Pharmacy Error Injury Lawyer Blog

Earlier this month in New Zealand, a pharmacist was reprimanded by the governing professional board after it was discovered that he made an error in providing a patient with the wrong medication and then tried to cover up his mistake. According to one industry news source, the pharmacist accidentally provided an elderly patient with a chemotherapy drug rather than his prescribed immunosuppressant medication.

A standard orange prescription bottle full of yellow pills. The information on the label has been covered. A few pills sit outside the bottle, at its base.

Evidently, the elderly patient had recently undergone a kidney transplant and was prescribed an immunosuppressant as a part of his recovery. However, when the man went to fill the prescription, he was provided a chemotherapy drug instead. It was not until three weeks later that the man returned, asking the pharmacist why his pills had changed, that the pharmacist discovered that there may have been an error. He told the patient to stop taking the drug.

Upon investigating the error, the filling pharmacist discovered that he was the one who had filled the prescription. Once he realized that he had made the error, the pharmacist failed to report the error. The Deputy Health and Disability Commissioner, who oversees pharmacists, explained to reporters that the pharmacist should have provided the patient with counseling as well as reported the error. It was not until the pharmacy owner later discovered that the chemotherapy drug supply was depleted that management knew there had been an error. He then made the appropriate report.

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Earlier this month, the Food and Drug Administration (FDA) announced a warning regarding the confusing packaging on the intravenous antibacterial drug Avycaz. According to one industry news source, the announcement was made after there were several reports of errors made in the dosing of the drug to patients. Evidently, the strength of the medication that was listed on the outside of the carton or vial was difficult to decipher for pharmacy personnel.

pills-1523293The confusion apparently arose because of the way that the label listed which substances were actually contained inside each package. Avycaz contains two active ingredients, ceftazidime and avibactam. The previous labels list each separate ingredient and its amount next to the drug’s name. For example Avycaz 2g/.5g means that the drug contained 2g of ceftazidime and .5g of avibactam. The new label will be more descriptive, explaining that the package contains a total of 2.5g of medication, which consists of 2g of ceftazidime and .5g of avibactam.

The Reported Errors

According to the article, there had been three reported errors since the drug’s approval back in February of this year. Two of the errors occurred as the drug was being prepared by the pharmacist, while the third arose due to the confusion in the language on the drug’s packaging. The FDA reported that at least one patient received and ingested a higher-than-prescribed dose, but there had been no adverse effects reported.

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Earlier this month, a study was released in the American Journal of Health Systems Pharmacy that looked at error rates in hospital pharmacies. Specifically, the study considered the link between the number of incoming orders over the course of a given shift and the prescription error rate. Not surprisingly, the results of the study indicated that the busier the pharmacy, the more likely that there would be a pharmacy error made.

blue-pills-1329868The study took place in Houston, Texas, between July 1, 2011 and June 30, 2012. Over the course of the study, over 1.9 million prescriptions were filled by about 50 pharmacists. In total, there were 92 prescription errors recorded.

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Earlier this month, a prescription drug designed and marketed for the treatment of some kinds of cancer, including brain cancer, was recalled because a number of the bottles that contained the drug had faulty caps. According to one industry news report, the caps of approximately 1,100 bottles of the prescription drug, Temozolomide, have the potential to crack, nullifying the childproof nature of the cap.

medicine-1413970Evidently, the side effects of the medication are potentially severe, even for adults, and can include respiratory failure, terminated pregnancy, infertility, severe vomiting, and nausea. To ensure that the medication is not ingested by curious children, the U.S. government requires that potentially dangerous drugs like Temozolomide are packaged in childproof packaging. However, for an unknown reason, the caps on a significant number of these bottles were defective.

Specifically, the bottles that may be in danger of having cracked lids were sold between July 2013 and August 2015. The bottles at issue are the five- and 14-count brown bottles with black lettering. Merck, the manufacturer of the drug, has told patients to inspect the caps of their medication and to remove the bottles from the reach of children. In addition, Merck has suggested that all pharmacists who handle bottles of Temozolomide double check to ensure that the caps are in good condition. Of course, any bottle that does have a cracked lid should not be distributed to a patient.

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Earlier last month, the major pharmaceutical company GlaxoSmithKline was named as a defendant in a lawsuit brought by the parents of a child who was born with a birth defect after his mother took medication produced by the drug manufacturer during pregnancy. According to one national news source, the drug, called Zofran, was initially approved for treating nausea in cancer patients after they received chemotherapy. However, over the years, the drug started to be prescribed to pregnant women looking to lessen the effects of “morning sickness.”

drugs-1328529Evidently, the couple filed suit in federal court in Ohio. They allege that the manufacturer marketed the drug for “off label” use to pregnant women back in the 1990s. Shortly after this time, the company allegedly started to get complaints from mothers who took the drug during pregnancy. They were reporting that their babies were being born with heart defects and kidney malformations. In fact, subsequent research has shown that mothers who take Zofran have twice the chance of giving birth to a child with a severe birth defect.

This lawsuit is not unique. In fact, there have been several dozen similar lawsuits brought by parents of children who have been born with severe birth defects after their mothers took Zofran.

