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When most people think of pharmacy errors, they think of a busy pharmacist behind the counter at a grocery store or retail pharmacy. However, pharmacy errors occur in all shapes and sizes and at all locations, including errors in medications that are administered in the hospital by medical professionals. Many of these errors include injectable medications that are given to the patient through an IV.

Of course, the ultimate burden of ensuring that a medication is safely administered to the patient lies with the pharmacist and, in cases of inpatient care, also with the nurse or doctor administering the medication to the patient. Whenever a patient is given the wrong medication or even the wrong dose of the correct medication, that patient may suffer a serious adverse reaction, potentially resulting in serious injuries or even death. In these circumstances, the patient or their family may be entitled to monetary compensation through a personal injury lawsuit. This is among the reasons that pharmaceutical companies take the possibility of errors involving their medication very seriously.

Pharmaceutical Company Develops System to Reduce Error Rates among Injectable Medications

It is estimated that the total number of errors involving injectable medications is roughly 1.2 million per year, making these errors not as uncommon as most people think. The cost of injectable medication errors reaches into the $5 billion range, and this figure cannot accurately take into account the pain and suffering of the patients and families involved. Because of the severity and frequency of these errors, one pharmaceutical company developed a specialized system to help combat injectable medication errors at hospitals across the country.

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It should come as no surprise that pharmacists are busy professionals. Often filling thousands of prescriptions a week for hundreds of clients, keeping everything straight can be a difficult task. However, it is one that pharmacists take on willingly. It is also a task that they are legally obligated to complete accurately. In other words, when a pharmacist makes a mistake with a patient’s medication, the pharmacist who filled the prescription, as well as the pharmacy that employs the pharmacist, may be held financially liable for any injuries as a result of the error.

The causes of medication error are not generally a lazy or uncaring pharmacist. In fact, according to a recent study, the causes of many pharmacy errors are that there are too many prescription drugs with similar names. According to one news report covering the new study, look-alike and sound-alike drug names are a real problem in the pharmaceutical industry.

The Study

The study took a group of pharmacists, nurses, doctors, technicians, and lay people, and it attempted to determine if mix-ups occurring in the labs (before a drug is released to the pharmacy) can be predictive of future errors that may occur in real life. The results of the study were not surprising in that similar-looking or similar-sounding drug names will result in an increase in error rates.

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Prescription drugs are controlled by the government for a reason. Often, prescription drugs are dangerous if they are taken in conjunction with other medications, can more easily lead to an inadvertent overdose, and may easily lead to abuse because of their addictive qualities. Over the past few years, the court system has seen a number of lawsuits brought against various manufacturers and distributors of addictive prescription pain killers, claiming that the manufacturer or distributor too loosely controls the dangerous medication. In the most recent case of this type, a court held that the insurance company that covered a prescription drug distributor was required to defend against a case filed against the distributor, alleging that the distributor was negligent in continuing to provide large amounts of prescription medication to local pharmacies.

The Facts of the Case

The State of West Virginia has long been suffering from an epidemic of prescription drug abuse. The government of West Virginia filed a lawsuit against a drug distributor, claiming that the distributor was continually providing dangerous medication to “pill mills” across the state. A “pill mill” is a pejorative term used to refer to a pharmacy where loose regulation of prescription drugs results in many drug-addicted patients filling fraudulently obtained prescriptions.

The drug distributor had an insurance policy through Cincinnati Insurance Company. When the distributor got notice of the lawsuit, it asked the insurance company to help defend against the suit, based on the contractual obligations in the policy. Specifically, the insurance company was obligated to cover any lawsuit arising from a “bodily injury” caused by the distributor. However, the insurance company refused to defend the lawsuit, claiming that the compensation sought was for West Virginia, rather than anyone who suffered a true bodily injury. The court declined to make this distinction and found that the case was based on a claim of bodily injury. Thus, the insurance company will be required to assist the drug distributor in defending the lawsuit brought by the State of West Virginia.

