Maryland prescription errors can occur at different stages in the prescription process. One of the ways errors can occur is when a pharmacist misinterprets the doctor’s handwriting on the prescription form. Errors can also occur when a doctor handwrites a prescription but forgets to include certain pertinent information.

Pharmacy CounterEven when a prescription error is not fatal, it can still seriously affect a patient’s safety and quality of health. Advocates have encouraged doctors to reduce prescription errors by introducing automated systems, uniform prescribing charts, and immediate review of prescriptions. Some argue that in addition to improving the readability of prescriptions, electronic prescriptions can also help by providing the doctor with optimal dosages.

Study Finds Handwritten Prescriptions Contain More Mistakes than Electronic Prescriptions

According to one news source, a recent study looking at opioid prescriptions found that there were more mistakes in written prescriptions than in electronic prescriptions. The study looked at prescriptions filled at a pharmacy at Johns Hopkins Hospital. The researchers sought to determine whether prescription processing methods contributed to inconsistencies and errors in opioid distribution. The researchers reviewed all of the prescriptions processed for adults during a 15-day period. There were 510 prescriptions in total. The study evaluated the prescriptions based on three criteria:  compliance with best practice guidelines, which include standards such as legibility and including the date; the inclusion of at least two patient identifiers; and compliance with federal opioid prescription rules, which require including the patient’s full name and address.

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Pharmacists are responsible for ensuring that the prescriptions they fill are correct. Of course, this means that pharmacists must take care to provide patients with the correct medication, at the correct dose, and with the appropriate dosing instructions. To be sure, most medication errors involve an oversight involving one of these issues. However, according to a recent news article, a pharmacist in New Zealand recently provided one patient with a three-month supply of medication that was just one month away from being expired.

White PillsEvidently, a patient went to the pharmacy to fill a prescription of Ferrograd. When the pharmacist provided the patient with the requested three-month supply, the pills provided to the patient were to expire in one month. A few months later, the patient went back to refill another prescription. This time, the pharmacist gave the patient the wrong drug entirely. At this time, the patient double-checked her Ferrograd prescription and realized it was expired. She returned the prescription for a replacement.

The supervisory board found that the pharmacist failed to fulfill the duty that was owed to the patient, and it implemented an investigation into the pharmacy’s practices. The pharmacy explained that whoever dispensed the prescription wrote down the incorrect drug name and retrieved the incorrect pills from a similar-looking bottle. The pharmacist ended up acknowledging her mistake and providing the patient with a written apology.

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Earlier this month, a federal appellate court issued a written opinion in a product liability case brought against the manufacturer of Zoloft, alleging that the medication causes birth defects. The court’s decision reviewed a lower court’s decision to prevent the plaintiffs’ expert witness from testifying. Ultimately, the court concluded that the lower court was proper to not allow the expert’s testimony.

GavelThe Facts of the Case

The plaintiffs were a class of people who collectively claimed that the medication Zoloft caused birth defects when taken early in a pregnancy. In order to establish their claim, the plaintiffs planned on presenting several witnesses to show that the ingestion of Zoloft actually caused the birth defects in their children. However, the court prevented one of the key witnesses from testifying, based on the novel method the expert used in arriving at her conclusion.

The plaintiffs then tried calling another witness in place of the one who was prevented from testifying. The drug manufacturer objected to this witness as well, and the court conducted a hearing to determine whether the expert’s testimony would be admissible.

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Chances are anyone who has followed the news over the past few months has noticed at least one serious pharmacy error occurring at either a hospital or a retail pharmacy. Indeed, the Food and Drug Administration estimates that there is on average one death per day in addition to approximately 1.3 million people harmed per year by pharmacy errors. However, these statistics are only estimates because the real number of errors cannot be determined, due to discretionary reporting requirements.

White PillsAs the law stands now, pharmacies are not required to report most of the errors that their pharmacists make. While some errors come to the public’s attention due to widespread press coverage or because a pharmacy error victim files a personal injury lawsuit, many errors go unreported. Thus, the true number of pharmacy errors is unknown.

According to a recent article, our neighbors to the north in Ontario, Canada have begun to implement mandatory reporting requirements. Evidently, the change in the law was spurred on by the death of an eight-year-old boy last year. The report indicates that the boy suffered from sleeping problems and was prescribed tryptophan by his pediatrician. The boy’s mother called in the prescription and went to pick up what she thought was tryptophan, but what she was given was actually baclofen, a powerful muscle relaxer. After the boy’s death, the coroner reported that “logic would dictate that baclofen was substituted for tryptophan at the compounding pharmacy in error.”

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Pharmacy errors have been on the rise over the past few years. While there are many reasons why a pharmacist may give the wrong medication to a patient, one of the most commonly reported causes of pharmacy errors is look-alike and sound-alike drug names.

Medicine PacketsThe pharmaceutical industry relies heavily on marketing to sell medication. Once a medication is established as effective and becomes popular, other medications that perform a similar function may be released with similar-looking or -sounding names. This can create a dangerous situation when a busy pharmacist needs to fill multiple medications for drugs that all sound the same, each with its own dosing requirements and instructions.

The Government’s Efforts to Curb Pharmacy Errors

According to an article in a recent industry publication, the Food and Drug Administration’s Division of Medication Error Prevention and Analysis (DMEPA) has recently ramped up its efforts to review drug labels prior to FDA approval in hopes of decreasing the total number of errors due to look-alike and sound-alike drugs.

