Pharmacy Error Injury Lawyer Blog

Earlier this week in Grand Rapids, Michigan, the owner of a pharmacy was sentenced to three years of probation, 200 hours of community service, and a $30,000 fine for his involvement in a drug repackaging scheme. According to one local Michigan news source, the man who was sentenced was not actually involved in the repackaging scheme, but under the law he was held responsible as the former owner and current registered pharmacist on location.

pills-1111307-mEvidently, the man who was just sentenced sold the pharmacy to another man, Mulder, back in 2008. Although Mulder was the new owner of the pharmacy chain, the defendant in the case stayed on as a registered pharmacist at one of the branches. Since the defendant self-financed the deal, Mulder was to pay the defendant a monthly payment, similar to a mortgage.

As time went on, Mulder had a difficult time paying the defendant back. The monthly payments were lowered, but he still couldn’t afford to pay them. Mulder then got the idea to repackage medication that was sent back from nursing homes and foster homes, although federal regulations required that these drugs be destroyed.

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Whenever a pharmacist is filling a prescription, if there is the potential that the medication they are providing to a patient may have an adverse interaction with another medication, should be taken with specific instructions, or is otherwise potentially dangerous, an alert will pop up on the pharmacist’s screen. However, given that most medications are dangerous under some circumstances, and pharmacists can fill hundreds of prescriptions a day, theses alerts tend to bog a busy pharmacist down.

pills-755991-mWhat is Alert Fatigue?

According to a recent industry report, alert fatigue occurs when a pharmacist is so accustomed to seeing an alert pop up that they almost automatically disregard the alert as unimportant. Reasons for dismissing the error vary, but the end result is the same. The patient ends up taking the prescription home and consuming it, leading to a potentially disastrous situation. As one can imagine, alert fatigue is the cause of a substantial number of pharmacy errors, since pharmacists are substituting their own on-the-fly judgment for the tried and true research of medical professionals.

What Can Be Done About Alert Fatigue?

Given that alert fatigue is a real problem in pharmacies across the United States, there has been a concerted effort by some in the industry to address the issue. One potential solution, according to the article discussed above, is the implementation of software that provides more accurate, more specific, and more targeted alerts. These new programs may also provide a “threat-level” for the pharmacists, so they are able to tell how serious an alert really is.

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Earlier this month, a local Canadian news source published an article about a hospital that admittedly provided substandard medical care to a patient but has since made serious efforts to provide better care. According to the report, the efforts were in response to the death of an 85-year-old patient who was being treated for a bowel obstruction.

injection-needle-macro-2-1285558-mEvidently, the attending nurse administered a prescribed narcotic intravenously rather than subcutaneously, as the physician had recommended. This resulted in the man contracting a case of pneumonia and passing away the following day. Initially, the medical examiner listed the man’s cause of death as “natural,” but as the examiner reviewed additional hospital documents the cause was changed to “accident.”

The man’s family was upset with the level of communication and respect they received after their loved one’s passing. Initially, family members felt as though the administration was “obstructing every attempt” to get information about their loved one. In fact, a professional investigation into the hospital’s chief of staff concluded that he was “evasive and vague” when it came to the incident.

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Over-the-counter and prescription medications are used by almost everyone to treat medical conditions from time to time. Often, these medications are powerful drugs that if used properly can have miraculous effects, curing or minimizing the symptoms or causes of a disease. However, they can also do great harm if abused or if taken with other medications.

pills-921107-mA recent study by the Center for Disease Control claimed that 28% of adults have two or more prescriptions during any given month. These prescription drugs—and even over-the-counter medications—can have nasty effects if taken together. Earlier last month, an online news source posted an article about some of the most dangerous, yet common, prescription and over-the-counter drug combinations that can result in serious negative long-term effects.

Drug Combinations To Avoid

The following is a list of medication combinations that should be avoided:

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Earlier this month, the FDA issued a prescription-drug watch surrounding the anti-bacterial drug, Zerbaxa. According to a recent report by Pharmacy Practice News, the FDA’s warning was based around the fact that the dosing information on the label of Zerbaxa cartons was confusing and not uniform with other prescription drugs, leading to the possibility of a pharmacist providing a patient with an incorrect dose of the medication. The report has caused the manufacturer of the drug to alter the drug’s label to make it more accurate and more easily read.

prescription-med-72201-mEvidently, Zerbaxa consists of two active ingredients, both of which are listed on the front of the drug’s carton. However, on the old label, the two active ingredients were listed separately, one after another. For example, on a package that contains a total of 1.5g medicine, the label read:  1g/.5g. This could give a pharmacist the idea that the amount of medicine in the carton was 1g and that it was equal parts of each active ingredient.