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As you may recall reading on this blog a few weeks ago, back in early June of this year, an eight-year-old Colorado boy passed away after he was given 1,000 times the correct dose of his medication. The news of this tragic accident shocked the nation, and reporters have been following up on the story to bring a more complete version of what actually happened to light.

According to one local news report that recently provided an update on the tragic accident, the boy had suffered from the symptoms of ADHD for nearly a year before his parents decided that medicating their son was the best option. Aware of the potentially harmful effects of the medication, the boy’s parents were hesitant to provide their son with such a powerful medication. However, his worsening symptoms and inability to deal with them necessitated the medication.

He was originally prescribed Clonidine, which is used to treat both ADHD and high blood pressure, in the form of a pill. Since he was so young, the doctor prescribed him one-quarter of a pill at first. That was then stepped up to a third of a pill. His parents would have to cut the pills into thirds, but this was difficult because the pills would often turn to powder. The boy’s parents found a solution in that they had a specialty pharmacy make a liquid compound so that their son could ingest the proper amount of medication in a less cumbersome, more accurate manner.

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Pharmacists are human, and humans make mistakes. Whether it be because the pharmacist has such a large work-load that individual patients get lost in the mix, or because the pharmacist has other things on their mind, serious and potentially fatal pharmacy errors are a reality that patients must face. While many of these errors can be caught by the patient, a pharmacy technician, or even a nurse, there continue to be tens of thousands of reported pharmacy errors each year across the United States.

However, according to a recent industry news article, it appears that the incidents of reported errors may be grossly underestimating the true number of mistakes made by pharmacists each year. The article notes that figures from 2013 indicate that there were between 210,000 and 440,000 pharmacy errors committed across the United States. This figure was up from an estimated 110,000 errors in 1999.

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A pharmacy’s duty to the patient generally involves ensuring that the provided medication is in accordance with what the patient’s doctor intended the patient to receive. This means taking care to be sure that the proper medication is provided to the patient in the correct dose, with the appropriate instructions. An error in any one of these areas can result in serious or fatal repercussions to the pharmacy customer.

However, a pharmacy also has a duty to the general public to obey the laws and regulations of the pharmacy industry. This includes filling only legitimate prescriptions filled out by bona fide physicians. This is especially essential in instances regarding highly sought after narcotic pain medication that is unfortunately abused by much of the population. When a pharmacy fails to live up to the expectations placed upon it by the legal system or by society in general, there are often hefty financial consequences. That is exactly what happened when CVS Pharmacy was discovered to have filled dozens of fraudulent prescriptions across several stores in the Boston area.

CVS Fills Fake Prescriptions for Painkillers

Prescription painkillers are some of the most abused prescription drugs on the market. Indeed, some hard-core drug users prefer prescription painkillers to street drugs because of the “clean” high that they provide. And, unfortunately, some people will go to incredible lengths to feed their addiction, including creating fake prescriptions.

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Pharmacy errors are an unfortunately common phenomenon across the United States. Most often, these errors stem from a single problem:  a lack of oversight. Often, serious pharmacy errors occur due to a busy pharmacist or pharmacist technician filling an order in haste, rather than taking the proper amount of time and double-checking their work. Ultimately, the responsibility for these errors falls not only on the pharmacist technician making the mistake but also on management in charge of supervising that pharmacist’s work.

In fact, the responsibility for a serious or fatal pharmacy error may lie with several parties. Depending on the specific facts involved in each case, liability may lie with the pharmacist, the management of the pharmacy, and potentially even with other supervising organizations. A recent article discussing a situation in Canada gives an example not often seen here in the United States, but one that could possibly arise.

First Nation Leaders Concerned over Dozens of Deaths Tied to Pharmacy Errors

Over two dozen First Nation citizens in Canada have died at least in part due to pharmacy errors that have occurred over the past 10 months. According to a local news source covering the deaths, all First Nation people in Canada have a specific company that oversees all their prescription drug needs. This company has a contract with the Canadian government.

