Pharmacy Error Injury Lawyer Blog

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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Over the last decade or so, the number of specialty pharmacies in the industry has greatly increased. According to one industry news report, this is due in part to the fact that drug manufacturers prefer to rely on a specialized pharmacy to assist patients with the administration and use of their drug than to rely on regular retail pharmacies. However, as the article notes, as more and more patients rely on these specialty mail-order pharmacies, the accuracy of these pharmacies becomes critical to patient health.

needle-syringe-1198924Most often, specialty pharmacies deal with very expensive medication. In many cases, this medication is provided to the patient in fairly small amounts in order to prevent what pharmacists call stockpiling, or refilling a prescription a few days early and saving the remaining doses. However, while stockpiling may be seen as a negative from the pharmacy’s and drug manufacturer’s point of view, it means that the accuracy of these pharmacies must be spot on, or else patients may miss a dose.

If a pharmacy only sends out enough medication to last a certain amount of time, and there is an error in the shipment, that may mean that a patient does not receive their required medication for several days. In some cases, this can result in serious health consequences. In fact, the article notes that it is not uncommon for a pharmacy to make an error in the quantity of medication that is sent to a patient, leaving them with less than the required amount for a given time period. Most often, a pharmacy will act quickly to remedy this error, but that doesn’t mean that the consequences can always be avoided.

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Back in 2006, Christopher Jerry lost his daughter when she died in a hospital after being provided an improperly dosed IV prepared by a hospital pharmacist. According to one recent news article, Jerry has since become an advocate to fix the errors he claims are inherent in the flawed system of pharmacies across the nation.

pills-2-1258724Evidently, back in 2006, Jerry’s daughter was diagnosed with a yolk sac tumor when she was about 18 months old. Her treatment was going well, and the cancer was nearly eradicated. However, during her final session of chemotherapy, she was given improperly dosed medication and passed away. On the day of the error, Jerry claims that the hospital pharmacy was under-staffed, the pharmacy’s computer wasn’t working, and there was a backlog of physicians’ orders waiting to be filled.

Since that day back in 2006, Jerry has collaborated with other advocates in the field to pass legislation in his home state of Ohio as well as several other states that requires a higher level of regulation for pharmacy technicians. At the time of his daughter’s death, anyone with a high school diploma or a GED could become a pharmacy technician and could end up dosing life-saving medication months later.

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When most people think of prescriptions, they think about their monthly trip to the pharmacy to pick up their medication. However, a large portion of the prescriptions written and filled each year in the United States originate and are delivered in hospitals. Each year, there are thousands of instances when a prescription is delivered in error to a patient at their bedside while in a hospital. For several years now, those involved in the health care industry have been searching for safer ways of delivering medication to patients.

pills-1153877-mAccording to a health care industry news source, some hospitals are implementing a new technology when delivering medication to their patients. The technology is called radio frequency identification (RFID), and it is what is used in drive-through toll booths that have become popular in recent years. The technology allows for a “proximity scan” to pick up information that is held in computer chips, called RFID chips. These RFID chips can hold all kinds of information, including a patient’s required prescriptions as well as their frequency and dose.

One of the hospital executives behind the push for the use of RFID chips explained to reporters that when humans are involved, there is always the potential for error. With the increasing use of technology, it is hoped that the instances of prescription drug errors will drop in the coming years.

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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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