January 27, 2010

Lawsuit Accuses Hospital of Medication Mistake and Wrongful Death

In a recent lawsuit that our Maryland Pharmacy Mistake Lawyers have been following, a hospital is being sued for dispensing an overdose of pain medicine to a 68-year old woman, which allegedly led to her wrongful death.

Mable Mosley was taken to the Brandon Regional Hospital last year complaining of neck and shoulder pain. She checked into the hospital on a Saturday, and within a few days stopped breathing. Mosley was put on life support, and died days later.

Mosley’s husband is suing the hospital, the hospital owners, and seven individual pharmacists in the case, claming medication negligence and wrongful death—that his wife was given enough pain medicine to end her life.

The drug in question that Mosley received is called Duragesic, a patch containing large concentrations of opioid fentanyl, a potent narcotic approved in 1990 by the FDA for use in patients that have become opioid-tolerant from using another strong narcotic pain medication for a week or longer.

Opioids are chemicals that are commonly prescribed because of their pain relieving properties. Opioids work by attaching to opioid receptors, or proteins, found in the brain, spinal cord and gastrointestinal tract. When the drugs attach to the opioid receptors, they can block out the body’s perception of pain.

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January 25, 2010

FDA Pressures Johnson & Johnson for Broad Recall of OTC Drugs

Johnson & Johnson (J&J) has recently recalled certain lots of Tylenol, Rolaids, Benadryl and Motrin, after consulting with the U.S. Food and Drug Administration (FDA). McNeil Consumer Healthcare, the J&J subsidiary that sells the drugs is voluntarily recalling the lots of the Over-The-Counter (OTC) products, in an effort to maintain the health and safety of the consumer, and to prevent OTC medication errors.

The company has recalled these drugs based on consumer complaints of an unusual moldy, musty smell that reportedly caused nausea, vomiting, diarrhea and gastrointestinal pain. The smell was found to be caused by trace amounts of the chemical 2, 4, 6-tribromoanisole (TBA)—a chemical often applied to wood pallets that are used in the transportation and storage of the materials used for product packaging.

The FDA has criticized J&J for not reacting quickly enough to customer complaints, and for failing to fix the problem, a problem that has been familiar to J&J. Customers have reportedly been complaining since 2008 about their pills having a mildew-like odor. In December of 2009, Tylenol Arthritis Pain medication was also recalled related this same issue.

According to the FDA, J&J and McNeil did not conduct a quick and comprehensive investigation into the problem, and failed to provide high quality products to consumers—responsibly protecting them from personal injury or illness. Many consumer complaints were received as early as 2008 and 2009, and the test results indicating TBA contamination were not shared with the FDA until after an inspection.

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January 20, 2010

Dangerous Error-Prone Prescription Abbreviations

As Maryland Pharmacy Error Attorneys, we have been following a recent report by The Institute for Safe Medication Practices (ISMP) about the danger of error-prone abbreviations and when it comes to writing a prescription—the fact that some shortcuts don’t save time, and can result in pharmacy error or injury.

According to the ISMP Error Alert article, nearly everyone in the healthcare industry uses shortcuts, like abbreviations and symbols, in an effort to save time when handwriting specifics for the prescription—including phrases, units of measure and words. Some shortcuts can in the end can be very time consuming, as they need to be checked and verified for accuracy on the receiving end. These verifications could also reportedly cause a greater chance for medication error than if the prescription was written out without abbreviations or symbols. The article claims that it is important to prevent future misunderstandings now, instead of waiting until medical abbreviations, dose designations or symbols lead to a patient injury.

The article lists a few common error-prone abbreviations, symbols and dosage misunderstandings that take more time for the pharmacist to check, and could cause medication mistakes:

• Some abbreviations that indicate the frequency of when to take the drug, can be difficult to understand, and can lead to error. In one prescription for “Penicillin VK 500 mg Q1D X 7D,” the physician accidentally typed “Q1D” (once a day) instead of “QID” (four times a day). The pharmacist realized the mistake, and that the patient was supposed to be taking the penicillin four times a day for seven days (7D). Another example of frequent error comes in the abbreviation for “D” (days), where it can also be mistaken for “doses.”

