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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Earlier last month, an appellate court in Tennessee issued a written opinion in a case involving the death of a man who had overdosed on prescription medication. The court ultimately determined that the patient’s death was attributable to his own actions. The case was presented to the court as a workers’ compensation case, but the issue the court decided was relevant to personal injury cases involving allegations of pharmacy error and medical malpractice.

PainkillersThe Facts of the Case

The petitioner was the surviving wife of a carpenter who involved in an accident while on the job. As a result of the accident, the man’s doctor prescribed oxycodone, a powerful and addictive pain medication. The man took the medication as directed at first but then began abusing it. According to the court’s opinion, he would skip doses of the medication in fear that he would run out when he needed it. He eventually started to take the medication with alcohol to increase the medication’s effectiveness.

About two years after his accident, the man’s wife discovered her husband’s lifeless body in bed. The woman, through her deceased husband, filed for workers’ compensation benefits based on the fact that the original injury her husband sustained occurred while he was on the job. An autopsy reported the man’s cause of death as opioid toxicity, with contributing causes of hypertension, alcohol use, and tobacco use.

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When most hear that a pharmacy error was made, they assume that a busy pharmacist grabbed the wrong prescription, got the dosage information incorrect, or printed the wrong instructions. However, according to a recent industry news report, a large portion of pharmacy errors list information technology as a contributing factor to the error.

Assorted PillsAs health care technology advances, pharmacies are relying more and more on technology to fill in the gaps where humans are prone to making errors. These areas include patient records, dosage instructions, drug-interaction alerts, and receiving and inputting customer orders. In many cases, technology allows for fewer pharmacists to fill more prescriptions per day, which benefits both the pharmacy owner as well as the patient, who presumably will have reduced wait times.

As the report notes, however, technology is not perfect. According to the report, the most common errors involved the dosage of medication, including omitting the dose, including the wrong dose, or including an extra dose of medication in a patient’s prescription. While many of these errors will be caught before the patient ingests the medication, some of these errors will result in a patient’s injury.

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While pharmacists are certainly busy medical professionals, there is no excuse to cut corners or to engage in any shortcuts that could potentially put a patient’s life at risk. However, despite the importance of a pharmacist’s role in a patient’s overall medical care, there are often lapses in care or judgment that put recovering patients at an increased risk of re-admission to the hospital. Similarly, even patients picking up routine medications are put at risk of serious complications when pharmacy errors are made.

Doctor's GearLegally, pharmacists have a duty to ensure that they provide a certain level of acceptable care. To be sure, this does not mean that a pharmacist can be held liable for every adverse drug reaction; however, when there is evidence that a pharmacist did not provide the adequate level of care, patients who suffered as a result may be entitled to monetary compensation for their injuries.

Proving that a pharmacist’s actions were legally deficient is not difficult in many pharmacy error cases, especially when the case involves allegations of the pharmacist providing a patient with the wrong medication or the wrong dosage of the correct medication. However, one of the most common areas in which plaintiffs run into problems is in establishing causation. Causation is an element in almost all pharmacy error cases that requires the plaintiff to establish that the defendant’s negligent act resulted in their injuries. In pharmacy error cases, this often requires the testimony of one or more medical experts.

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Last month, a jury in Massachusetts rendered a guilty verdict in a case brought against a pharmacist who had run a pharmacy that was tied to hundreds of cases of meningitis in 20 states. According to a national news source covering the case, the pharmacist was acquitted of murder charges but was convicted on several counts of “racketeering, racketeering conspiracy, mail fraud and introduction of misbranded drugs into interstate commerce with the intent to defraud and mislead.”

Mortar and PestleEvidently, the pharmacist ran a compounding pharmacy that would create custom-made medications. However, inspections conducted during the investigation revealed that the equipment used to create the medication was not sterilized, and ingredients used in the process had expired. In addition, prosecutors alleged that the pharmacist, as well as several of his employees, actively lied about the condition of the lab.

The medication created in the lab was shipped to 20 states and was tied to 700 cases of meningitis. It is believed that 64 people died due to the unsafe medication that was created in the lab, which was the deadliest meningitis outbreak in U.S. history.

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In most professions, when someone makes a serious error that affects the health or safety of another person, it becomes public knowledge. Indeed, we often read in the news about reports of doctors, police officers, and politicians who make questionable judgment calls. The fact that these lapses in judgment become public knowledge allows for the public to better understand the errors and encourages brainstorming about how to reduce those errors in the future through better policy-making and enforcement.

Mixed PillsPharmacists, however, do not face mandatory reporting requirements in much of the country. In fact, in most states, pharmacists are given discretion about when to report most errors. Interestingly, Maryland is ahead of the curve in requiring that certain adverse patient-related events, including medication errors, be reported within five days by medical professionals, including pharmacists.

The Seriousness of Pharmacy Errors

The Food and Drug Administration estimates that medication errors cause more than one death a day and injure over 1.3 million people annually. While not every prescription error will result in a serious injury or death, it is important to realize that the effects of a pharmacy error may not be immediately apparent. In some cases, medical experts are required to establish which, if any, consequences a patient who has been provided the wrong medication may face in the future.

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Earlier last month, a news article discussed a recently filed case brought by a woman who was provided the wrong medication by a national pharmacy chain. According to the news report, the woman suffered from restless leg syndrome and was provided a prescription for Ropinirole by her physician. She called in the prescription to a nearby pharmacy, picked up her pills, and took them home. She took the first dose later that night.

PillsAfter taking the first dose of the medication she was provided by the pharmacist, the woman started feeling odd and suffering from serious nightmares. She explained that she was hallucinating and didn’t know what was going on, and it felt as though her limbs were detaching from her body. Her husband told reporters that his wife awoke in the middle of the night, telling him strange stories that did not make any sense.

On the next day, the woman’s daughter noticed that her mother was not acting normally and checked the pill bottle. Her mother’s name was on the outside of the bottle, and the correct medication name and dosage was on the front of the bottle; however, when she opened the bottle, the pills did not match the label. The bottle contained Risperdone, a powerful anti-psychotic used to treat schizophrenia. After the woman discovered the error, she was taken to the hospital and connected to an IV to flush her system.

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Earlier this month, a British news source published an article discussing the 2016 death of a man who was provided the incorrect prescription just days before he died. According to the report, the man had been receiving medication for type II diabetes, heart problems, and glaucoma. He had filled the prescriptions in the past with no problem, but in May of last year he was provided another patient’s prescription. Apparently, the packet containing the pills contained another customer’s prescription with his name on seven different labels; however, the victim’s name was printed on the outermost packaging.

Silver PillsAn investigation was conducted into the fatal pharmacy error, and it was discovered that the filling technician had opened the interior packet of pills, added additional requested pills, and then sealed the package back up. Apparently, the technician did not notice that the name on the seven labels inside the packaging and the name on the outside packaging did not match. And neither did her supervisor.

After the error occurred, but before it was discovered, the man began complaining of chest pain and having a difficult time breathing. Two days after the error, he passed away. The coroner’s report indicated that the prescription error at least “hastened” the man’s death. However, the prosecuting authority determined that there was insufficient evidence to pursue criminal charges. Since the accident, the branch where the error occurred has stopped assembling medication packets on location.

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