In fact, according to the FDA, there have been several pharmacy errors made involving this exact situation, seven since the drug’s approval back in December 2014. In four of these cases, the patient took the extra dose and suffered an injury. Thankfully, they suffered no serious harm as a result. In the three other cases, someone caught the error before the patient actually took the medication.

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Earlier this year, the Supreme Court of Texas affirmed the dismissal of a woman’s case after she failed to provide the requisite expert opinion supporting her claim within the required time period. In the case of Randol Mill Pharmacy v. Miller, the court determined that the a claim alleging negligence in a pharmacy’s compounding services qualifies as a “health care liability claim” and must therefore comply with the applicable rules governing those claims.drugs-ii-183492-m

The Facts of the Case

The plaintiff in the case was prescribed a special prescription by her doctor to treat her Hepatitis C. The prescription was not available in a mass-produced form, so a pharmacy had to create the medicine in a process called “compounding.” However, after a few weeks of taking the medication, the woman suffered a serious adverse reaction, resulting in several blood transfusions and ultimately ending in her losing sight in both of her eyes.

The woman filed suit against the pharmacy, alleging that the pharmacy “breached their implied warranties in the design, manufacture, inspection, marketing, and/or distribution.” She also filed suit against the doctor, but it was severed and tried separately.

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Earlier this month, a CBS news affiliate published an article discussing pharmacy errors broadly and also focusing in on the fact that Walgreen’s Pharmacy is currently facing several lawsuits based on the alleged negligence of their pharmacists. According to the report, just this year two serious pharmacy errors have occurred at Walgreen’s stores across the country.

pills-755992-mThe first was a five-year-old boy who was somehow provided with anti-psychotic medication rather than his normal allergy medicine. Not only was the provided medication the wrong one, but the dose was ten times stronger than that which should be used for a child his age and size. The boy took two doses of the unprescribed medicine before his parents noticed the mistake. His parents told reporters that “he couldn’t breathe, he couldn’t talk” after taking the two doses. His parents were later told by doctors that if they had given him one more dose they may have lost their son.

The second situation involved a 15-year-old girl who was allegedly given schizophrenia medication instead of simple antibiotics. After getting home and taking the medication, she experienced blurred vision and a racing heart. The girl’s mother told reporters that, as she stood by her daughter’s side that day, she was afraid she was going to lose her. Thankfully, both patients recovered from the medication errors.

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Medication errors are a serious problem in today’s health care world. In fact, it is estimated that there are over 65,000 medication errors that occur across the United States each year, many with disastrous consequences. According to one article published by Modern Healthcare, some are suggesting that the industry shift over to the metric system to decrease the chance of a medication error.

weight-scale-1186279-mThe argument suggests that requiring doctors and pharmacists to document a patient’s weight in pounds is counterproductive and dangerous, given the fact that most medications are dosed according to the kilogram-weight of the patient. In other words, the prescribing physician or filling pharmacist must make the calculations to change a patient’s weight from pounds into kilograms.

While this doesn’t sound all that difficult, in the hustle-and-bustle environment that many doctors and pharmacists find themselves in on a daily basis, anything that can decrease the chance of an error should be considered.

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Earlier this month, a local Virginia pharmacy was shut down by state regulators after myriad safety violations were discovered. According to one news source, not only was the pharmacy shut down and its ability to operate suspended, but the lead pharmacist’s license was suspended.

medikit-1444193-1-mEvidently, the pharmacy was the subject of two unannounced visits:  one in May 2014 and another in February 2015. After the second inspection, regulators called into question the pharmacy’s ability to “assure the quality, sterility, integrity, safety, and efficacy of drugs dispensed, along with its ability to safeguard against the diversion of drugs.”

According to the report, regulators discovered numerous issues during their inspections, including:

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When a person goes to their pharmacy to get a prescription filled, they hope that it is accurate. However, if there is a problem with the prescription—whether it be the dosage, the instructions, or the drug itself—the patient has an opportunity to review the prescription before ingesting the medication. However, this is not the case in the fast-paced environment of emergency rooms.

pharmacy-1-193922-mMedication errors in emergency rooms are frighteningly common and can carry with them devastating results. However, according to one recent article by the Pharmacy Times, a newly released study shows that there may be something that drug manufacturers can do to decrease medication errors in the surgical and emergency room settings.

Label Design and Its Effect on Error Rate

According to the new study cited in the article, several types of intravenous medications had their labels redesigned after having a team of pharmacists, anesthesiologists, and nurse anesthetists suggest changes that make the label more reader-friendly. The researchers then conducted a study using trainees where the trainee would have to select the requested medication in a fast-paced environment. Researchers used a control group that consisted of trainees using the old labels in order to compare the results.

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