Laws vary from state to state regarding the authority of certain persons to dispense medication. In Maryland, physicians are permitted to dispense medication subject to certain regulations. Maryland physicians who are permitted to dispense medication must obtain a dispensing permit from the Maryland Board of Physicians. But the ability to dispense medication poses additional avenues of liability for physicians and raise concerns among some and may pose additional risks for Maryland patients, as one recent article showed.

The article raised the issue of whether physicians should be permitted to dispense medications. In an editorial in another paper, a writer had suggested that it is a good idea to have doctors dispense medications directly to patients, because it may be easier and cheaper for patients. Three doctors in Montana recently filed a lawsuit seeking to be allowed to dispense medications directly to their patients. Dispensing medication directly to patients is prohibited in that state. However, critics say that dispensing medication directly to patients raises serious medication safety concerns. In particular, there is a concern that there would not be a second review by a pharmacist of the prescription. There is also a concern about the lack of regulatory oversight, such as labeling, supervision, and storage.

Pharmacy errors can occur at different stages in the process. Having a pharmacist dispense and administer the medication means that the pharmacist can act as a check on errors that can occur when prescribing medication. Allowing a doctor to prescribe and dispense a medication means that there would likely be no second person reviewing and checking for errors before the medication reaches a patient. Prescribing errors can, of course, cause significant harm to patients.

Maryland pharmacy errors can take many forms—an incorrect dosage, for example, or even the incorrect medicine. Perhaps the pharmacist accidentally prints instructions telling the patient to take the medicine twice a day instead of twice a week, or misreads a doctor’s written prescription. Whatever the error, pharmacy errors have one important thing in common: they are more likely to happen when pharmacists are stressed, overworked, and distracted—three things they have been known to be since the beginning of the COVID-19 pandemic.

With pharmacists and pharmacy technicians overworked and operating in stressful and hectic work environments, it may come as a surprise to many that there has been a significant decrease in the number of pharmacy errors and patient safety incidents being reported since March. According to a Pharmacy Business article, there was a 44.5% decrease in the number of incidents reported during the second quarter of 2020, compared to the first. Additionally, there was a 40.6% decrease in the number of incidents reported compared to the same quarter in 2019. While this may seem like good news, experts say it’s not. In fact, the National Pharmacy Association (NPA) has asked community pharmacies to report all safety incidents—believing that they are currently not doing so. In a recent update, NPA said that the significant reduction in the number of incidents being reported “may be due to the increased workload and pressure on pharmacy teams due to the COVID-19 pandemic, whereby pharmacy teams may not be prioritizing reporting of patient safety incidents.”

It is thus important that Maryland residents understand that a decrease in reported errors probably does not mean an actual decrease in errors—if anything, pharmacy errors are expected to be increasing during this stressful time. Pharmacists are working frantically to fill prescriptions, maintain a safe and clean working environment, and respond to patient requests, with the stress of COVID-19 constantly looming. As such, they are likely to be distracted and hurried, perhaps missing pharmacy errors that could cause significant harm to patients. Maryland residents are encouraged to double-check every prescription and refill to make sure the drug inside the bottle matches the description and the instructions match their doctor’s instructions. If a pharmacy error does occur, they should immediately call their doctor to mitigate any harm. Additionally, in cases causing serious illness or injury, Maryland patients always have the option of filing a personal injury suit against a negligent pharmacy or pharmacist. These suits can help hold the pharmacist responsible and provide monetary compensation for the injured victim, allowing them to pay off their medical bills or cover costs incurred due to the error.

Maryland pharmacy errors occur when a patient is given a prescription drug that is flawed in some way. It may be the incorrect drug, or the incorrect dosage, or it may be that the instructions are incorrect, causing the patient to take the drug too often, not often enough, or at the incorrect times. Because prescription drugs are often powerful and dangerous if taken incorrectly, pharmacy errors can cause severe illness or injuries, especially if they are not caught for a significant period of time.

Patients can protect themselves from Maryland pharmacy errors by carefully reading the drug labels and prescription information every time they pick up a prescription. These labels not only provide important information on safe and proper medication use; they also can help the patient check for errors. For example, the information provided with the prescription often indicates what the medication looks like, by describing it as “small white pills” or “red oblong capsules.” Patients should compare this information to the actual medication they receive, to ensure there has not been a drug mix-up.

Additionally, the information included with the prescription explains how to use the drug and drug interactions. This information should be compared with instructions given by your doctor or pharmacist. If there’s a conflict, it’s safest to call your doctor or pharmacist to clarify. The information on drug reactions can also help patients avoid a common pharmacy error—doctors prescribing a medication that has an adverse interaction with another medication the patient is already taking. If you are already taking any form of medication, even if it’s over the counter, it is best practice to read the information on drug interactions provided with your prescription drug to make sure there are no problems.

