Pharmacy Error Injury Lawyer Blog

Recently, my father attempted to relive his glory days on the football field with unfortunate results. While attempting to imitate some of the great wide receivers of his day, he ruptured his Achilles tendon and required surgery. I accompanied him to one of his follow up visits to his doctor’s office and was surprised to see the level of technology the doctor used when treating patients. In prior posts, Maryland medication error attorneys have extolled the virtues of computerized prescription programs, but I was still surprised to see how efficient those systems are when used in the day to day operation of a busy doctor’s office.

The doctor who treated my father asked him a series of questions about how the surgical site was healing, his pain, and any other prescriptions he was taking, and examined my father’s range of motion. The doctor entered all of that information into a computer terminal in the examination room and returned, within minutes, with a print out that contained my father’s prescription. Additionally, the doctor’s office electronically sent the prescription ahead to a local pharmacy.

Last month, Medicare and certain private health care plans began paying doctors bonuses for using similar E-prescription software. The private health care plans provide doctors with extra payments for services along with free equipment, such as PDA’s, if they use computerized prescription software. Medicare’s bonus amounts to 2% of charges billed to Medicare for 2009 and 2010. This translates into approximately $1,700 to $3,500 a year per doctor. As a result of the new incentives, the number of doctors using E-prescription programs has doubled over the past year and, nationwide, nearly 70,000 doctors use these programs.

Electronic prescription programs not only reduce the risk of medication errors, but they also help lower patients’ health care costs by suggesting low cost generic alternatives to expensive name brand medications. In a recent study, researchers at a hospital in Milwaukee, Wisconsin discovered that E-prescription software saved patients a substantial amount of money by allowing more doctors to prescribe safe generic prescriptions.

Additionally, by reducing the time a patient has to wait in a pharmacy to receive a prescription, E-prescription programs ensures that more Americans will fill the prescriptions their doctor’s prescribe. Fortunately, nearly all big box pharmacies and many independent pharmacies accept electronic prescriptions. This allows doctors, like my fathers, to forward prescriptions ahead of the patient and reduce the amount of time a sick or injured patient has to wait in a pharmacy waiting area.

Under the stimulus package, the government plans to invest $ 50 billion dollars over the next five years in technological advancements in health care. The Maryland medication error attorneys at Lebowitz & Mzhen, LLC will carefully watch these advancements as they arise in the future.

External Resource

Wall Street Journal article

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One of the sources of information that we read regularly is published by the Institute of Safe Medication Practices. Recently, the ISMP wrote about individuals who were using a dosage cap from one over the counter medication, to measure medication from another medication.

When the measuring cups were swapped as described above, the result was that the individual taking the medication received an overdose of medication. Just as a reminder, Maryland medication error attorneys at Lebowitz & Mzhen, LLC recommend that measuring cups stay with the produce that they are designed to measure so that easily avoidable, but potentially dangerous, errors are avoided.

As the parent of children in elementary school, I recently received a call from the school nurse who reported that one of my kids was sick. I was impressed with the professionalism and competence shown by the school nurse.

When I was in the nurse’s office, with children as young as age 5, I noticed how careful school nurses must be to make sure that these young children receive only the appropriate medicines. The nurses must make their decisions based upon their knowledge, training and experience, and must carefully consider the prior authorizations and advice given by the parents who might have anticipated school house illnesses of their children.

The Maryland State Department of Education has adopted policies regarding the role of school nurses as developed by the American Academy of Pediatrics (“AAP”).

In litigating Maryland pharmacy error cases, our pharmacy negligence attorneys have learned some interesting facts about different drugs, their effects, and the proper manner they are designed to be ingested. Drug manufacturers design medications with a specific method of patient ingestion in mind. Some drugs are designed to be administered through an IV, some are slow release medications that must be swallowed, and others are specifically designed to be chewed and released quickly into the patient’s blood stream.

Other methods of ingestion also exist, for example, some drugs must be taken in form of eye, ear, or nose drops. Still other medications are designed to be absorbed through a patient’s skin.

The varying methods of drug transmission can be daunting and many patients place too much confidence in their pharmacist or doctor and fail to ask questions so that they completely understand their dosage instructions. The Institute for Safe Medication Practices published the story of a woman who suffered from similar overconfidence and died as a result of a negligently prescribed medication. The story is a warning for others to make sure they understand their dosage instructions.