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December 17, 2009

Childrens' Doses of Swine Flu Vaccine Recalled in Maryland

In Maryland news this week, our medical mistake lawyers have been following the recall announcement by Sanofi-Aventis, the vaccine manufacturer of 800,000 doses of H1N1 vaccine for children under the age of three. According to the Washington Post, the flu vaccine has lost potency after being shipped from the factory, and doses are being recalled in Maryland and nationwide.

The recall dosages are single-dose pre-filled syringes containing the vaccine specifically created for children ages 6 to 35 months. It is a voluntary, nationwide recall by Sanofi Pasteur.

During testing at the time of the vaccine’s manufacture, the doses contained 7.5 micrograms of antigen, the recommended dosage used to stimulate immunity in children. But later testing showed degradation of the vaccine, making it less potent than desired. This proved to be the case with four lots of the vaccine, totaling 800,000 doses.

According to the Centers for Disease Control Prevention (CDC), this recall is part of a routine quality assurance program and is non-safety related. Children who received the vaccine do not need to be re-immunized, but with future immunizations, children should be given the proper vaccination dosage. With children who have only received one vaccine dose, they should get the get their scheduled second dose.

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November 18, 2009

Alert for Public Safety—FDA Reports Medication Error with Tamiflu

The FDA has recently published a patient safety alert, reporting medication dosage errors associated with Tamiflu, (for oral suspension), the top doctor prescribed anti-viral flu medication, administered to both adults and children. Our Maryland Pharmacy Misfill Injury Attorneys have been following this prescriber and pharmacy alert report, and how it could effect patient safety in this current H1N1 influenza pandemic.

According to the agency alert, the FDA has received reports that the Tamiflu (oral suspension) dosing instructions for the patient do not match the dosing dispenser. U.S. health providers often write liquid medicine prescriptions in teaspoons or milliliters (mL), while the dosage of Tamiflu is in milligrams (mg). Prescribers and pharmacists have been warned that Tamiflu's dosing dispenser included in the package has markings only in mg—30, 45, and 60.

The alert recommends that:

• If the dosing dispenser included with the drug is in mg, prescribers should write doses in mg

• Pharmacists should also ensure that the unit measurements on the instructions of the prescriptions match the dosage dispenser included.

• If the prescription instructions specify that the drug is administered using mL, the dosing device should be replaced with a new measuring device and calibrated in mL.

Tamiflu (oseltamivir) is an antiviral drug that slows the spreading of the influenza virus in the body. According to the Centers for Disease Control and Prevention (CDC), 22 million Americans have become ill with the H1N1 virus in the past six months, and 3,900 have died— 540 of which were pediatric deaths. The number of people who have been hospitalized is reportedly 98,000, with 36,000 patients younger than 17. The largest majority of deaths have been between the ages of 18 and 64—around 2,920.

Maryland’s Department of Health and Mental Hygiene reported last week that six more people have died in Maryland in the past four weeks from the swine flu, bringing the total death toll to 19 since the pandemic began. The H1N1 virus has also hospitalized 664 people in Maryland.

The Los Angeles Times reported that in the last week of October, 587,960 prescriptions for Tamiflu and other antiviral drugs were filled in the United States— according to Wolters Kluwer Pharma Solutions of Bridgewater, N.J., the company that tracks FDA prescription data.

If you or someone you know has been injured by a medication mistake or pharmacy misfill in Maryland or the Washington, D.C. area, contact the attorneys at Lebowitz and Mzhen, LLC for a free consultation. Call us today at 1-800-654-1949.

