Pharmacy Error Injury Lawyer Blog

Maryland Pharmacists Must Offer to Educate Patients on Medication Errors

January 15, 2009 | Lebowitz & Mzhen

We recently posted that pharmacists owe a duty of care to patients filling their prescriptions in Maryland pharmacies. Pharmacists owe a duty to accurately fill these prescriptions. Maryland law, however, increases the duty of care owed to Medicare pharmacy patients in the state by requiring pharmacists to offer to discuss issues pertaining to the prescription being filled. A Maryland pharmacist may be responsible for injuries that occur as a result of a failure to comply with this expanded duty of care.

In 1990, Congress passed legislation that increased the responsibilities of pharmacists with regard to Medicare recipients. The Omnibus Budget Reconciliation Act of 1990 (the “OBRA”) required pharmacists to offer to educate individuals receiving Medicare on the medications that they are taking. Under federal law, a pharmacist’s patient counseling must address a number of topics designed to reduce the chance of prescription errors. In the OBRA, Congress also suggested that individual states develop their own laws that require pharmacists to educate consumers about the risks of medication errors pose.

Maryland’s legislature passed laws that increase a pharmacist’s duty of care in the state that helps protect patients from prescription errors. Under Maryland law, a pharmacist must offer to discuss information pertaining to a Medicare recipient’s prescription. A Maryland pharmacist must offer this consultation through face to face communication, or by way of pamphlets included within the prescription’s packaging, signs posted throughout the pharmacy, or communication by telephone. The topics addressed during the consultation may include the following:
1. the name and description of the medication;
2. how to take the medication;
3. any special directions and precautions for preparation, administration and use by the patient;
4. common severe side effects or drug interactions;
5. techniques for the patient to monitor the drug’s effectiveness;
6. proper drug storage;
7. prescription refill information; and

8. actions to be taken in the event of a missed dose.

However, the law does not make these consultations mandatory, and a patient may waive his or her right to talk with their pharmacist. The medication error attorneys at Lebowitz & Mzhen Personal Injury Lawyers suggest that our readers take full advantage of the protections provided by Maryland law and consult with their pharmacists when receiving their prescriptions.

Related external source

Article discussing how the OBRA 1990 has affected pharmacists’ duty of care

Maryland law requiring pharmacists to educate patients

Maryland and D.C. Pharmacies Among Those Requesting Federal Aid

January 12, 2009 | Vadim A. Mzhen

In the past year Americans have watched the federal government bail out failing banks, and the lagging automobile industry. As the economic downturn progresses, the flow of government funds into the flagging commercial sector is likely to continue. The pharmacists’ lobby has added its name to a growing list of corporations seeking federal stimulus dollars. Recently, representatives from the American Pharmacists Association and similar organizations wrote a letter on behalf of America’s pharmacists to Congress. The letter sought federal stimulus money to help employ cutting edge health information technology (“Health IT”) in more pharmacies.

According to the U.S. Department of Health and Human Services, Health IT can help reduce medical errors, improve health care quality, and reduce health care costs. In an earlier post, we noted how the use of technology reduced the number of medication errors in cancer outpatient clinics. The attorneys at Lebowitz & Mzhen Personal Injury Lawyers recognize the important role technology will play in reducing the threat caused by prescription errors.

However, medication error attorneys believe that increased technology alone is not the solution to the widespread problem of prescription misfills. Lebowitz & Mzhen Personal Injury Lawyers urges Congress to, for example, require pharmacies to implement better training of their technicians, and to increase the number of pharmacists who staff busy pharmacies in order to reduce the number of prescriptions filled per pharmacist, per day. Additionally, Congress should better monitor and enforce the requirement that pharmacists review all prescriptions before they are dispensed.

Pharmacy Errors Harm Children More Than Adults, So Says the Joint Commission

January 9, 2009 | Jack D. Lebowitz

In preparing a recent case for an 8 year child and her parents, I came across an interesting report from The Joint Commission. (The Joint Commission is a private organization that works closely with the Federal Government to evaluate the quality of care being provided by hospitals.) The report indicated that experts within the medical community agree that children are at a higher risk of harm from prescription errors than adults.

The Joint Commission reported that pediatric medication errors occurred more often due to weight-based dosage calculations that are required when prescribing and administering medication to children, and the more frequent use of decimal points in prescriptions for children. The report went on to indicate that medication errors injure children more severely than if the same errors were made to an adult patient.

