Articles Posted in Pharmacy Errors and the Visually Impaired

Most people would like to think that if they were ever given an incorrect prescription by a pharmacist, they would catch the mistake. However, statistics indicate that most people who are provided with the wrong medication, incorrect dose, or improper instructions at the pharmacy counter do not notice the error until they have taken the medication home and ingested at least one dose.

When dealing with visually impaired patients, there is a drastic reduction in the chance that the patient will notice the error. This pertains not just to those who are legally blind but also to the elderly or others with poor vision. A patient with compromised eyesight may be able to see well enough to find their way to the pharmacy counter but will likely have difficulty reading the small print on prescription bottles.

Pharmacists have a duty to fill all patients’ prescriptions accurately, and they may be held liable for any injuries that result from an error. Under the law as it pertains to pharmacy error claims, a visually impaired patient will not be expected to catch the error. That is to say that the pharmacist will not be able to argue that the patient should have caught the error in an attempt to avoid liability.

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A recently published medical industry report attempts to point out the surprising threat that American patients face every day in doctor’s offices and hospitals due to the small print that is used on many prescription forms, medication bottles, and medical review materials. The report, which was supplied to the publisher by a company seeking to profit from the present-day problem, notes that a survey of health care professionals performed in 2014-2015 found that almost 90% of doctors, nurses, and other health care professionals reported difficulty reading the small print found on drug labels and that over 35% were aware of a close call or actual prescription error that occurred because of the small print on some medical materials.

Doctors Who Don’t Need Reading Glasses or Assistance From a Colleague with Adequate Vision May Make Mistakes and then Blame the Small Print

The report contains startling information that millions of patients may be placed at risk every day because doctors and nurses are unable to read medication bottles correctly, and some of these professionals apparently do not take the initiative to ensure that their eyes are functioning well enough to protect their patients from a pharmacy or medical error stemming from a piece of medical literature that is read incorrectly. The article seems to place the blame for these errors and any injuries, illnesses, or deaths they cause upon the small print that is used on medication bottles. However, the bottom line is that medical professionals are responsible for reading what is on medication bottles and other literature before they give a potentially dangerous medication to a patient.

If a medical professional is unable to read a piece of text and does not seek assistance by consulting a colleague, putting on some glasses, using an app on their smartphone, or using a piece of magnification equipment to ensure that they understand what they are doing, they should be held responsible for any injuries that are caused by their mistake.

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A woman who lost one of her eyes after eye surgery got a new trial after her case went before the Iowa Court of Appeals. After a trial in Whitley v. C.R. Pharmacy Service, Inc., a jury originally returned a verdict in favor of the defendant pharmacy. The plaintiff appealed, arguing that the trial court erred in allowing the pharmacy to introduce never-before disclosed evidence at trial. The appeals court agreed that this prejudiced the plaintiff, and granted the new trial.

Whitley was a member of the Iowa Army National Guard who needed to improve her eyesight in order to apply for an officer commission in the armed forces. An ophthalmologist, Dr. Lee Birchansky, performed Epi-LASIK on both of her eyes in November 2005. Whitley later developed corneal scarring, a known side effect of the procedure. At Birchansky’s recommendation, she underwent a procedure called corneal scraping on March 9, 2006. A medication called mitomycin is used during this procedure. Birchansky’s office ordered a 0.02% mitomycin solution from C.R. Pharmacy.

Whitley reported a stinging sensation when Birchansky applied the mitomycin, which continued long after the procedure. After several weeks, she could only see colors and shapes, and she had persistent headaches. Birchansky referred her to a glaucoma specialist, who suspected Whitley had received the wrong concentration of Mitomycin. Birchansky sent the remaining mitomycin, which he found in a container with a C.R. Pharmacy label dated March 9, for testing at the University of Iowa. The tests revealed that the solution contained no mitomycin. Whitley’s condition deteriorated further. She underwent corneal transplant surgery in both eyes, but still lost her left eye.

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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.

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AFB Survey

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