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.

Liquid MedicineAccording 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.

Yellow PillsHowever, 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.

White PillsHowever, 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.

Various PillsIn 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.

Blue PillsRegardless 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.

Mixed PillsThe 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.

Medication SuppliesThe 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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Earlier this month, a federal appellate court issued an opinion upholding a lower court’s verdict in favor of a mother whose child was born with a cleft palate and lip. According to one news source covering the case, the young girl suffers from hearing loss and speech problems, and she has undergone approximately 14 surgeries to correct the condition. The plaintiffs claim that the girl has also been subject to teasing and bullying as a result of her appearance and speech.

White PillsThe case was brought against a subsidiary of a drug manufacturing giant, Johnson & Johnson, and it alleged that the company failed to warn doctors that pregnant patients may experience a heightened chance of birth defects if they take Topamax during the first trimester of pregnancy.

A Drug Manufacturer’s Duty to the Public

In general, manufacturers of over-the-counter and prescription drugs have a duty to warn people who may take a drug of any potential serious side effects. Of course, not every side effect of a medication is known at the time of manufacture, so only those potential complications that are known about must be disclosed. However, if a company fails to warn patients or prescribing physicians of potential dangers associated with the medication, the manufacturer may be held liable for injuries caused as a result.

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Almost everyone has been to the pharmacy to fill a prescription at some point in their life. In fact, many people routinely visit the pharmacy each month to get their regular prescriptions filled for maintenance medications. Some of these frequent pharmacy customers have many different prescriptions of which the pharmacist must keep track. And in the case of some HIV patients, the varying doses of the prescribed medication adds yet another element for pharmacy staff to handle.

Assorted PillsNo matter how complex a patient’s prescription order may be, pharmacists are required to take their time with each order, ensuring that it is properly filled and labeled. In the case of some patients with complex prescription orders, like those diagnosed with HIV, this may mean a significant amount of work for the pharmacist, including fielding constant updates from a patient’s care providers about the patient’s status and current prescription requirements. With this increased workload, unfortunately, comes an increased chance that an error will be made.

HIV Patients Are Especially at Risk for Medication Errors

According to a recent article by an industry news source, a study may have come up with a way that can decrease the likelihood of medication errors in HIV patients. As with other illnesses, the transitional time between care providers is the most dangerous time for HIV patients. The premise of the study was simple:  increase the amount of face-to-face contact the pharmacist has with the patient. Specifically, the pharmacist would be present at the patient’s admission to the hospital as well as each day for some defined period.

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When someone is admitted to the hospital, they generally have a dedicated team of doctors and nurses attending to their every need. Hospital staff is in charge of writing prescriptions, filling them, and then administering the medication to the patient. However, the transitional period following a patient’s discharge from the hospital is another matter, when patients are often left on their own to ensure that the care and medications they receive outside the hospital are congruent to those that are received while under the hospital’s care.

Pills in HandThe transition period between hospital care and outpatient care is a critical time during which medication errors often occur, according to one recent news article. In fact, this is seen as one of the most dangerous times for patients, who will likely be treated by a new team of doctors, nurses, and pharmacists.

The Sad Story of One Patient’s Experience with Hospital Discharge

Mrs. Oyler was admitted to the hospital after she was experiencing congestive heart failure. She was treated at the hospital, where she was prescribed eight new prescriptions. Upon her discharge from the hospital, the pharmacist overseeing the transition failed to accurately document all eight of the new prescriptions, leaving one off the list. The medication was called “metolazone.”

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