Causation is an essential element of any Maryland pharmacy error claim. Establishing the element of causation means showing that a defendant’s wrongful conduct was a “cause-in-fact” and a legally cognizable cause of the plaintiff’s injuries. This means that a plaintiff has to show that the defendant’s actions were an actual cause of the plaintiff’s injuries and that they were reasonably foreseeable and expected so that the defendant should be held liable. A defendant’s conduct may not be a legally cognizable cause of the plaintiff’s injuries if the resulting injuries were not an expected or reasonably foreseeable consequence of the defendant’s conduct.

In pharmacy error cases, causation can be more complicated, because many patients who take medication are already sick. So in some cases, it can be difficult to determine whether the patient’s injuries were caused by the pharmacy error or by the patient’s underlying ailment. In cases where there was more than one factor that brought about an injury, Maryland courts apply the substantial factor test. Under that test, courts will look at the defendant’s conduct to determine if it was a substantial factor in causing the plaintiff’s injuries. Pharmacy error cases often require testimony from an expert to provide an opinion on the effect of the pharmacy error and to explain how it affected the patient.

Cancer Patient Given Dosage Five Times Stronger Than Prescribed

According to the U.S. Food and Drug Administration (FDA) and National Coordinating Council for Medication Error Reporting and Prevention, a medication error is a “preventable event that may cause or lead to” a patient using inappropriate medication or experiencing harm while the medication is in control of a healthcare professional or patient. Maryland medication and pharmacy errors can occur at any time during a patient’s care, such as during prescribing, dispensing and administering medications. Although medications may carry the risk of side effects, a medication error can result in severe and life-threatening injuries.

The FDA reports that the agency receives over 100,000 complaints of suspected medication errors every year. The report separates the claims and classifies them based on cause and type of error. The reports stem from healthcare professionals, drug manufacturers, and consumers. The reports often allege death, life-threatening injuries, hospitalizations, disability, and birth defects. The FDA takes steps to prevent and reduce medication errors by taking steps before the pharmaceutical receives approval. The agency reviews the drug’s name, labeling, and design to reduce the likelihood of medication errors. For example, they take steps to ensure that the names are not easily confused with another drug. Further, they review labels to ensure that drugs that have different strengths are distinguishable from one another.

While these steps are necessary and likely prevent many medication errors, pharmaceutical errors continue to occur. These errors often stem from poor communication between a patient’s various healthcare providers or between a healthcare provider and a patient or pharmacist. Further, they may arise because of issues with similar-sounding drug names or medical abbreviations.

Medication errors still occur frequently despite substantial efforts to reduce medication errors throughout the country. According to one study, adverse drug events make up over one million emergency department visits and 3.5 million physician office visits each year. Those who are injured due to Maryland medication error may suffer from physical and mental effects after the error.

Medication errors may occur because of look-alike or sound-alike medications, labeling errors, unclear prescriptions, prescribing errors, failure to check for adverse reactions due to allergies or other drugs, or other reasons. Pharmacists may also fail to give adequate instructions and warnings. If someone has been injured due to a medication error, they have the right to file a claim for monetary compensation from the wrongful actor. An injured patient in Maryland may be able to recover compensation through a negligence claim by demonstrating that the wrongful actor failed to meet the required standard of care and injured the patient due to the negligent conduct. Certain family members may be able to file a wrongful death claim in the tragic event of the patient’s death.

Denial After a Medication Error

A recent article discussed the tendency of pharmacists to deny an error and become defensive in the event of a medication error. Pharmacists and other medical professionals may fear litigation which causes them to treat patients as a threat. As the article noted, taking this approach can alienate patients and ignores the issues that caused the error and any ongoing risks to patients. Thus, the patient may be put at greater risk, and the issues that caused the error may continue. Pharmacists should instead be honest and transparent with patients and evaluate the error. Honesty and transparency facilitate communication, helps to improve systems and puts the safety of patients first.

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Victims of a Maryland medication error may be able to recover financial compensation through filing a civil claim against the people and entities responsible for the medication error, such as a pharmacy or a medical provider. Filing a civil claim against those responsible (generally through a negligence claim) includes investigating, preparing, and filing the claim in court. Some defendants may choose to settle the case, while others may proceed to trial. In a successful claim, a victim may be able to recover a range of damages.

Generally, damages fall into two categories: economic and non-economic damages. Economic damages are damages with a fixed dollar amount, whereas non-economic damages do not have a fixed value. Examples of economic damages are past and future medical treatment, lost income, transportation costs, and physical therapy treatment. Examples of non-economic damages are pain and suffering, disfigurement, loss of companionship, and loss of parental care. Both economic and non-economic damages are considered “compensatory” damages—intended to compensate the victim for the losses the victim suffered. There is a cap on non-economic damages in injury cases in Maryland, though there is no cap on economic damages, and more can be recovered in some instances.

In certain cases, punitive damages are appropriate. Punitive damages are reserved for cases in which the defendant acted with actual malice or with deliberate wrongdoing. They are meant to serve as a punishment for the defendant and as a deterrent for others. At trial, the victim has to prove all of the damages they are claiming. Generally, a plaintiff has to prove all damages under the “preponderance of the evidence” standard, but punitive damages must be proved by the higher standard of “clear and convincing evidence.”

