Articles Posted in Pharmacy Errors in the News

It is estimated that Maryland medication errors are responsible for up to a third of all preventable deaths in the state. Thus, encouraging safer prescription practices is a paramount concern among lawmakers. According to a recent news report, there is currently ongoing debate on whether imposing criminal sanctions against medical professionals who were found to be negligent would decrease the total number of errors.

Earlier this year, we covered a tragic case involving the death of a hospital patient after he was administered the wrong medication by an attending nurse. The nurse is alleged to have disregarded hospital protocol and overlooked several errors, ultimately resulting in the patient’s death. Although the state health department decided not to revoke the nurse’s license, the local prosecuting authority recently filed reckless homicide charges against her, claiming that her conduct was criminal. If convicted, the nurse could face years in prison.

The local prosecuting authority’s decision to pursue criminal charges against the nurse has triggered a discussion regarding the possible effects that imposing criminal liability against negligent nurses or pharmacists could have on Maryland pharmacy error rates. On the one hand, patient advocates argue that more accountability would increase the amount of care that nurses and pharmacists would provide to each patient. Because the leading cause of pharmacy errors is distraction or inattention, in theory, this would decrease the number of pharmacy errors.

Recently, the Institute for Safe Medication Practices (ISMP) issued a report asking that Maryland pharmacists, as well as pharmacists across the country, take additional precautions in the wake of a fatal 2017 pharmacy error. The ISMP is a nonprofit organization dedicated to reducing the number of pharmacy errors across the United States. In furtherance of that goal, the ISMP operates a voluntary error-reporting system. The ISMP then uses this data to work with pharmaceutical companies to eliminate the root causes of common errors such as similarly named drugs, confusing packaging, and dangerous device design.

The Error

According to the ISMP report, a patient was admitted into the ICU with a headache and vision loss. An MRI was conducted, and it was determined that the patient had a hematoma of the brain. The patient was transferred, and a full-body scan was ordered. While the radiologist was explaining the procedure to the patient, the patient indicated she had claustrophobia. The radiologist requested the patient be given a dose of Versed to help with her claustrophobia.

Evidently, the patient’s primary nurse requested that a radiology nurse provide the patient with the medication. The radiology nurse declined, stating that the patient would need to be monitored after administration of the drug. The primary nurse indicated she would send another nurse to the radiology department to monitor the patient after she was given the medication.

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Pharmacy errors can be the result of any number of failures in the medication delivery system. More often than not, however, Maryland pharmacy errors are the result of human error. One of the most commonly cited causes of prescription drug errors is when a pharmacist provides a patient with a medication that has a similar name to the medication the patient was prescribed. In the pharmacy industry, these medications are referred to as look-alike sound-alike (LASA) drugs

According to the Food and Drug Administration, LASA medications are involved in about 41% of all fatal pharmacy errors. An example of two medications that are commonly mixed up and have been placed on the list of LASA medications are Aricept (a drug designed for Alzheimer’s disease), Azilect (an anti-depressant used to treat Parkinson’s disease), and Aciphex (a prescription used to treat acid reflux and stomach ulcers).

Of course, pharmacists have a duty to ensure that they are providing their patients with the correct medication in the right dose. Needless to say, when a pharmacist fails to fulfill that duty, a patient can be exposed to serious risks. In many cases, the symptoms of a pharmacy error are immediately evident; however, that it is not always the case. In some situations, it may take days, months, or even years to discover the extent of the harm caused by an error.

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Each year, it is estimated that there are approximately 700,000 medication errors resulting in over 100,000 patient hospitalizations. The pharmacy industry realizes that this is a major problem, and for decades has been taking steps to reduce the rate of prescription errors among retail and hospital pharmacists. Most recently, a representative from the Institute for Safe Medication Practices (ISMP) gave a lecture discussing common types of pharmacy errors and what pharmacists can and should do to guard against them.

Medication errors occur due to a breakdown somewhere along the line; from when a physician writes a prescription to when the pharmacist provides it to the patient. According to a recent industry news report detailing the speaker’s comments, she claimed that pharmacy errors occur throughout various points in the process, and pharmacists should take precautions every step of the way.

The ISMP representative discussed that there are several situations in which an error was more likely to occur. For example, when a pharmacist is dealing with drug shortages, vaccines, improperly or unlabeled medication, and insufficient drug allergy alerts, the rate of error was highest. The pharmacist detailed three of the most alarming prescription errors that she was made aware of over the past year, including:

  • A patient who was prescribed 25 mg of hydralazine rather than the prescribed medication, hydroxyzine;
  • A child-patient who developed Parkinson-like symptoms after being provided with an improperly diluted dose of risperidone; and
  • An elderly Alzheimer’s patient who was given both a 5mg and 10 mg dose of donepezil at the same time rather than the prescribed 5mg dose for four weeks to be followed by the 10mg dose afterward.

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Over the past decade, the U.S. has seen a dramatic increase in the number of deaths as a result of opioid use and abuse. Indeed, according to the most recent government statistics, over 35,000 people die each year as a result of opioid overdoses. Roughly half of these deaths are caused by prescription painkillers. These figures represent a nearly three-times increase over previous years.

The recent rash of opioid deaths has called into question the medical profession’s reliance on these drugs to treat pain. Notwithstanding the well-understood dangers of opioid use and abuse, opioid painkillers are still prescribed in record numbers each year. Not surprisingly, given the number of prescriptions filled each year, there are a significant number of pharmacy errors involving opioids.