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Pharmacy errors are fairly commonplace, but they range in severity and cause. While most serious pharmacy errors are the result of a pharmacist providing a patient with the wrong medication, there are a good number of errors that are the result of a patient receiving the correct medication but the wrong dose. These errors are especially dangerous to children, who are often prescribed minute amounts of a medication due to their small size and low tolerance of serious medications.

Regardless of the reason for an error or the type of error, pharmacists are ultimately responsible for the medications they provide to their patients. While a pharmacist may not be found to be liable if the doctor fills out the wrong prescription, when a pharmacist receives a correct prescription but improperly fills it, liability may arise. This is even the case if the pharmacist was well-intentioned at the time of the mistake.

Recent Pharmacy Error Claims Eight-Year-Old Boy’s Life

Earlier this month in Colorado, a young boy died after ingesting 1,000 times the prescribed dose of his ADHD medication, Clonidine. According to a recent news article reporting on the tragic accident, the young boy was initially given the extreme dose back around Halloween of last year. He was hospitalized for a short time and then released. It seemed as though he was doing fine, but then his condition started to worsen again. He died a short time after he was admitted to the hospital.

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It’s no secret that pharmacists are prone to making mistakes. It’s nothing against pharmacists themselves, but merely the fact that they are human, and humans make mistakes. In fact, it is estimated that each year there are between two and three million prescription errors occurring in pharmacies across the nation. Most of these errors are caught before the patient ingests the medication, and many of those that are not caught do not result in serious life-threatening consequences. However, approximately 7,000 deaths each year are caused by pharmacy errors.

The causes of pharmacy errors are several. Most commonly, pharmacy errors are the result of overworked and overburdened pharmacists. Pharmacies, like other businesses, operate for a profit. The higher the cost of labor, the less there is left at the end of the day in profit. Thus, pharmacy management tries to staff just enough technicians and pharmacists to get the job done. However, often an unexpected demand arises, and pharmacists are put in a position where they need to fill this increased demand. This results in less time per patient and an increase in the likelihood that a pharmacist will make a mistake.

Could Pharmacists Be Replaced by Machines?

A recent article listing the top nine jobs that could be replaced by robots placed pharmacists at the top of the list. (The remaining eight professions were cab drivers, debt collectors, bank tellers, writers, astronauts, waiters and waitresses, rescue workers, and housekeepers). Regarding pharmacists, the article cited a 2011 study conducted by the University of California, San Francisco Medical Center, in which two hospitals implemented a completely automated, robot-controlled pharmacy. The results of the study were fascinating, in that not one error was reported in the 350,000 prescription orders that were filled.

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As business practices across the board evolve, so does the pharmacy industry. And with brick-and-mortar pharmacies requiring high month-to-month operating costs, mail-order pharmacies are becoming more common as a way for some patients to save money on their costly prescriptions. With the increase in popularity of mail-order pharmacies, more and more people are getting experience dealing with these companies, which do not present any opportunity for face-to-face interaction.

The truth of the matter is that pharmacies – regardless of where they are based – have a duty to their patients to accurately fill all prescriptions. And if a mail-order pharmacy can save customers money on prescriptions by not needing to pay real-estate or rental costs, that is fine, but pharmacies should not cut corners when it comes to staffing or customer service. However, that is exactly what one woman experienced when trying to secure her husband’s necessary daily medications from one mail-order pharmacy.

According to a recent article by Forbes, customer service at some mail-order pharmacies may be so poor that it puts patients in danger of running out of necessary medication. The article details the plight of a woman whose husband had recently been diagnosed with Parkinson’s Disease. Aside from dealing with the life-changing realizations the diagnosis brought, the couple also had to find a way to ensure a steady supply of the husband’s extremely expensive day-to-day medications.

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