FDA Public Health Alert: Potential Medication Errors with Tamiflu for Oral Suspension

New CDC Estimates Show What Toll Swine Flu is Taking in U.S., Wasington Post, November 13, 2009

Booster Shots: Swine Flu Continues Slow Climb on College Campuses, The Los Angeles Times, November 13, 2009

Swine Flu Kills 6 More People in Maryland: All Had Underlying Conditions, Baltimore Sun, November 13, 2009

Related Web Resources:

U.S. Food and Drug Administration, (FDA)

October 30, 2009

Veterans Hospital Paves the Way for Computerized Records

In a post from earlier this year, our attorneys at Lebowitz & Mzhen, LLC discussed how computerized health records would help Maryland pharmacists and doctors to eliminate Maryland medication mistakes.

According to a recent article in the Wall Street Journal, on how to digitize the health-care industry, Veterans hospitals have proven to have paved the way——showing doctors and pharmacists important lessons on how to effectively make the digital transformation.

The U.S. Department of Veterans Affairs digitized their records years ago, with great results. Independent studies show that the VA outperformed the private sector and Medicare on preventative services and chronic care. VA officials have claimed that the digital technology has helped cut down on patient hospitalizations and has helped patients live longer.

The VA’s digital records system has been a blessing to patients, allowing doctors and nurses at more than 1,400 facilities to share the medical history of the patients—avoiding the unnecessary repetition of costly tests. As well as storing patient data, the system gives screening warnings and keeps an eye on patient levels, like blood pressure and weight—all safeguards for improved quality care.

In a digitized record for a 59-year old Maryland patient at the VA medical center, all of his health problems were listed, like diabetes and hypertension, as well as all of his data since he has been a patient at the center. The screen showed a list of all current medications, including insulin, the drug Furosemide for heart failure, and Oxycodone, the pain medication. The patient’s doctor can reorder a drug through the system, sent directly to the pharmacy—eliminating medication mistakes and pharmacy misfills. If the doctor orders a new prescription that conflicts with a drug the patient is already taking, there is a warning in the system.

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October 26, 2009

Medication Error Injury Prevention—Study Recommends Knowing Your Pharmacist

A recent American Pharmacists Association (APhA) survey, that our Maryland Pharmacy Error Injury Attorneys have been following, revealed that 1.5 million people are injured by medication-related errors every year. The APhA commissioned the consumer survey, led by Harris Interactive, to investigate how consumers interact with their pharmacists, and how building relationships with pharmacists can avoid patient error and reduce medication mistakes and pharmacy misfills.

The APhA always recommends that people carry an updated list of their current prescription medications, over-the-counter (OTC) drugs, herbal supplements and vitamins. The list should include the name of the medications, the dosage, as well as the conditions that the medications treat. Any patient allergies should also be included in the list.

The study reports that while a large percentage of Americans have an up-to-date list of medications, only 28% of consumers actually carry the list with them at all times—an act that could prevent personal injury and medication mistakes, by providing emergency personnel and pharmacists with lifesaving information regarding drug names, proper dosing, allergy information, and drug interactions and side effects.

According to Kristen Binaso, pharmacist and national APhA spokesperson, until electronic medical records are used as the standard in sharing patient information in the health care industry, consumers should protect themselves by keeping a current medication list with them at all times, to show the doctor and pharmacist—to avoid the risk of improper dosing, medication duplication, pharmacy misfill, and harmful drug side effects and interactions. In a recent post, our Maryland Mistake Attorneys further discussed how these electronic health records will help pharmacists and doctors to eliminate medication errors.

Next to doctors, pharmacists are the second most trusted health care providers and trained medication experts, yet the survey found that 77% of consumers do not know their pharmacists names, and only 40% of consumers have asked their pharmacists valuable questions about their medication needs.

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October 9, 2009

ISMP Medication Error Cases and Prevention Checklist

In a prior post from this week concerning pharmacy error injury, our Maryland Medication Error Attorneys at Lebowitz & Mzhen, LLC discussed a recent study published by the Institute of Medication Practices (ISMP), and the ongoing problem with drug naming standards in extended release medications.

