Many people take some form of medication on a daily basis. Whether it is a short stretch of antibiotics or a daily pill to help with your blood pressure, recipients of medications should be able to reasonably trust that their pharmacies and healthcare providers are giving them proper care. Sometimes, however, even pharmacists and professionals are prone to errors. These errors, however, can often have devastating consequences if they involve medications. Maryland pharmacies can be held accountable for the errors they make.

According to a recent report summarizing common medication errors in long-term care facilities, pharmacists are essential as gatekeepers in the proactive prevention of prescription errors. Some of the most common medication errors include issues with dispensing, delays in delivery, and expired inventory.

Dispensing errors in long-term facilities often include incorrect dosages, incorrect drugs, incorrect patients, incorrect routes, or incorrect times. Many times, pharmacists will mix up lookalike and soundalike drugs in pharmacies. In addition, incorrect packaging can also result in dispensing errors.

A 4-year-old was recently accidentally administered a COVID-19 vaccine when she was brought in to get a flu shot. According to one news article, the Maryland pharmacy error occurred when the 4-year-old girl went with her parents to a Walgreens pharmacy in Baltimore, Maryland. She was supposed to receive a flu shot but the pharmacist accidentally injected her with a dose of the Pfizer/BioNTech COVID-19 vaccine. The vaccine is not currently authorized for children younger than 12 years old and the vaccine for 5 to 11 year-olds, which is not yet authorized, only has about a third of the dosage given to the 4-year-old.

The girl’s parents did not know what to do and a nurse’s hotline and Poison Control “yielded few answers.” Researchers are still looking into the effects of COVID-19 vaccines on young children and toddlers, including at the University of Maryland School of Medicine in Baltimore. A representative from the U.S. Food and Drug Administration stated that vaccination providers are supposed to report vaccine administration errors to The Vaccine Adverse Event Reporting System, managed by the federal government.

Although no adverse effects were reported in this case, the case illustrates that other, possibly more serious, errors can occur. Medical errors and vaccine errors occur all too frequently. In the event of a Maryland pharmacy error, victims may be able to recover financial compensation for their injuries, which may include medical bills, lost wages, and other financial losses, as well as emotional suffering. In a lawsuit against the parties responsible for the error, a victim would have to show that the defendant(s) owed a duty of care to the victim, the defendant(s) failed to meet the standard of care required in that situation by acting or failing to act in some way, the defendant(s)’s wrongful act caused the victim’s injury, and the victim suffered damages as a result.

Medication errors occur every day and in most recent years, they have received significant attention from the media and have been the subject of many studies. But such studies often focus on adult errors rather than pediatric errors. Children may be at greater risk because of the additional calculations and variations in medication for children. A recent study with implications for Maryland medication error victims looked at the occurrence of ten-fold medication errors in children.

According to the article, results from the study were recently released after the two-year study was conducted on pediatric ten-fold medication errors. In one case, a professional administered an unintentional ten-fold overdose to a four-year-old child. The investigation looked at medication errors not just in prescribing, but also in dispensing and administering doses. A consultant explained that there are more steps involved to calculate a children’s prescription than an adult prescription. The dosing for children is often based on weight. Sometimes another calculation needs to be to convert medicine to a liquid formula and sometimes another calculation to adjust the concentration based on the specific product that is available.

The study showed that of the ten-fold medication errors that occurred during the study, the vast majority—76 percent—occurred during the prescription phase. Another 20 percent occurred while administering the medication and 4 percent while dispensing it. The study offered solutions to decrease pediatric medication errors, such as shifting medications from liquid form to tablet form but noted that not enough is known about such errors to give a clear solution.

The FDA recently announced that Azurity Pharmaceuticals (Azurity) is voluntarily recalling some batches of its medications related to a diluent mix-up. The recall may affect Maryland patients who have consumed the antibacterial medication. According to the statement, the company is recalling Firvanq and Vancomycin as certain lots of their products contain incorrect diluents.