The Joint Commission gave four reasons why children are more prone to medication errors that result in serious injury:
1. Medications used for children are primarily designed and packaged for adults. Before medications are administered to children, the concentrations must be appropriately diluted according to the child’s weight. These solutions require a number of complicated calculations that significantly increase the possibility of error;
2. Many health care facilities are primarily designed to care for adults and lack personnel adequately trained in pediatric care. The study found that emergency rooms are particularly high-risk environments for children;
3. Young children are unable to physically tolerate medication errors due to under developed immune systems; and

4. Young children cannot communicate the side effects they suffer due to medication errors.

Medication Errors Common in Hospital Outpatient Cancer Clinics

January 7, 2009 | Vadim A. Mzhen

Recently, University of Massachusetts Medical School researchers concluded that medication errors are increasingly common at outpatient cancer clinics across the country. The report reviewed nearly 11,000 prescriptions dispensed at adult and pediatric oncology clinics nationwide. The research published in the Journal of Oncology, found medication errors in 18% of pediatric visits and 7% of adult visits.

The researchers also found that patients made dosage mistakes at home due to poor communication between doctors, pharmacists and the patients. The authors concluded that better communication between oncology clinics and pharmacists would prevent many prescription errors. One of the clinics reviewed in the study utilized an electronic record keeping system. Not surprisingly, the computerized system reduced the frequency of medication errors.

The medication error attorneys at Lebowitz & Mzhen Personal Injury Lawyers suggest that our readers always check with their nurses and physicians prior to receiving any intravenous medication to make sure that the correct drug and dosage are being supplied.

The Maryland Board of Pharmacy Accepts Complaint Forms When Pharmacy Errors Occur

January 2, 2009 | Jack D. Lebowitz

Maryland law does not require pharmacies to report medication errors. The Maryland Board of Pharmacy, the body that licenses pharmacists in the state, relies upon inspections and consumer complaints to assist in keeping drug stores and pharmacies operating safely.

The Maryland Board of Pharmacy provides a pharmacy error complaint form on its website. Once the Board receives a consumer complaint, a Disciplinary Committee initiates an investigation. If the Maryland Board of Pharmacy concludes that a pharmacy error has occurred, it may take several types of actions, including:

1. Letter of Education (informal, non-public discipline): This is a letter aimed at improving the pharmacist’s adherence to safety procedures in the pharmacy.
2. Letter of Admonishment (informal, non-public discipline): This letter is normally issued following the Board’s determination that a minor violation has occurred.

3. Formal Disciplinary Action: Formal discipline can result in fines, or more severe discipline, including suspension or revocation of a pharmacist’s license.

If you are the victim of a pharmacy misfill, or any other type of pharmacy error, please consider filing a complaint. Your involvement will assist in the process of making Maryland pharmacies safer.

Hospital Pharmacies Require Experienced Hospital Pharmacists

December 29, 2008 | Vadim A. Mzhen

The Federal District Court in Northern Ohio recently decided an employment law case that highlights the potential for frequent hospital pharmacy errors committed by inexperienced hospital pharmacists. In Colvin v. Veterans Administration Medical Center, the Federal District Court decided that a hospital properly dismissed an inexperienced hospital pharmacist for his repeated errors while dispensing medication to hospital patients.

In a lawsuit against Ohio’s Veterans Administration Medical Center (“VAMC”), Deon Colvin (“Colvin”) claimed that the hospital breached the parties’ contract when it fired Colvin in May, 2003. Colvin began working at the VAMC in June 2002, and after a seven week orientation period, began working in the hospital pharmacy on the midnight shift, where Colvin was the only pharmacist on duty.

In his complaint, Colvin stated that he was “ill prepared to work the night shift by himself because he had little experience working in a hospital environment where many of the practices, procedures and medicines were different from that which he was used to dispensing at a pharmacy in a retail environment.” During his first few weeks on the midnight shift, Colvin made three signification errors: first, he dispensed ten boxes of syringes of injectable morphine, where the physician’s order called for only ten syringes; second, he dispensed an insulin prescription without including important special instructions; and third, Colvin failed to find and correct a doctor’s error in an order for the blood-thinner, heparin

The Veterans Administration Hospital fired Colvin as a result of these medication errors, and Colvin subsequently filed suit in federal court. The Federal Court agreed with VAMC that Colvin’s errors constituted serious mistakes that justified his termination. The Court granted summary judgment in favor of VAMC, and it threw out Colvin’s lawsuit against the hospital.

While it is clear that the hospital needed to protect its patients by firing the negligent pharmacist, the Maryland medication error attorneys believe that the Veterans Administration Hospital was also negligent in hiring and placing an inexperienced hospital pharmacist alone in the pharmacy without the support and supervision of more senior pharmacists.