In this study, the ISMP revealed a series of cases reported to the institute, in which drug name suffix medication mistakes have frequently occurred. This study showed specific case examples in order to establish clearer naming conventions in the industry, and improve comprehensive pharmacist and patient awareness—to prevent pharmacy error injury and misfills in the future.

The ISMP study reported these specific medication mistake cases:

• Physicians often prescribe extended release products without the correct suffix, or with a suffix that does not exist for that particular product.

• In an analysis of 402 prescribing errors published by Medscape Pharmacists, the most common type of error in the study (280 cases, 69.7%) was failure to specify the controlled release formulation.

• The ISMP received reports of cases in which pharmacists dispensed Metadate ER instead of Metadate CD—two different extended release forms of methylphenidate-UCB, a stimulant medicine commonly used to treat ADHD. In one case, a prescription for Metadate CD 20 mg was misfiled at a pharmacy, where the staff dispensed Metadate ER 20 mg.

• Some products have multiple suffixes for different formulations of the same drug. Diltiazem products for example (calcium channel blockers) are used to slow the heart rate and normalize the heart rhythm in hypertension and arrhythmia. The many suffixes for Diltiazem include SR, CD, XR, XT, and LA.

• Electronic prescribing can also lead to medication errors on behalf of the prescriber. In one case, a prescriber electronically selected metroprolol tartrate instead of metoprolol succinate because of choosing incorrectly on his PDA.

According to this report, pharmacists, practitioners, and patients should take extra care when reviewing the different formulations and medication names, especially if the medication is available in more than one dosage form.

The ISMP recommends the following medication error prevention checklist:

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October 6, 2009

Patient Safety Alert: ISMP Reports Medication Error with Drug Name Suffixes

As Maryland Medication Error Attorneys, we have been following a recent study published by the Institute of Safe Medication Practices (ISMP), about the lack of prescription drug naming standards in extended release medications that lead to pharmacy error injury.

According to the study, although extended release drug formulations provide multiple benefits for many patients, the titles used for many medications are often confusing, and can cause patient error when the same drug is presented with several different oral dosage forms in the suffix.

Extended release drug formulations play an important role in maintaining consistent prescription therapies, by preventing the need for patients to remember to repeat dosages—delivering a steady dose of the medication throughout a specific period of time. The difficulty with many of these medications comes in the name. According to the study, drug manufacturers add suffixes or modifiers to already well-known medication names, to keep awareness of the brand, yet differentiate between the immediate-release counterparts. For example: Wellbutrin SR is a sustained release anti-depressant, whereas Wellbutrin XL is the extended-release version. Same name, different release rate.

ISMP reported that there is currently no standardization for the many different types of extended release formulations, nor is there any standard definition describing the dosage or release characteristics of the drugs. Patients are left to discern between identical formulations with different suffixes, or even similar prescription suffixes with dissimilar formulations, creating potential for pharmacy error injury or misfills.

The ISMP has recommended to the United States Pharmacopeial Convention (USP) that naming standards be established to avoid patient confusion with the many similar formulations of the same drug, by incorporating suffixes or descriptive phrases into the drug names, or by inventing new brand names to designate different formulation properties. The FDA is also reportedly aware of the suffix problems and currently exploring new ideas to improve the naming convention.

If you or someone you know has experienced pharmacy error injury in Maryland or Washington, D.C., contact the attorneys at Lebowitz and Mzhen, LLC for a free consultation.

The Alphabet Soup of Drug Names Suffixes, ISMP Error Alert—Pharmacy Today, August 2009

Related Web Resources:

Institute for Safe Medication Practices, (ISMP)

Council Recommendations: Promoting the Safe Use of Suffixes in Prescription Drug Names, National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP)

MedWatch: The FDA Safety Information and Adverse Event Reporting Program


May 27, 2009

Maryland Law Encourages Maryland Doctors to Computerize Patient Records

In prior posts concerning Maryland medication mistakes, the attorneys at Lebowitz & Mzhen, LLC have discussed how computerized health records help doctors and pharmacists eliminate medication errors.