A doctor prescribed an 83 year old patient Cardizem to control her blood pressure. The patient chewed the pills since the pills were too large to swallow. As a result, the patient’s heart rate slowed to dangerous levels, and the woman’s family contacted her pharmacist for assistance. The pharmacist suggested that the physician prescribe a form of the same drug that came in chewable capsules.

Months later, the patient returned to her physician for a check up and the physician put her back on Cardizem without warning the patient not to chew the pills. The patient subsequently began to chew the pills, over time became weaker and died three weeks later.

This story reminds us of the need to carefully question our health care providers until we fully understand the dosage instructions that come along with our prescriptions. According to the patient’s family, she was a smart and alert woman, who just put too much faith in her providers’ instructions and failed to ask questions.

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Americans suffering from vision loss are at an increased risk for injuries caused by pharmacy errors. In a recent survey, the American Federation for the Blind (“AFB”) reports that nearly 20 million Americans suffer from some form of significant vision loss and many have suffered injuries due to their inability to read prescription names or dosage instructions. Maryland pharmacy error attorneys join the AFB’s call for Congress to take up legislation to develop safeguards for this class of citizens susceptible to medication errors.

As we have discussed in previous posts, medication instructions are notoriously confusing and difficult to read even under the best of circumstances. The AFB report is accompanied with personal stories describing how people with vision loss can suffer disproportionately from pharmacy negligence.

In one situation, the legally blind parents of an infant nearly lost their child due to their inability to catch a pharmacy prescription misfill. The parents managed several prescriptions for their child, but they were unable to read the labeling on the bottles. A pharmacist misfilled the prescription with a medication that was potentially lethal to the child. Fortunately, the parents were able to catch the error before it was too late.

In another anecdote, a respondent to the survey explained that a negligent pharmacist dispensed twice the amount of insulin that the man’s prescription required. Since the respondent was not able to read the medicine’s label, he took a double dosage of insulin, passed out from hypoglycemia, and had to receive treatment at a local emergency room.

Currently, there is no federal or state law requiring that pharmacies provide medication dosage or side effect information in Braille. Unfortunately, the AFB reports that devices to assist the vision impaired with medication labeling are not widely available.

External Links

AFB Survey

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In earlier posts, the Maryland pharmacy error attorneys at Lebowitz & Mzhen, LLC have discussed how computerized prescription entry programs decrease the risk of patient injury due to pharmacy errors. A study at the Norwalk Hospital in Norwalk, Connecticut is another example of how these systems work.

Recently, I spoke on the phone with a friend who lives in Norwalk and who is currently expecting her first child. As we talked about her child’s upcoming birth and the plans of her and her husband, she mentioned that the hospital where she is likely going to deliver her baby was in a local paper for being one of the safest in the nation. A recent newspaper article highlights how Norwalk Hospital in Norwalk, Connecticut employs a computerized prescription program that has, in part, helped earn nationwide recognition for patient safety. The computer system allows physicians at the hospital to electronically submit prescriptions with dosage instructions to the pharmacy, bypassing the necessity for doctors to write a hardcopy of the prescription. This procedures largely eliminates the possibility that the doctors’ handwriting will be misread.

Dr. Stephen O’Mahony, the associate chairman of medicine and a medical quality officer at Norwalk Hospital commented that, “With the old way we were doing things there was the chance of there being transcription errors, meaning a patient could get the wrong medication, but now there is no chance of [hospital pharmacists] reading it wrong.”

During the three years since the hospital introduced the computerized system, medication errors have decreased from an average of 13 errors per 1,000 patients to 2 errors per 1,000 patients. Additionally, the hospital has noticed a decrease in the length of hospital stays for Medicare recipients from an average of 7 days down to 5.7 days.

The electronic system not only prevents medication errors, it also uses a “best practices” approach to suggest the appropriate drug therapy for particular patients. For example, if a patient comes to the hospital suffering from a heart attack, the computer system will remind the doctor to prescribe aspirin. Also, when a doctor treats a person suffering from pneumonia, the system will prevent the doctor from discharging the patient until the patient has received a flu shot. With features such as these, the hospital’s computerized prescription program helps reduce the time patients suffer from their current aliments, and it also helps reduce the risk of further health problems.

External Links

Newspaper Article

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