blister packsThis blog has covered a number of the common causes of Maryland pharmacy errors in hopes of increasing patient awareness. One common cause of pharmacy errors that has not recently been discussed is when a patient’s prescription is filled multiple times.

Most often, these errors are the results of two different pharmacies each filling a prescription and providing it to the patient. These errors are more common in mail-order pharmacies than in retail pharmacies. More often than not, these errors involve elderly patients that are prescribed multiple medications and may have a difficult time reading or understanding the numerous directions they should follow.

Patient Dies after Taking Twice the Number of Pills That Were Prescribed by His Physician

Back in 2016, an older man died from what appeared to be a medication overdose. According to a local news report covering the tragic accident, the man was prescribed medication to control his heart, liver, and anxiety-related conditions. The medications were provided to the patient in blister packs containing 108 pills each. The patient’s prescription was supposed to include a total of four blister packs.

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healthcare blocksSome pharmacy errors can be difficult to prove because patients are often already sick and suffering before the error. In any Maryland medical negligence claim, a plaintiff must establish the following elements: 1.) a healthcare professional owed the plaintiff a duty of care; 2.) the healthcare professional failed to meet the relevant standard of care; 3.) the plaintiff was injured as a result of that failure; and 4.) the professional’s lack of care caused the plaintiff injuries.

Proving causation means showing that the plaintiff was injured as a result of the professional’s breach of the standard of care. Simply showing that a healthcare professional did something wrong is not enough—a plaintiff must also show that the act caused the plaintiff’s injury.

The plaintiff has to prove causation by showing that it is “more probable than not” that the professional’s negligent act caused the plaintiff’s injury. This can be tricky if the patient was already suffering from health issues, or if there may have been more than one cause of the injury, for example. In a medical error case, there is almost always an underlying issue that caused the patient to receive medication, and patients often have multiple issues and several care providers. A recent study discussed some common medication safety risks in health care.

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prescription medicationGiven the prevalence of smartphones in today’s society, as well as the fact that doctors entering the medical field today are much more likely to be tech-savvy than ever before, it is no surprise that some doctors are relying on text messaging to deliver prescriptions to pharmacies. However, some experts are concerned that prescriptions that are sent in by text message may result in a higher overall rate of pharmacy errors.

According to a recent industry news report, while texting provides some potential benefits to physicians and pharmacists alike, the medical field is not yet prepared to safely implement the practice. The article outlines several errors that are more likely to occur when a physician texts – rather than calls, faxes, or electronically submits – a prescription.

First, physicians who use text messaging to submit a prescription bypass all clinical decision-making support offered by electronic-prescribing systems. Electronic-prescribing systems show providers relevant portions of a patient’s medical record and alert prescribers to a potential adverse reaction as well as the possibility of a better-suited medication.

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pharmacyThe increasing number of Maryland pharmacy errors has drawn attention not just from within the industry but also more broadly from the media and lawmakers. As the population grows and pharmacies take on more patients, the number of prescriptions filled per day continues to grow exponentially. With limited space and the pressure to keep costs down, pharmacies often have a difficult time staffing enough pharmacists and technicians to safely fill patients’ prescriptions.

This is not to say that being busy is an excuse to commit an error. It isn’t. In fact, regardless of how busy a pharmacist is, how long they have been on a shift, or how many prescriptions they have filled in any given day, pharmacists always have a duty to ensure that the prescriptions they fill are accurate.

A recent industry news source discusses several common errors that are seen in pharmacies across the country. As is the case with most errors, these are based on a lack of communication, problems with data management, and issues with conveying important and technical information quickly.

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prescription pillsMost people assume that when they go to the pharmacy to pick up a prescription, the medication provided to them by the pharmacist is the same medication that their doctor prescribed. However, the reality is that each year there are thousands of reported pharmacy errors. Many of these errors result in a patient being provided the wrong drug, while others involve the pharmacist providing patients with the wrong dose or the incorrect instructions. If you believe you were injured as a result of receiving the wrong prescription medication or dosage, contact a Maryland pharmacy error attorney.

Pharmacists have a duty to ensure that the prescriptions they fill are accurate. Often, retail pharmacies are extremely busy and rely on a pharmacist technician to fill a prescription, which is then later checked by the pharmacist prior to being provided to a patient. However, during these busy times, both pharmacists and technicians are often handling multiple prescriptions and are more likely to make an error.