Today, Governor Martin O’Malley, signed a bill that is designed to increase the speed with which Maryland doctors implement electronic patient records. The new law hopes to reduce the high costs that doctors must pay to implement electronic patient records systems by requiring private insurance companies to give physicians financial incentives to implement electronic patient records. Under the law, after a doctor implements a computerized records system, insurance companies may offer the doctor increased reimbursements for procedures they perform, a lump sum payment, or some other monetary advance. Additionally, under the new law, the state will fine physicians who have not adopted a computerized records system by 2015.

Since 2003, Maryland has been on the cutting edge of the movement towards computerized patient records. In that year, The Montgomery County Health Information Exchange Collaborative began a pilot program that linked community hospitals, the county’s health department, and area health clinics. The link allowed participating health care providers to easily access patient records.

The program developers believed that their medical information network would have the greatest impact on the county’s poorer citizens and those without health insurance. These individuals generally receive care in a number of different locations, and often times, the facilities do not share vital patient information. The link allowed the facilities to share patient information and reduce the risk of medication errors.

Maryland medication mistake attorneys will review the impact this law has on patient safety, and the state’s progress towards completely computerized patient records.

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April 28, 2009

Patient Safety Alert: Medication Mistakes with Injected Medicines Are Frequent

According to researchers, the results of a recent international study demonstrate that patients receiving injected medicines are at a higher risk of medication mistakes. Researchers determined that oral or written miscommunication were the root cause of 24% of all errors, and that health care workers confused drug names in 18% of the cases.

Researchers in the study observed patients in Intensive Care Units in 27 countries, including two in the United States, and found that 20% of patients experienced at least one error and 14% experienced more than one injected medication mistake. Fifteen errors caused either permanent injury or death of the patient involved.

Overall, researchers concluded that patients with more serious illness were at a higher risk for injuries caused by these mistakes. Maryland medication mistake attorneys believe that the results of this research demonstrate the importance of patients having a family member act as their advocate during an extended hospital stay. In addition to questioning doctors, the advocate should pay particular attention to the medications prescribed to the patient and attempt to make sure that health care workers administer the medications at the proper times and in proper dosages.

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April 27, 2009

Government Program Hopes to Reduce Medication Mistakes Across the Country

In prior posts, Maryland medication mistake attorneys have asked our readers to question their doctors before taking prescription medications. Proactive patients are better able to notice potential medication mistakes before they occur and are less likely to suffer injuries.

The Agency for Healthcare Research and Quality (“AHRQ”), a part of the U.S. Department of Health & Human Services, has noted the substantial impact medication mistakes have on patients and the country as a whole. On itswebsite, the AHRQ quotes a report from the Institute of Medicine (“IOM”) which found that medication mistakes kill from 44,000 to 98,000 people each year. The report also indicated that medical mistakes cost the country approximately $17 billion each year in increased health care costs.

In order to help reduce medication mistakes, the AHRQ has developed a national ad campaign to encourage Americans to take a more active role in their health care by asking critical questions of their doctors, nurses, and pharmacists. The program drives home the point that Americans typically ask more questions of a cellular phone salesperson than they do of their physicians. The campaign’s website provides a top ten list of critical questions patients should ask their health care providers during appointments. Additionally, the website also has a “Question Builder” that allows readers to develop their own personalized list of questions.

March 27, 2009

New Technology: Handheld Device May Help Reduce Hospital Medication Errors

In a recent study, researchers found that improper dosages account for nearly 40% of medication errors. Additionally, researchers found that poor communication between health care professionals was the underlying cause of 15.8% of prescription errors. I read an article about an interesting piece of new technology that helps improve dose accuracy and communication between care providers.