Modern medicine and technology have expanded the number of drugs and medications available to patients struggling with illness, pain, or other health concerns. However, these medications can be dangerous if taken unnecessarily or in the wrong dosage. Generally, Maryland patients cannot decide which medication they will take—they usually need a prescription from a doctor, who has years of training and experience assessing patients’ needs and prescribing drugs that fit their needs. Maryland residents trust doctors to do this for them, but occasionally errors will be made, or a doctor will have a lapse in judgment, leading to injury to the patient.

For example, recently, a government official reported on a case where a doctor breached his duty of care and acted somewhat negligently, giving a patient access to a potentially dangerous quantity of medication. According to an independent news source, the patient in question had a long history of substance addiction and mental illness. In 2017, she was prescribed two drugs. The prescription stated that the drugs were to be given to her in 14-day supplies, so she only had access to two-weeks’ worth of the drug at a given time.

A few months later, the woman requested a three-month quantity when picking up her prescription. The pharmacy sent the request to her doctor, who changed her prescription to allow the pharmacy to dispense 90-day supplies of the medications without reviewing the patient personally. This, according to the government official’s report, was very dangerous—the type and quantity of the medication could be misused, especially considering the patient’s history of substance addiction and mental illness. The doctor had erred by allowing her a 90-day supply without examining her and considering whether she was at risk for misusing the drugs, and in doing so, increased the risk of harm to the patient.

Every day, many Maryland residents visit doctors for various reasons, ranging from mild illnesses or slight pain to severe sickness or life-threatening medical conditions. No matter the reason, Maryland patients expect that they can trust their doctors to give them high-quality care. Doctors are highly trained and highly educated precisely because of the important nature of their jobs, and so Maryland residents understandably rely on them when something is wrong. But doctors sometimes make mistakes, and unfortunately, sometimes those mistakes can cause severe injury or illness for Maryland patients. One of the most common mistakes doctors make is also one of the hardest for patients to catch before it’s too late—a mistake in the prescription that causes a pharmacy error.

Pharmacy errors can occur at any time between when the prescription is written and when it is taken by the patient. Sometimes the errors are caused by pharmacists filling a correctly written prescription. Other times, however, the doctors themselves make the mistakes while writing out the prescription, usually because they are distracted by something when writing it out. There are several different types of potential mistakes. Doctors may prescribe the wrong drug, for example, or not remember that the drug they are prescribing has adverse side effects when taken with another drug the patient is on. They may also write the wrong dosage, causing a patient to receive either too little or too much of the medication. Doctors may even forget what allergies their patient has and prescribe them a drug that leads to a severe allergic reaction. All of these may occur without a patient even realizing until it’s too late.

If a patient does fall ill or get injured due to a doctor’s negligent error in writing a prescription, Maryland state law allows them to file a personal injury lawsuit. Many people might balk at the idea of suing their doctor, but sometimes it is necessary for a patient to do so to avoid going into financial ruin because of someone else’s mistake. Maryland pharmacy errors can become costly. Depending on the situation, patients can rack up thousands in debt, even hundreds of thousands, due to medical expenses and lost wages. Sometimes pharmacy errors can even be so severe that a patient’s life will be permanently affected. Because the stakes are so high, Maryland law allows patients to hold doctors liable and recover for their losses. The process may seem overwhelming and confusing, but most Maryland pharmacy error victims do not go through it alone—instead, they choose to work with an experienced personal injury attorney who can handle the bulk of the case for them.

When Maryland residents become sick or injured and need to take medication, they generally trust their medical professionals and pharmacists to give them the right medication, dosage, and instructions. However, as past victims of Maryland pharmacy errors can tell you, that unfortunately does not always happen. Doctors, medical personnel, and pharmacists are human, and will occasionally make mistakes. Unfortunately, those mistakes can be deadly.

For example, take a recent error where a 55-year-old man was given ten times the amount of pain relief medication than he should have been, tragically causing him to pass away. The victim—a painter and decorator—had been taking pethidine for some time to deal with back pain from a prior incident. However, he was then switched to methadone, as there was a shortage of pethidine. When calculating how much methadone to give the man, the pharmacist made a fatal error—he believed that the methadone was of the equivalent strength to pethidine. However, 5mg of methadone is actually the equivalent of 50mg of pethidine. Because the pharmacist did not double-check, and did not know this, he gave the victim ten times the amount of medication he should have.

Just a few days after taking this medication, the victim was found dead in his home by his son. A post mortem report found that he died in part due to methadone toxicity. After his death, his daughter also discovered a methadone leaflet, which warned patients not to take methadone if they had a lung condition—which her father had. This also raised questions as to why he was prescribed methadone in the first place.