Regardless of the type of medication involved, pharmacists have a duty to ensure that a patient’s prescription is filled accurately. This means not only making sure that the correct drug is provided to the patient, but also providing the proper dose and instructions. When pharmacists make an error involving a drug as dangerous as an opioid painkiller, there is a high likelihood that the patient could accidentally overdose.

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Medical professionals, such as doctors, nurses, and pharmacists, are human, and as a result, it is expected that they will, on occasion, make mistakes. This does not mean that they are bad people or have a malicious intent behind their actions; the vast majority of medical errors are results of a system that places too heavy a burden on medical professionals.

Putting aside the lack of intent to cause harm, the reality is that Maryland pharmacy errors do cause a significant number of patients to suffer serious injuries each year. According to a recent study by Johns Hopkins University, there are over 250,000 pharmacy errors each year. However, according to a recent news report discussing the new study, the actual rate of pharmacy errors may be much higher than originally thought.

The reason for the potential disparity, the article claims, is the manner in which physicians, funeral directors, coroners, and medical examiners fill out death certificates. Evidently, it is common practice to use broad categories when referring to someone’s cause of death. This, in effect, groups preventable medical errors that were results of human or computer errors in with other non-preventable causes of death. As a result, the reported instances of preventable pharmacy errors are difficult to determine.

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When a pharmacist gives a patient the wrong medication, or the incorrect dose of the proper medication, the patient can be put in great danger. The range of medical issues that can result from a Maryland pharmacy error is broad, but the most common problems that arise after a pharmacy error are adverse reactions and overdoses.

Many prescription medications are controlled for the very reason that they interact negatively with a large number of other medications – both prescription and over-the-counter. Other medications are controlled due to the fact that they require a very precise dosage to be effective. If these medications are provided in excess strength, the patient may suffer an overdose that can potentially be fatal.

Of course, pharmacists are responsible to correctly fill patients’ prescriptions. And while pharmacists cannot normally be held criminally liable for their errors, injured patients and their families may be able to pursue a claim for financial compensation from the pharmacist as well as their employer. These pharmacy error lawsuits, however, can be complex due to the scientific issues that arise when attempting to prove that a pharmacist’s error was the cause of the patient’s injuries.

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When a pharmacist provides a patient with the wrong medication, and the patient suffers harm as a result of the pharmacist’s error, the patient may be entitled to monetary compensation though a Maryland pharmacy error lawsuit. However, while these cases seem to present straightforward and easily identifiable issues, in practice, pharmacy error cases can be extremely complex. Most often, these complexities arise when attempting to establish causation.

Some pharmacy error cases, however, are straightforward, and liability is more easily established. When this is the case, it is more likely that the defendant pharmacy will opt to settle the case out of court rather than take the case to trial.

Regardless of the specific facts at issue, pre-trial settlements can help both sides in a Maryland personal injury case. For one, settlement agreements allow for each side to know exactly what the outcome of the case will be without the uncertainty of having a trial. This allows for pharmacies to more accurately gauge what their liabilities will be and allows for the victims to have a firm grasp on how much compensation they will receive for their injuries. In addition, pre-trial settlements can result in the efficient resolution of a case, often saving months, if not years. For these reasons, among others, it is estimated that approximately 95% of all civil cases result in the parties settling the case out of court.

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Tens of thousands of patients are provided the wrong medication, wrong dose, or wrong instructions in their prescriptions each year. These Maryland pharmacy errors can range in seriousness. On one end of the spectrum are the errors that are caught by the patient before any medication is ingested. While these errors present no risk of injury, they are still alarming.

More serious prescription errors are those that result in serious injuries or death. While there are tens of thousands of documented errors each year, approximately 7,000 of these errors are fatal. Over the past decade, the pharmacy industry has been the focus of many studies looking at how to decrease the cases of serious and fatal errors. A recent report discusses five of the most common recommendations for pharmacists to take that will decrease their error rates.

Provide enough pharmacists – One of the leading causes of pharmacy errors is that the pharmacist filling the prescription is overworked. By ensuring that there are enough pharmacist staff members on duty, pharmacies are able to keep workloads manageable and provide much-needed breaks to pharmacists.

Pharmacists are responsible for ensuring that the prescriptions they fill are correct. Of course, this means that pharmacists must take care to provide patients with the correct medication, at the correct dose, and with the appropriate dosing instructions. To be sure, most medication errors involve an oversight involving one of these issues. However, according to a recent news article, a pharmacist in New Zealand recently provided one patient with a three-month supply of medication that was just one month away from being expired.

Evidently, a patient went to the pharmacy to fill a prescription of Ferrograd. When the pharmacist provided the patient with the requested three-month supply, the pills provided to the patient were to expire in one month. A few months later, the patient went back to refill another prescription. This time, the pharmacist gave the patient the wrong drug entirely. At this time, the patient double-checked her Ferrograd prescription and realized it was expired. She returned the prescription for a replacement.

The supervisory board found that the pharmacist failed to fulfill the duty that was owed to the patient, and it implemented an investigation into the pharmacy’s practices. The pharmacy explained that whoever dispensed the prescription wrote down the incorrect drug name and retrieved the incorrect pills from a similar-looking bottle. The pharmacist ended up acknowledging her mistake and providing the patient with a written apology.

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