Healthcare providers typically prescribe Vancomycin to treat clostridium difficile, commonly known as C-Diff. C-Diff is a bacterium that can cause severe diarrhea and inflammation of the colon. The bacterium causes about half a million infections every year in the United States. The medication specifically targets the bacteria responsible for enterocolitis and diarrhea. The medication package includes a bottle of the medication, a USP powder, and a flavored diluent. However, nearly 3,000 kits contained a diluent that goes with a different gastric medication. The company stated that the incorrect diluent might not completely solubilize the c-diff medication. As such, the mistake may lead to persistent diarrhea, resulting in electrolyte imbalances, dehydration, and colitis. In some severe cases, patients may suffer colon perforation that may require colectomy or lead to death. The company is urging retailers and patients to review their medications and return the medication.

Drug manufacturers, pharmacies, and healthcare providers have the duty to warn users of the risks associated with a medication or medical device. Each provider’s duties vary depending on the type of error and the relationship between them and the consumer. However, those who fail to warn a patient or consumer may be liable for related injuries or illnesses.

Medications not only have to be safe but also must contain sufficient warnings and instructions so that patients will know how to use them safely. A medication’s lack of clear instructions and warnings puts patients at risk. A plaintiff may bring a Maryland pharmacy claim against a drug manufacturer for failing to warn of the dangers of taking a medication.

Unless a danger is obvious and widely known, the medication must provide adequate warnings concerning the medication’s risks, such as known side effects. Warnings must also be clear and easy to understand. The medication also must include adequate instructions on how to take the medication safely. Courts will consider the knowledge and expertise of the average consumer that uses the medication. If a medication’s instructions are not clear enough or do not contain sufficient information so that consumers will know how to safely use the medication, the instructions are not sufficient, and the manufacturer may be liable for injuries that occur as a result.

In cases where a patient is injured due to a lack of sufficient instructions or failure to adequately disclose risks, the patient may be able to file a Maryland injury claim and recover financial compensation for the injuries. Successful plaintiffs may be able to recover financial compensation for damages including medical bills, psychological suffering, future medical expenses, lost wages, and more. One recent study revealed that at half of the patients were using inhalers incorrectly.

Pharmaceutical drugs are intended to treat serious illnesses and conditions. As a result, these drugs are often very powerful and carry the potential to cause severe injuries in the event of even a minor error. One common type of Maryland medication error involves recalled medication.

While most pharmaceutical drugs are manufactured according to very specific criteria, sometimes something goes wrong during the manufacturing process. It could be that a base ingredient was contaminated or the factory where the drug was created suffered some type of equipment malfunction. When a medication is not made according to the precise specifications, it can cause the medication not to work—or worse—it can cause other very serious side effects.

Recently, an industry news source reported on several drug recalls. For example, one manufacturer recalled 267 million prefilled saline syringes after finding that the plunger may pull back and introduce air into the syringe, which can cause serious adverse outcomes. Another recall, issued by the manufacturing giant, Pfizer, involved the company pulling several batches of its smoking cessation drug Chantix off the shelves after finding some pills contain elevated levels of a likely carcinogen.

Medication errors are an unfortunate yet avoidable part of the healthcare system in the United States. While technology, training, and oversight aimed at reducing medication errors have improved over the years, these instances continue to occur. According to the Academy of Managed Care Pharmacy (AMCP), Maryland medication errors cost patients, consumers, and the healthcare system millions of dollars. Further, data indicate that medication errors harm over 1.5 million people each year.

Medication errors are preventable events that result in inappropriate medication use and patient harm. The events may stem from a healthcare professional’s conduct, a specific product, or a system. For instance, errors may stem from communicating prescriptions, dispensing or administration, marketing or labeling, or monitoring. Many errors stem from illegible handwritten prescriptions, missing information, incorrect drugs or dosage, orally transmitted prescriptions, or medication samples.