If you live in Maryland and a medication you are or were taking has been recalled, what you should do depends on the specifics of the recall. The first thing to do is to determine what to do to keep you safe and healthy. The recall generally will include guidance on what consumers should do with the impacted product and what steps to take. That means that in some cases, consumers may need to stop taking the impacted drug immediately, but in others, continuing to take a drug may be the safest course of action for the short-term. Patients should also speak with their healthcare provider to determine if there are any alternative medications they could take. After addressing that concern, the next step is to consider any legal recourse you can seek through a Maryland product liability or negligence claim.

When a company issues a recall, the FDA then classifies the recall and oversees the company’s strategy for recalling the drug. The most serious class of recall is a class I recall. Those are recalls in which the product could cause serious harm or death. The next serious is a class II recall, which is for products that pose a notable risk and threat. The lowest level recall is a class III recall, which is for products that violate the agency’s labeling or manufacturing laws but are not likely to cause adverse health consequences.

If a Maryland resident has taken a recalled drug, the patient may be able to sue the drug manufacturer to recover damages. However, it is not enough to show that the patient took the drug. The patient must also show that they suffered injuries as a result.

It’s no secret that the COVID-19 pandemic has overwhelmed the health care system. High rates of infection and death have sent thousands of Americans to hospitals and health care clinics, most of which were already busy treating patients before the pandemic. The country’s medical providers and health care workers are working hard every single day to try and help people and combat the virus, but the sheer amount of work and stress they are under may take a serious toll on their mental health and their ability to perform the job effectively. Recently, a hospital nurse spoke to the Institute for Safe Medical Practices (ISMP) about the impact that COVID-19 is having, and what he said has implications for how the pandemic may increase Maryland pharmacy errors.

According to an article detailing his experiences and report, medication errors have been increasing in his hospital. Because nurses are working long hours with critically ill patients in a stressful, hectic, and overwhelming work environment, medication errors are more common. However, it is likely that this pattern is not isolated to just hospitals. The entire health care system is overwhelmed right now that it is likely that the rise of medication errors is also occurring in other settings, including pharmacies.

Pharmaceutical errors can be just as dangerous as errors occurring in hospitals. Many Maryland residents rely on their local pharmacy for their medications, but when pharmacists and pharmacy technicians are stressed out and overwhelmed they may make significant errors, such as providing the wrong dosage of a medication, or even the wrong medication altogether. With the COVID-19 pandemic, pharmacies may be overwhelmed by more calls from patients than usual, or requests for more prescriptions as individuals stock up. They may also be short-staffed if a pharmacist or technician gets sick or needs to stay home to take care of a family member. All of this can negatively affect Maryland residents, who rely on pharmacists to fill their prescriptions correctly and likely to not expect to be injured from taking prescribed medicine.

The COVID-19 pandemic had changed the lives of almost every American in too many ways to count. Among those who have been the most impacted by the pandemic are medical workers, including pharmacists. Pharmacies have seen surges in volume as more people are more frequently visiting doctors and obtaining prescriptions for all types of health conditions. As the demand on pharmacists increases, so does the risk of a Maryland pharmacy error.

The Institute of Safe Medication Practices has released a list of tips that pharmacists should follow to decrease the risk of error during these challenging times. The tips are broken down into three categories:

Preventing Pharmacy Errors

When it comes to preventing Maryland medication errors, the Institute of Safe Medication Practices recommends pharmacists take the following steps:

  • Keep certain IV infusions standardized to a single concentration or dose, when possible.
  • Use visually identifiable premixed solutions for common infusions.
  • When dispensing a nonstandard concentration or a paralyzing agent, be sure to clearly label these infusions.
  • Implement frequent safety meetings and create processes for pharmacy members to double-check solutions before administering infusions.

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Many people will admit that they occasionally get distracted while at work. It’s human nature to get distracted occasionally, and even to occasionally make mistakes. However, in some lines of work, the costs of distractions and mistakes are much higher than others, and employees need to be particularly careful to ensure they are not harming others. This is true, for instance, in pharmacies. Maryland pharmacy errors cause harm and injuries to patients every year. Part of the reason is that pharmacists and pharmacies have recently been expected to handle more and more tasks faster and faster, making it easy for mistakes to occur and not get caught until it is too late.

Recently, an industry news source published a piece discussing the importance of minimizing distractions whilst working in a pharmacy. The post shed light on the fast-paced pharmacy work environment, and how often pharmacists are interrupted while doing important tasks, like filling prescriptions, checking dosages and instructions, and communicating with patients.

According to the post, a recent study found that those working in pharmacies were interrupted an average of seven to thirteen times each hour. The interruptions could be categorized into five major categories: (1) patients walking up to the counter or calling in refills; (2) technicians interrupting pharmacists, usually for assistance on something they are unauthorized to do; (3) pharmacists self-initiated distractions, such as calling a prescriber’s office or initiating a non-work conversation; (4) technological distractions, such as a phone ringing or an announcement over the store’s loudspeaker; and (5) other pharmacists having questions.

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