The Intellidot Corporation has released the wireless IntelliDot Bedside Medication Administration (“IntelliDot BMA”) which will help eliminate hospital medication errors. The handheld device reads a barcode attached a patient’s wrist and provides the health care professional with all of the patient’s relevant health information. At an instant, a nurse or doctor will know all of the patient’s prescriptions, their required dosages, and the proper way to administer the medication. Additionally, in a hospital equipped with a computerized pharmacy, a doctor can electronically submit a prescription to the hospital’s pharmacy, and the pharmacy can transmit the prescription along with administration instructions to the IntelliDot BMA. Under this system, a hospital can eliminate the need for handwritten prescriptions and therefore greatly reduce the risk of errors caused by a physician’s poor handwriting or the use of improper medication abbreviations.

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March 24, 2009

Universal Medication Form May Help Reduce the Risk of Injuries From Dangerous Prescription Interactions

In earlier posts, Maryland medication error attorneys at Lebowitz & Mzhen, LLC have suggested that our readers always provide their health care providers with a full list of the prescription and over the counter medications they are currently taking.

The Institute of Safe Medication Practices (“ISMP”) has published a Universal Medication Form for patients to give to their doctors and pharmacists at each visit. On the form, a person can list their medication allergies, their immunizations, their current medications, the strength of their medications, and the frequency with which they take each prescription.

In order to avoid harmful drug interactions that can cause serious injuries or death, please take the time to accurately fill out this form or a similar one and bring it with them to all pharmacy, doctor, or hospital visits.

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March 20, 2009

U.S. Army Uses Electronic Health Records To Help Reduce Medication Errors

The medication error attorneys at Lebowitz and Mzhen, LLC are proud to have represented members of this country’s armed forces and their families in a variety of legal matters. In addition to the stresses that come with being a member of the military, soldiers and their families also have to be concerned about the risk of injury from medication errors.

The United States Army is comprised of 675,000 active duty soldiers. Army health centers are responsible for providing medical care to active duty personnel, their dependants, and a substantial population of veterans and their families. As a result, busy Army health facilities, including pharmacies, face the same risk of committing medication errors as their civilian counterparts.

The DeWitt Health Care Network serves 150,000 people in the Fort Belvoir Army community and is taking steps to reduce the risk of injuries from medication errors. Major Lela C. King, Chief of Pharmacy, reported that the network has given its patients pocket-sized medication cards that contain patient allergies, prescriptions, and other vital health information. These cards will reduce the risk of dangerous a physician prescribing a medication that interacts with one the patient is already taking.

Additionally, Major King has overseen the installation of digital patient records software and hardware in Dewitt facilities. According to Major King, the Army has recognized that such electronic health information can “decrease the number of medication errors made at the pharmacy by 70 percent.”

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March 18, 2009

Side Effect Labels on Prescription Bottles May Help Reduce Injuries

The Food and Drug Administration is taking steps to warn consumers about potential drug side effects. The Maryland Pharmacists Association reports that sometime this year, the FDA will require all prescriptions to include a “side effects statement” that lists all of a drug’s potential side effects. The proposed labeling could appear on prescription containers and will advise patients to contact their health care provider and the FDA if they experience drug side effects.

Many of these side effects initially may be as minor as a runny nose or muscle stiffness. However, many of these insignificant annoyances can develop into more serious health concerns if a patient continues taking the prescription. To prevent more serious side effects, a patient should recognize any less serious side effects that might occur first and immediately contact their doctors. However, in order to take action, a patient has to know all of a drug’s potential side effects.

Listen to any radio or television commercial for the newest “wonder drug” and you’ll be shocked by the long list of potential side effects that the announcer speed reads before the commercial ends. Maryland medication error attorneys urge our readers to consult their physicians before taking medications so that they know a drug’s potential side effects.