Maryland Hospital Pharmacy or Local Drugstore Errors: The Case to Be Made

December 26, 2008 | Lebowitz & Mzhen

Yesterday, a potential client called me concerning injuries that she sustained when a pharmacist employed by a Baltimore hospital had made a pharmacy error which resulted in her being given the wrong medication for an extended period of time. This middle aged woman explained that she received the wrong antibiotic which failed to control her infection. She explained that she was stuck in the hospital for many extra days as a result of the pharmacy error, and that she was unable to be with her family on Thanksgiving.

Before telling me the facts of this case, this potential client asked me a very appropriate question: “What do I need to show in order to win my case?”

Pharmacy misfill cases are tort cases, or cases brought pursuant to the negligence laws of the state of Maryland and the District of Columbia. There are four basic elements to every successful negligence case:

Duty: Hospital or drugstore pharmacists are professionals who must fill prescriptions in a reasonably competent manner. The pharmacist must fulfill his or her duties carefully, and with a close attention to detail.

Breach of Duty: A pharmacist’s failure to fill a prescription accurately (or provide competent advice). Carelessness, distractions or allowing a pharmacy technician to perform the activities properly reserved for the pharmacist are common causes for a breach of duty.

Causation: As a result of the carelessness of the pharmacist, the wrong medicine is given, and the customer or patient sustains injuries, harms, losses or damages.

Damage: Injuries, harms and losses, including a prolonged recovery from surgery, illness or sickness, death, disability and impairments that can be temporary or permanent, lost wages and additional medical bills, are all common forms of damages

Nationwide, Medication Errors Put Millions in Danger

December 22, 2008 | Jack D. Lebowitz

According to the National Coordinating Counsel for Medication Error Reporting and Prevention (NCC MERP), medication errors kill more Americans annually, than work place accidents. Maryland lawyers who pursue prescription error cases recognize the financial and human impact that errantly filled prescriptions have on the citizens of this state. Pharmacy negligence is one of the most pressing health concerns across the nation due to the sheer number of people affected by errantly filled prescriptions.

Some common types of medication errors include:

• Incomplete patient information (i.e. not knowing about patient’s allergies, other medicines they are taking, previous diagnoses, and lab results);

Maryland Patients Face Dangers Caused by Prescription Abbreviations

December 18, 2008 | Vadim A. Mzhen

It is clear that patients are put in danger by simple things such as penmanship and the use of inconsistent abbreviations. This must change. Maryland pharmacy negligence attorneys work with clients to hold negligent pharmacist responsible for the injuries that they cause across the state.

Your doctor hands you a prescription that you quickly take to your local pharmacy to fill. You look down at the unintelligible handwriting and find that it looks like a foreign language full of jumbled, incomprehensible abbreviations. Doctors, physician’s assistants, and other medical professionals often use abbreviations on prescriptions in order to save time. Too often, unfortunately, pharmacists misinterpret abbreviations used on prescriptions and, as a result, Maryland patients are put at risk of injury or death caused by improperly filled prescriptions. From January 2000 to August 2004, 498 health care facilities reported 19,000 medication errors caused by a pharmacist’s misinterpretation of another doctor’s short hand.

A pharmacist in Virginia misread a doctor’s abbreviation and dispensed two times the proper amount of heparin to a patient. As a result, the victim suffered a massive hemorrhage. The pharmacy ultimately settled the plaintiff’s case for $200,000.

Maryland Pharmacists Warn of Anticoagulation Medication Errors

December 16, 2008 | Jack D. Lebowitz

The Maryland Pharmacists Association Newsletter for November, 2008 reported that in the last seven years, in hospitals alone, anticoagulation medication errors occurred in 70,000 instances. In twenty-six of those instances, the patient died. The report goes on to state that “[h]eparin and warfarin are consistently ranked among the 10 most frequently reported drugs involved in errors.” (Warfarin is the generic name for the better known brand name drug, Coumadin.)

When I read this article, I was surprised and concerned that such a potent drug – a blood thinner – given in too high a dose can cause a deadly hemorrhage, and that given in too low a dose might fail to prevent the formations of blood clots that the drug is designed to prevent, is so regularly dispensed by hospitals improperly.

I am interested to learn the names of the other medications that are most commonly misfilled by hospital pharmacies. Are they pain medications, like oxycodone or morphine, insulin injectables that can provide treatment in a rapid onset or an intermediate duration, or antibiotics that combat specific infections?

A doctor in Baltimore once told me: “Hospitals are dangerous places.” Add hospital pharmacy errors to the list of dangers.