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Pharmacists have a great deal of responsibility in that they are responsible for accurately providing patients with physician-prescribed medication, double-checking that their prescribed medication does not negatively interact with other medications, and advising patients with medication-related advice. There can be little doubt that pharmacists have their hands full. This is especially the case when pharmacies are understaffed or during unusually busy hours.

Pills in HandAccording to a recent news report, the long hours and stressful work conditions present in many pharmacies across the country result in an increased risk of potentially serious errors. The article interviews several retired pharmacists, who relay their concerns about how the industry has become more demanding on pharmacists, often requiring that they work 14-hour shifts with only a few short breaks.

With drive-thru windows becoming more common over the years and the pressure to keep the pharmacy’s bottom line in mind, pharmacists not only are working long hours but are highly stressed while on the job. By some estimates, pharmacies are filling up to 800 prescriptions per day. These factors, according to the pharmacists interviewed in the article, have contributed to an increase in errors over the past several years. However, due to a lack of regulations, pharmacies are not required to report most of these errors, resulting in a dearth of accurate official statistics.

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The availability of prescription medication is restricted and controlled by the government for good reason. In most cases, prescription medications are powerful drugs that, while they do have the power to heal, also have the potential to cause serious adverse effects in some patients.

White PillsIn some cases, medications are only available through a prescription because that specific medication presents an increased risk of abuse. However, some drugs pose no real potential for abuse but are controlled due to the serious effects they may have on the patient. Of course, this includes situations in which the patient is taking other prescription medication, as well as cases in which the patient is prescribed only one medication. The reality is that even with the advancement of medicine, doctors and pharmacists cannot always know how a patient’s body will react to a certain medication.

In general, doctors and pharmacists have a duty to ensure that the medication they are providing to a patient is not known to be dangerous. This means that a pharmacist should not substitute generic medication for name-brand drugs unless the physician specifically allows for such a substitution. It also means that pharmacists should be double-checking which medications a patient is taking before providing a new medication that may adversely react with an existing one.

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Medical errors can occur in a number of situations, including by filling a prescription with the wrong pills, operating on the wrong limb, or providing medication to the wrong person. These mistakes can be devastating for patients as well as their families.

Mixed PillsIn a medical malpractice claim based on a medical error, a plaintiff has to demonstrate that the medical professional acted negligently by either engaging in a negligent act or negligently failing to take a required action. That is, a plaintiff must show that the medical provider failed to meet the applicable standard of care by failing to act in a manner in which other medical professionals would act under the circumstances.

A 74-Year-Old Grandfather Fell into a Coma After Being Given the Wrong Medication

According to one news article, a 74-year-old man went into a coma after having been given the wrong medication at a hospital. Earlier this year, the man went to the hospital with flu-like symptoms. He was diagnosed with liver cancer and admitted to the hospital. After a couple of weeks at the hospital, he was given medication that was not prescribed to him.

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In some ways, the pharmaceutical industry is heavily regulated. Medications must undergo years of testing before they are released and available for prescription. Similarly, pharmacists themselves must obtain a specialized advanced degree and have a certain amount of on-the-job training before they are certified. However, pharmacy technicians require less training and are often permitted to fill prescriptions on their own, requiring only a brief glance by the overseeing pharmacist before being provided to the patient.

Random PillsAccording to a recent news report, a lack of regulations inside the pharmacy may be responsible for the increase in pharmacy error rates across the country. The report details one woman’s experiences after being prescribed a dose of a prescribed medication. The report notes that lawmakers in many states have not enacted rules limiting the number of prescriptions a pharmacist can fill per hour or per day. This means that, rather than being permitted to focus on assuring that each prescription is properly filled, a pharmacist may be pressured by management to fill large amounts of prescriptions. This emphasis on quantity over quality can have disastrous results.

Prescription Error Results in Patient’s Skin “Melting Off”

Earlier this month, a local news report documented one woman’s struggles after being prescribed the wrong dose of the medication lamotrigine. According to the report, the woman went to the doctor because she felt depressed. The doctor wrote a prescription for lamotrigine, and the woman took it to her local pharmacy. However, the pharmacist on duty incorrectly filled the woman’s prescription at the wrong dose.

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The dangers of prescription drugs have been well-documented over the past several decades. In most cases, a medication is made available only by prescription because it presents an increased risk of causing harm to a patient who should not be taking it. This can be due to an increased risk of negative interaction with other medications, an increased risk of abuse, potential side effects, or the ease with which a patient could accidentally overdose.

Blister PacksPrescription errors can occur any time a patient is given medication. While many of these errors occur at local retail pharmacies, a large percentage of prescription drug errors occur in long-term care facilities. Once a patient is discharged from the hospital, their medical records are supposed to follow them. However, the reality is that many of the prescription errors that occur in long-term care facilities occur shortly after a resident is discharged from the hospital. This is most often due to a miscommunication between the hospital and the long-term care facility.

A recent report discusses how the period of transition from hospital to long-term care facility is one of the most dangerous times for patients. The report notes that in many cases, patients in transition are in “crisis mode,” after having recently been admitted to the hospital. The patient most likely has seen several medical professionals, and they may be taking multiple prescription medications that they are not accustomed to taking. Thus, the patient is less likely to be able to catch an error before it occurs.

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