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March 11, 2009

Maryland Medication Error Prevention Checklist

Sometime ago, we posted an article on our Maryland truck accident blog that highlighted some of the steps accident victims should take if they are victims of a Maryland truck accident. Our Maryland pharmacy error attorneys have prepared a similar list to help our readers reduce their risk of injury caused by medication errors. We suggest that our readers do the following:
1. When you are given a prescription at the pharmacy, check the label very carefully especially checking the name of the medication and dosage;
2. if the prescription is a refill, examine the pills to ensure that they look like the pills from the prior prescription;
3. List all of your over the counter and prescription medicines and take this list to your health care provider and ask him or her to review it for dangerous interactions;
4. Know the name (generic or brand name) of your medicines and the directions for their proper use;
5. Know that you have a right to counseling provided by your pharmacist if you have questions. During these counseling sessions, you can have your pharmacist explain how to take the medications and warn you about potential side effects;
6. Request written dosage directions from your doctor or pharmacist, and make sure you understand them before you leave the office or pharmacy;
7. Ask about your drugs’ potential side effects and what to do if you experience one or more of those symptoms;
8. When in a hospital, ask what drugs the nurses and doctors administer to you;
9. Take advantage of your right to have a family member present to ask questions of your doctor or pharmacist.

Our attorneys believe these steps will help our readers and their loved ones reduce their risk of medication error injuries.

March 9, 2009

MRI Scans and Drug Patches with Metal May Cause Burns

The medication error attorneys at Lebowitz & Mzhen, LLC recently learned that the Food and Drug Administration has warned consumers who use medicated skin patches to remove those patches before going through a MRI scan. According to the FDA, some patches contain metal which may heat up during an MRI and burn the patient’s skin. The FDA warns that the metal in many of these patches may not be visible to the patient and not all transdermal patches that contain metal have patient warnings printed on the box. The FDA is currently reviewing the labeling requirements to ensure that patients are adequately warned of this new danger.

Until this review is complete, the FDA suggests that patients who use medicated patches do the following:
• Before undergoing an MRI scan, tell your doctor that you are using a patch and why you are using it;
• Ask your doctor for counsel regarding whether to remove the patch before the scan, and whether to replace it after the procedure;
• Tell the MRI technician that you are using a patch. The FDA suggests that you do this when making the appointment and again when you arrive at the MRI facility.

Transdermal patches deliver medication slowly through a patient’s skin. When most people think of patches that deliver medication through the skin, they immediately think of the nicotine patch. However, in the years since the development of the nicotine patch, the drug industry has developed a number of other medications that are effectively administered through the skin. For example, to treat angina many doctors direct their patients to wear nitroglycerin patches. Some women going through menopause also use patches that deliver hormones into their system, and doctors can prescribe Clonidine patches to patients with high blood pressure.

February 12, 2009

Chewing Some Prescription Medications Can be Harmful

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.

Continue reading "Chewing Some Prescription Medications Can be Harmful " »

January 30, 2009

New York Pharmacies to Provide Foreign Language Prescription Instructions

Maryland pharmacy error attorneys serve a number of clients who do not speak English as their first language. Some of these clients have raised the issue of not being able to receive prescriptions or dosage instructions written or spoken in their native languages from big box pharmacies. The attorneys at Lebowitz & Mzhen, LLC believe that this shortcoming places a large number of citizens in danger of harmful pharmacy errors. According to the 2000 US Census, 667,357 Marylanders speak a language other than English in their homes.

As we discussed in an earlier post, Maryland pharmacists must provide medication counseling to patients when requested, and must provide written dosage instructions with prescriptions. Counseling and written instructions in English are useless to a pharmacy patient that has difficulty understanding the language.

Pharmacy Today reports that following an undercover investigation by New York Attorney General, Andrew Cuomo, Rite Aide and CVS have agreed to provide medication instructions in languages other than English at their New York locations. The investigation began after reports that pharmacies failed to provide side effect information and drug interaction warnings in patients’ native language. New York Rite Aid and CVS locations will now provide dosage and side effect information to patients in Russian, Spanish, Chinese, Italian, French and Polish. The companies also agreed to provide assistance using an over the phone translation service.

Our attorneys believe that Maryland pharmacies should follow suit and help ensure that all patients fully understand their medication dosage instructions and other relevant information.

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