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Plaintiffs have to be careful when it comes to filing a Maryland pharmacy error claim. A recent case shows how asserting the wrong claim in a case can result in the case’s dismissal.

In that case, the plaintiff brought a claim against a drug manufacturer for allegedly causing her husband’s death due to the manufacturer’s failure to provide a medication guide with her husband’s prescription. The manufacturer made a generic form of amiodarone hydrochloride, a drug used for certain life-threatening heartbeat irregularities. As a generic drug, it is required to have the same labeling as its approved brand-name counterpart. One of the labeling requirements is making medication guides available for distribution to each patient who is prescribed the drug. The medication guides explain the approved uses of the drug and also explain the drug’s side effects “in nontechnical, understandable language.” In amiodarone’s medication guide, it states that the drug should be used only to treat “life-threatening heartbeat problems.”The plaintiff’s husband died after taking amiodarone to treat his non-life threatening atrial fibrillation. The plaintiff alleged that her husband died because he had been taking amiodarone, which he had been prescribed. The manufacturer allegedly failed to provide the medication guide for distribution, which her husband did not receive when he filled his prescriptions in May and June 2015. The plaintiff claimed that her husband was not aware that only those with life-threatening heartbeat irregularities should take the drug, due to its serious side effects. She argued that the manufacturer failed to warn her husband by failing to provide the medication guide, as required under federal law.

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Recently, a state appellate court issued a very interesting and important opinion in a pharmacy error case discussing a pharmacist’s duty to inform a prescribing physician when a patient attempts to fill a prescription that required pre-authorization from the patient’s insurance company. Ultimately, the court held that pharmacies have a limited duty to notify both the patient as well as the prescribing physician each time a patient attempts to fill a prescription requiring pre-authorization.

The Facts of the Case

When the plaintiff was 18 years old, she suffered her first seizure. She was taken to the hospital and given a dose of Topamax, an antiepileptic medication. After discharge, the plaintiff saw a neurologist who recommended she continue taking Topamax and wrote her a prescription.

The plaintiff filled the prescription without incident until her 19th birthday. However, when she went to fill the prescription after turning 19, the pharmacist informed her that her insurance company required pre-authorization for Topamax prescriptions for patients over 18 years of age. The pharmacist told the plaintiff that they would follow up with her physician in order to obtain the required pre-authorization. Although not required to do so by law, the pharmacy routinely sent a fax to prescribing physicians offices when a patient tried to fill a medication that required a pre-authorization.

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Pharmacists are highly trained medical professionals, much like doctors or nurses. And under the United States’ medical system, pharmacists have a very important role to play in providing medical care to patients. Indeed, patients not only rely on pharmacists to be accurate, but also to be diligent in looking out for potential adverse drug interactions that a physician may have missed.

Like other medical professionals, pharmacists have a duty to those whom they serve. While the nuances of a pharmacist’s duty to her patients is exceedingly complex; at its most basic level it requires pharmacists to accurately fill all patient prescriptions and provide meaningful medication consultations when requested or required. However, each year there are thousands of medication errors, many of which result in serious harm to the patient.

The duty pharmacists owe to their patients evolves over time as scientific research uncovers new best practices and technology developments allow for more accurate record-keeping and prescription dispensing. According to a recent industry news source, all pharmacists should be taking the following steps to avoid making preventable errors:

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Earlier this month, the Food and Drug Administration announced a voluntary recall of several lots of an increasingly popular drug that is designed to combat the effect of an opioid overdose. According to a recent news report discussing the voluntary recall, two specific lots of the drug Naloxone have been recalled based on the “potential presence of embedded and loose particulate matter on the syringe plunger.”

Hospira, the company that manufactures the drug, moved forward with the recall after it discovered that users may experience certain side effects if they inject the affected medication. These side effects include local irritation, an allergic reaction, inflammation of a vein, restriction of blood supply to healthy tissue, pulmonary embolism, and pulmonary infarction.

The FDA explains that users should be sure to check the medication before injecting it. Specifically, users should look for discoloration or particulate matter. The drug’s manufacturer explained that the recalled medication was provided to medical professionals and law enforcement. The company has stressed that none of the recalled lots were distributed to individual patients.

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Medical errors are all too common in hospitals throughout the country. In any Maryland medical error case, a plaintiff must show that the defendant was negligent in acting or failing to act in some way. There are four elements a plaintiff must prove in order to be successful in a medical negligence claim: a legal duty, a failure to perform that duty, causation, and damages.