While the ultimate duty to ensure a patient is not given the wrong medication rests with the pharmacist, there are certain precautions patients can take to decrease the chance that they will be sent home with the wrong medication. A recent news article discusses a few of these steps, including:

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funeralMaryland personal injury plaintiffs can bring failure-to-warn claims if a manufacturer fails to adequately warn consumers of a product’s risks. In one recent case against drug manufacturer GlaxoSmithKline, a patient alleged that the manufacturer failed to warn consumers of its association with suicide for certain patients.

The Facts of the Case

A doctor prescribed a patient Paxil, manufactured by GlaxoSmithKline (GSK) to treat the patient’s depression and anxiety. However, his prescription was filled with the generic version of Paxil, paroxetine. A few days later, the patient committed suicide and paroxetine was found in his system. The patient’s wife sued GSK, alleging that the manufacturer negligently failed to warn patients that paroxetine was associated with suicides in patients older than 24, and that her husband (who was 57) died as a result.

Generic drug manufacturers are required to use a label approved  by the brand-name manufacturer and approved by the U.S. Food and Drug Administration (FDA), and only the brand-name manufacturer can obtain FDA approval to change the label. In this case, the brand-name manufacturer of Paxil, GSK, created the its label, and the generic drug manufacturers were required to use the same label. Labels for paroxetine warned that it was associated with suicide in patients under 24, but did not warn about an association with suicide in older patients.

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pharmacyLast week, the Food and Drug Administration announced that the manufacturer of a popular blood-pressure medication would be recalling thousands of bottles of the medication after what appears to have been a medication mix-up. According to one news source covering the recall, Accord Healthcare announced that it would be recalling one lot of its Hydrochlorothiazide tablets in the 12.5mg dosage.

The recall was announced after a pharmacist at a local drugstore discovered that a bottle marked as containing the 12.5mg tablets of Hydrochlorothiazide tablets actually contained another medication. None of the medication was provided to patients, and the manufacturer’s initial investigation into the error did not cause them to believe that any other lots suffered from a similar error. However, out of precaution, the manufacturer recalled the entire lot that contained the bottle with the wrong medication.

The Hydrochlorothiazide tablets are round orange pills that have the letter “H” on one side, and the number “1” on the other side.

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medical assessmentMedical errors routinely rate among of the most frequent causes of preventable death in the United States. One of the more common types of medical errors are pharmacy misfills or prescription errors. These errors occur when a pharmacist provides a patient with the wrong medication, wrong dose, or wrong instructions.

According to one industry news source, pharmacy errors are on the rise. Evidently, the National Pharmacy Association released its most recent data which showed a 64% increase in pharmacy errors between April and June of this year. The data showed that nearly half of all of the reported pharmacy errors were caused by “workload and time pressures.”

The types of errors reported varied, but the following were some of the more common error types:

  • providing the wrong medication to the patient based on medication with similar sounding or looking names;
  • mixing up patients’ names and addresses; and
  • attaching the wrong information slip to a patient’s prescription.

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prescription instructionsWhile there are many causes of Maryland pharmacy errors, one of the most frequently reported errors involves a patient receiving the wrong medication from their pharmacist. In many cases, the pharmacist provides a patient with a drug that has a name similar to the drug which they were prescribed.

The Institute for Safe Medication Practices (ISMP) has coined the term look-alike sound-alike (LASA) drug to describe a medication that is either spelled or pronounced similar to other medications. It is estimated that up to 35% of all medication errors involve LASA medications. The IMSP has also published a list of the most common LASA drugs.

For example, common LASA drugs include:

  • hydromorphone and morphine
  • vinblastine and vincristine
  • tramadol and trazodone

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When most people hear that a pharmacy error has been made, they picture a busy pharmacist who provided one patient with another’s medication after transposing a few letters in a patient’s last name. And with thousands of medications in the average pharmacy, there certainly are a significant number of Maryland pharmacy errors involving a pharmacist providing a patient with the wrong medication altogether. However, this is only one type of pharmacy error.Legal News Gavel

Many pharmacy errors involve a patient receiving the correct medication, but the wrong dosage. This can either occur when a pharmacist provides the patient with the wrong strength of medication or when the instructions provided to the patient are incorrect. In either event, a patient can suffer serious injuries by taking too much (or too little) of a prescribed medication. Children are especially susceptible to this type of error, since medication tends to affect them more, given their size and weight.

Parents are encouraged to double-check their children’s prescriptions for any errors at the pharmacy. In addition, parents should consult with pharmacy staff, letting them know that the medication is for a child.

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