shape, DeRosa said they could be in a very serious situation right now.

Children’s Hospitals Form Collective Effort on Patient Safety to Prevent Medication Errors

April 13, 2011 | Lebowitz & Mzhen

According to a recent article in Pharmacy Practice News that our Washington D.C. pharmacy error injury attorneys have been following, a group of children’s hospitals in Ohio have prevented around 3,600 adverse drug events and surgical site infections, along with saving over $5 million, during an 18-month program initiative that was launched in 2009.

The initiative, called “Solutions for Patient Safety,” was reportedly launched with support of the Cardinal Health Foundation, who gave 1.5 million, along with the shared motivation of children’s hospitals in an effort to work together to eliminate preventable injury or harm to children.

Before the initiative began, each children’s hospital in the state reportedly collected data on adverse drug events in a different way—making it very difficult to compare or share information within hospitals. After conducting audits of a random collection of charts, the group was able to come together and manually identify and review the root cause of adverse events, and pinpoint a set of common concerns.

The initiative found that the main collective medication error problem was constipation from opioids, as well as over sedation as a result of the narcotics. Although constipation is not a life-threatening adverse drug event, it can reportedly add to more time in the hospital, more lab work, and tests, which can all add to additional costs.

Hospital Sued for Wrongful Death After Patient Dies from Drug Error

March 22, 2011 | Lebowitz & Mzhen

Our Baltimore-based pharmacy error injury attorneys have been following the recent and tragic news story surrounding a Massachusetts woman, who endured a hospital medication error during a routine hospital stay that reportedly led to her wrongful death.

According to the Boston Globe, Geraldine Oswald was hospitalized in November of last year to clear up an infection that had developed after breaking her shoulder. While staying in the hospital, she reportedly received too much Lepirudin, a blood-thinning drug used to prevent the formation of potentially dangerous blood clots. The medication overdose affected Oswald’s own blood clotting ability, leading to internal bleeding. While in the hospital’s care, Oswald reportedly hemorrhaged for 12 hours before her wrongful death—which the hospital later stated could have been preventable.

The family of Oswald recently stated that they plan to file a wrongful death lawsuit against Massachusetts General Hospital, two nurses and five doctors, claiming that Oswald was supposed to be treated for a common infection, and instead received a blood thinner that was 30 times too high in dosage, and proved to be lethal.

According to the hospital’s report, the on-duty nurse understood the dosage intended for Oswald, but made a medication error while administrating the dose into the I.V. pump. In a meeting with Oswald’s family members after her death, the hospital reportedly stated that the medical error was preventable.

Another Child Receives Prescription Mix-up From Same Walgreens Pharmacy

February 23, 2011 | Lebowitz & Mzhen

According to news from the Jersey Journal that our Baltimore, Maryland medication mistake attorneys have been following, a local Walgreens Pharmacy has made another pharmacy error, the second in six months, by erroneously filling an 18-month old child’s acetaminophen elixir medication, similar to Tylenol, with an acetaminophen product containing codeine, a powerful pain reliever.

After unknowingly giving her child a pharmacy misfill for a week, Jannette Jackson reportedly became alarmed when her daughter seemed groggy and tired and was not improving with the medication.

Jackson then discovered the pharmacy error and confronted Walgreens, who admitted the prescription mistake. Jackson claims that her pediatrician was shocked to hear of the error, and stated that luckily the codeine dosage was not lethal, and did not cause any allergic reaction or personal injury to the child.

In the previous medication error six months ago by same Walgreens Pharmacy, that our attorneys reported on in a related Baltimore prescription error blog, a two-year-old boy was prescribed a hydrocortisone prescription to treat his allergies. The pharmacy mistakenly gave the child an incorrect prescription for 10mg of oxycodone, a powerful pain medication that had been filled for another patient. The two-year-old child was reportedly given one of the Oxycodone pills, upon which the pharmacy error was discovered and the child was rushed to the hospital.

Study Finds Frequency of Pain Relieving Medication Errors in Hospitals

February 9, 2011 | Lebowitz & Mzhen

According to a recent study in The Journal of Pain, that our prescription error attorneys based in Rockland, Maryland have been following, medication errors involving pain relievers, or analgesics, including errors made in prescribing, are a substantial contributor to adverse patient events in pain therapy that are preventable.

The study was performed in a hospital facility with 631 beds, and found that the frequency of pain medication errors in hospitals to be 3 per 1,000 prescriptions.

Researchers at the Albany Medical Center in the state of New York reportedly found in previous research that a major number of prescription analgesic errors are preventable, occurring in all stages of the prescription medication usage process, with the primary cause being prescribing errors. The researchers then combed through a large database containing prescribing errors that had been previously prevented by pharmacists in order to pinpoint the main characteristics associated with an increased risk for medication errors.

The overall drug error rate in the study was found to be 2.87 errors per 1,000 orders with a drug prescribing error rate of .63 per 1000 that was potentially serious. Error rates with analgesics were reportedly found to be higher in pediatric orders, a topic discussed in our pharmacy error injury blog from last week.

Dangerous Safeway Pharmacy Mix-up Gives Pregnant Woman Wrong Medication

February 5, 2011 | Lebowitz & Mzhen

In recent news that our pharmacy misfill injury attorneys in Washington, D.C. have been following, a medication error occurred in a local pharmacy, after a pregnant woman in Colorado was mistakenly given the incorrect medication for another patient who had a similar sounding name.

According to KDVR-TV, Mareena Silva, who is six weeks pregnant, went to Safeway to pick up her antibiotics and was mistakenly given the prescription for Maria Silva, containing Methotrexate, a medication reportedly used to treat cancer.

By the time Silva realized the pharmacy misfill, she had already reportedly taken the first pill. Silva reportedly rushed back to Safeway, where the pharmacist recommended that she throw the pill up, as it had been 30 minutes since she took the medication. Her doctor then sent an ambulance to Safeway.

Methotrexate, the drug Silva took due to the prescription mix-up, can reportedly cause birth defects in an unborn baby. The drug is also reportedly used to cause abortions in pregnancies that are troubled. The manufacturer also warns that there have been reported deaths linked to the incorrect administration of this drug.

After picking up what she thought was the antibiotic, the pharmacist reportedly even stated that the prescribed drug was not good for a pregnant woman. What Silva didn’t realize at the time is that the pharmacist was talking about the Methotrexate.