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Earlier this month in Auburn University’s Harrison School of Pharmacy, students and professors put on a mock trial, mimicking a real criminal law trial that alleged criminal negligence on the part of a pharmacist who signed off on an improperly diluted medication that was given to a young child. According to an article by Pharmacy Times, the mock trial is used by administrators to impart the real-world consequences that can result from a pharmacist’s mistake.

Tablets for a raising of immunity 2

The original case arose back in 2006, when a two-year-old girl died as a result of being provided her final chemotherapy session that was improperly diluted. Apparently, rather than having less than 1% salt, the solution contained 23% salt, which ended up being a toxic dose for the two-year-old child. While it was not a pharmacist who prepared the solution, the pharmacist on duty did check the work of the technician who did prepare the solution.

After the error, the girl’s father learned that there were several other problems that contributed to the fatal pharmacy error, including the fact that the pharmacy’s computers were down that day, the pharmacy was understaffed, and there was a backlog of physician orders waiting to be filled. In the real case, the pharmacist was found to be criminally negligent because she inspected and checked off on the work of the technician. She lost her license to practice as a result. The students at the Harrison School of Pharmacy came to the same conclusion, finding that under the facts provided, the pharmacist was acting negligently on the day in question.

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Earlier this month, two pharmacies in Saskatchewan, Canada, were fined a total of $43,000 after it was discovered that between the two pharmacies, they had misfilled roughly 20 prescriptions over the past few years. According to one local news source, regulators found several errors, including filling prescriptions for medication that was no longer prescribed, providing the wrong doses of a medication, providing pill packets with missing pills, improper labeling, and even two cases where a patient was given “mystery pills” that the pharmacist could not identify even after the error was pointed out.

pills-1-1419381Apparently, one of the pharmacy’s managers was cited for being an “absentee manager” because she was not present on a daily basis and allowed her name to be used in order for the pharmacy to keep open operations. That pharmacist was fined $8,500 and ordered not to practice in the province for two years. Additional failures were cited, including employing poorly trained assistants, not implementing a tracking system for errors and close calls, several lost or misplaced prescriptions, and failing to provide a pharmacist behind the counter during business hours. The combined effects of these errors resulted in at least 16 patients getting the wrong medication altogether.

In response to these allegations, the pharmacies told reporters that they were going through a time of high staff turnover and had to rely on temporary employees until they were able to hire permanent employees. A spokesperson for the pharmacies indicated that both pharmacies are fully staffed, and every prescription is double-checked by the pharmacist on duty.

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Picking up a prescription at the local pharmacy is something almost everyone has the occasion to do at some point in their life. In fact, many people pick up multiple prescriptions per month. Picking up a prescription that was provided or filled in error seems to many to be one of those situations that “couldn’t happen to me.” However, as a recent article points out, prescription errors are more common than most people think, and they can often have dire consequences if they are not caught immediately.

medicine-1255448Common Causes of Prescription Errors

The causes of prescription errors are several, but certain causes appear again and again in studies. The volume of prescriptions that pharmacists and pharmacist technicians must fill on a daily basis results in a high-stress environment where little time is left to double-check one’s work.

A rushed pharmacist is likely working to fill several customers’ orders at a time and may cut corners to save time. However, that type of behavior can increase the risk of providing an incorrect medication to a patient, such as either of the following examples:

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Earlier last month, an Oregon woman filed a lawsuit against the national supermarket chain Fred Meyer, alleging that an error made in one of the chain’s pharmacies greatly decreased her chances of becoming pregnant. According to a local Oregon news report, the woman is seeking damages in the amount of $680,000 against Fred Meyer.

tablets-1484886Evidently, the woman was prescribed the fertility drug clomiphene. However, upon taking the prescription to get filled at the Fred Meyer pharmacy, the woman was provided with a similarly spelled medication instead. Upon taking just a single dose of the medication, the woman began suffering what she explain as “severe bodily injuries,” including “severe pain, shock to her nervous system, sleeplessness, fear, nervousness, nausea, balance issues, altered consciousness,” and a number of other problems. As a result, she had to stop taking the fertility medication that she was prescribed.

In a lawsuit filed by the woman against Fred Meyer, she claims that by providing her with the wrong medication, the Fred Meyer pharmacy greatly decreased her chances of ever becoming pregnant. The lawsuit was just filed in court during the past month, so a final result is not expected for some time.

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Earlier this month in the English county of Kent, a mother of a five-year-old boy discovered that the pharmacist had included a bottle of what was later determined to be methadone. The bottle had a label on it indicating that it was supposed to have been provided to another patient. Thankfully, the mother discarded any of the medication that was in the bottle, and her son was not provided any of the dangerous opioid.

medicine-1325116According to one English news source, the woman went to her local pharmacy to pick up her son’s prescription for his acid reflux medication. When she got home, she noticed that there were two bottles in the bag. One was her son’s usual medication and the other a bottle indicating that it contained 70 milliliters of methadone, a dangerous opioid drug used as an alternative to morphine and also to treat heroin addiction.

When the pharmacy was made aware of the mistake, their initial response was that the bottle was empty, so it created no actual health risk. However, the mother told reporters that the bottle was indeed full of a liquid that she dumped down the sink as a precautionary measure. The pharmacy issued the following statement following what they called a “highly unusual incident”:

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