Medical errors cases can be hard to prove in some cases because a plaintiff must show that the defendant’s actions or failure to act were the cause of the plaintiff’s injuries. This can be tricky, especially in medical error cases, because patients are often already sick and proving causation is not always clear-cut. Additionally, the issues involved in the case are often complex and involve scientific principles beyond the understanding of most people. For that reason, such cases often rely on the testimony of experts.

In some cases, an expert is needed simply to understand whether mistakes were made and who may be at fault. As one example, a recent study revealed the problem of accidental overdoses from a drug that has been used on cancer patients for many years.

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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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While a Maryland pharmacy error can result in serious and even fatal consequences for any patient, the very young are at an especially high risk. This is a frightening thought, considering that pharmacy errors are much more common than most people believe. Indeed, it is estimated that there are over 63,000 medication errors involving child patients each year. This amounts to one error approximately every eight minutes.

Researchers have noted that the most common type of medication error involving a child patient is when the prescribed medication is an analgesic or a cold/cough syrup. Commonly, these medications result in the pharmacist providing patients with a double-dose of the prescribed medication. That being said, it is not unheard of for a pharmacist to give a parent the wrong medication altogether.

When a pharmacist error results in patient harm, the injured patient may be able to pursue a claim for compensation through a Maryland pharmacy error lawsuit. While proving that an error was made is not necessarily difficult in many cases, establishing that the error resulted in a patient’s injuries can be challenging. For this reason, many pharmacy error cases require expert testimony to help prove causation.

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Shingles is a viral disease characterized by a skin rash consisting of painful blisters that usually appear in a strip across a person’s face or body. While the symptoms of Shingles will usually go away within a few weeks, some experience nerve pain that can last years.

The disease is caused by a reactivation of the varicella zoster virus (VZV), the initial exposure of which causes chicken pox. The reason why the VZV virus reactivates is not widely understood by the medical community, although it is understood to occur more in the elderly and those with a compromised immune system.

There have been several vaccines created to prevent Shingles. As of 2017, a new vaccine called Shingrix was approved for patients over 50 years of age and can prevent most cases of Shingles. Once Shingrix was approved for use, it later became the preferred vaccine according to the Center for Disease Control (CDC). Unfortunately, it has been involved in Maryland pharmacy errors and errors in other states.

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Recently, a state appellate court issued a written opinion in a personal injury case brought by the parents of an 18-year-old man who died of an illegal drug overdose while at the defendant’s residence. The case presents interesting issues that may arise in Maryland personal injury cases in that it illustrates the well-known dangers of illegal drugs as well as touches on the theory of premises liability as it pertains to drug use in a defendant’s home.

The Facts of the Case

The plaintiff was the surviving loved one of a young man who died of an illegal overdose of illegally obtained drugs. The evidence presented at trial showed that the victim met up with one of the tenants who lived in the defendant’s home, purchased ketamine and acid, and brought the drugs back to the defendant’s home.

The facts were somewhat disputed, but it was uncontested that several people, including the plaintiffs’ son, took the ketamine. Within minutes, the plaintiffs’ son began acting odd, and he was told to leave by the tenants. The young man was found dead later that day. The cause of death was determined to be an overdose of ketamine.

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While the exact number of Maryland pharmacy errors is disputed, the U.S. Food and Drug Administration offers a conservative estimate of approximately 7,000 deaths per year due to medication errors. Due to lenient reporting requirements in the pharmacy industry and the industry’s interest in keeping errors out of the mainstream news, experts believe that the true number of errors is much higher. Some reports suggest that upwards of 1.3 million people are harmed each year by prescription errors.

Prescription errors have a number of potential causes. However, like most mistakes, the most common cause is that the pharmacist filling the prescription overlooked something they shouldn’t have. Poor communication between health care professionals plays a role in many pharmacy errors. Along those lines, pharmacists will often misinterpret a physician’s abbreviations, either prescribing the wrong medication or the wrong dose. Mistakes are also commonly made involving drugs with similar-sounding names.

Each of these situations involves one common variable:  a negligent pharmacist. Undoubtedly, most of the pharmacists who are responsible for pharmacy errors are well-intentioned. However, given the everyday stress and steady workload, many pharmacists end up taking short cuts that can hurt their patients.

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