While advanced technology, reporting technology, and monitoring address some of the common causes of medication errors, there are fundamental issues with addressing systematic attitudes of blame and liability. Medication errors can result in serious formal punishment against the healthcare provider. These punishments can include fines, license suspension, or revocation. As a result, many healthcare providers focus on shifting blame rather than addressing the system issues that caused the error.

The Pharmacy Times recently reported an issue that many parents are facing when administering ibuprofen oral medication to their children. Maryland medication errors can result in serious adverse side effects to infants and children taking cold and flu medication or pain relievers. In some cases, these errors result from a caretaker’s failure to read the packaging instructions. However, marketing errors increase the likelihood of a dosing error.

The report focuses on the two different concentrations of children’s and infant’s ibuprofen. The infant’s formulation is intended for babies aged 6-23 months, weighing between 12-23 pounds. The infant’s formation is 40 mg/mL, whereas the children’s formulation contains 20 mg/mL. The childrens’ formulation is intended for children aged 2-11 years or weighing 24-95 pounds. While companies rely on the consumer carefully reading the dosing and administration instructions, confusion often arises because of the similarities in packaging and labeling.

Pediatric hospitals and medical providers are becoming more aware of the confusion, and as such, parents are receiving education regarding dosage upon discharge. However, the Institute for Safe Medication (ISM) reported that medical providers had received several reports about medication mix-ups occurring after a child was discharged.

Pharmacies and pharmacists play a critical role in the stream of efficient healthcare in the United States. While advances in clinical therapies have resulted in life-saving measures for many people, pharmacies have become inundated with patients. As a result, Maryland pharmacies are more prone to engaging in medication errors. Medication errors are any error that occurs at any step along a patient’s healthcare treatment plan. These errors can occur when a clinician prescribes a medication to when the patient receives a refill. If a patient experiences an adverse drug event because of a medication error, they may recover damages from any negligent healthcare providers responsible for the error.

Adverse drugs events are a common yet preventable healthcare event. The Patient Safety Network (PSN) reports that healthcare providers have access to over 10,000 prescription medications, and almost one-third of American adults take five or more medications. Moreover, every year, adverse drug events make up approximately 700,000 emergency room visits. These errors occur to every type of patient, including those receiving care and treatment in the hospital.

Some groups of people are more vulnerable to medication errors. These groups include older adults, especially those who take several medications. Further, pediatric patients often experience medication errors because clinicians may fail to account for the patient’s stature before dispensing medications. Moreover, another notable factor is a patient’s socioeconomic status and literacy.

Pharmacy errors can occur at different stages of the process of prescribing and dispensing a medication. And although some pharmacy errors may be caught quickly or may have a short-time effect, others can be devastating for Maryland pharmacy error victims. To decrease the prevalence of pharmacy errors, many researchers have looked to documented cases to determine where and how changes can be made.

According to a recent article, the labeling and packaging of medication contributed to two recent pharmacy errors. In one case, the prescriber of a mediation had prescribed sacubitril-valsartan (Entresto), a multi-ingredient medication that combined two drugs. The prescriber listed the strength of the medication prescribed as 100 mg, which was to be taken twice a day. When the pharmacist was filling the prescription, the pharmacist saw that the medication did not include a 100-mg strength, so the pharmacist chose the closest choice—97/103 mg strength (97 mg of one drug and 103 mg of another). However, the prescriber had intended that the patient take the total amount of the 2 drug ingredients (49/51) with 100 mg total.

The patient’s doctor later increased the dose to 100 mg, which was to be taken twice a day. The pharmacist dispensed the same 97/103 mg medication and gave instructions to take two tablets twice a day. The patient had severe adverse effects and the error was discovered. The insert on the medication suggested that the total amount was the basis for clinical trials, but the label listed the ingredients separately. To make matters more confusing, other combination tablets are prescribed according to the strength of each drug rather than the total, such as carbidopa-levodopa (for example 25-100).

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