Despite efforts to reduce medication errors in pharmacies and other medical settings, medication errors continue to occur all too frequently. If a person suffers an injury due to a medication error in Maryland, they may be able to obtain monetary compensation through a Maryland medication error lawsuit. Generally, a medication error lawsuit is based on a claim that the prescribing physician, pharmacist, or another medical professional acted negligently.

In a negligent suit, the plaintiff has to prove that the defendant owed the plaintiff a duty of care, that the defendant failed to meet the applicable standard of care by acting or failing to act in some way, that the plaintiff was injured because of the breach of the standard of care, and that the defendant’s breach caused the plaintiff’s injuries. A plaintiff must show that it was more likely than not that the defendant’s conduct caused the victim’s injuries. Medication error cases may be difficult to prove, in part because the patient may have been sick before the medication error. For that reason, expert testimony is often required to explain how the defendant’s actions caused the plaintiff’s alleged injuries.

Successful plaintiffs may be able to recover monetary compensation, including past and future medical expenses, lost wages, physical therapy bills, and emotional suffering. If someone dies due to a medication error, family members of the decedent may be able to file a wrongful death claim against the parties responsible for the medication error. Negligence claims are subject to time limits for filing a claim. The general time limit that applies to Maryland negligence claims is three years after the date of the injury, though there are exceptions. If the time limit has passed, the case may no longer be able to be filed. Evidence can also disappear after some time, so acting as quickly as possible is best. The prevalence of medication errors and the devastation it can cause has prompted new efforts to reduce such mistakes, including the introduction of a new technology that uses barcode scans on medications.

Medication errors continue to harm over one million people each year, and between 7,000 to 9,000 are killed each year in the U.S. due to a medication error. Maryland medication errors can occur in multiple care settings, including hospitals, pharmacies, and doctors’ offices. Researchers continue to investigate causes for medication errors and ways to decrease the risk of errors.

A new survey revealed that burnout is very common among hematology/oncology pharmacists. According to the results of the survey, 62 percent of those surveyed reported symptoms of burnout. Factors that contributed to high dissatisfaction at work for the hematology/oncology pharmacists included the quantity of work, workflow disruptions, working many hours per week, and concerns for major medical errors within the past three months.

The leading author of the study explained that burnout is associated with mental and physical symptoms including anxiety, depression, heart disease, headaches, gastrointestinal issues, and more. In addition, the author explained the burnout is associated with a higher risk of making a major medical error. Researchers found that hematology/oncology pharmacists with high levels of burnout were four times more likely to think they made a major medication error in the previous 3 months. A shocking 20 percent of survey respondents reported believing to have made a major medication error in the previous three months.

Maryland, along with every other state in the U.S., paused the use of Johnson & Johnson’s coronavirus vaccine last week after six recipients of the vaccine in the country experienced a rare blood-clotting disorder. Over seven million people have received Johnson & Johnson’s vaccine in the United States so far. The six people who experienced the clotting disorder were women between 18 and 48 and experienced the disorder within three weeks of receiving the vaccine. In those cases, the blood clots occurred in the brain, and the women all showed low levels of platelets. One woman died from the illness. In a step to reduce Maryland vaccine errors and adverse reactions, Maryland’s Department of Health decided to pause the use of the Johnson & Johnson vaccine in the state “out of an abundance of caution.”

The AstraZeneca vaccine, which has been distributed in Europe, also had cases of individuals with blood clotting, which were “very, very similar” to the Johnson & Johnson clotting cases, one expert noted. Both vaccines use similar technology. A government committee will meet to evaluate further use of the Johnson & Johnson vaccine. The Centers for Disease Control said that individuals who have received the Johnson & Johnson vaccine in the past month should reach out to their doctors if they have abdominal pain, shortness of breath, leg pain, or severe headaches. Health officials reported that the people who experienced the clotting disorder most commonly had a persistent, moderate to severe headache that started six days or later after receiving the shot.

Individuals who experience vaccine errors or adverse reactions may be able to recover compensation from the administrator or manufacturer of the vaccine in some cases. A Maryland vaccine error claim based on negligence requires a showing that the defendant owed the individual a duty, the defendant failed to meet the relevant standard of care, the defendant’s negligent conduct caused the individual’s injuries, and the individual suffered damages. These cases can be complicated and often must rely on the testimony of experts to explain the link between the error and the injuries the individual suffered. Victims of a vaccine or medication error may be able to receive financial compensation for past and future medical expenses, loss of wages and earning capacity, and other damages depending on their circumstances. A negligence claim in Maryland has to be filed within three years after the date of the injury.

During the COVID-19 pandemic, Maryland residents may have found themselves relying more and more on pharmacists and local pharmacies, particularly as social distancing measures have limited the opportunities to speak with pharmacy staff and ask questions about prescriptions. Although many Maryland patients have been able to get the medication they need from pharmacies, it is important to remember that Maryland pharmacy errors are still happening. Pharmacy errors—which are not unique to Maryland but happen all across the country—can have significant negative consequences, especially during the current public health crisis.

Recently, a pharmacy error made headlines when a pharmacist’s methadone dosage error landed his client in the emergency room. According to a news article covering the incident, the client, a man in his 60s, was at the pharmacy waiting in line to receive his dosage of methadone under an Opioid Substitution Treatment program. The pharmacist identified the client he thought would be the next to receive a dose and turned away to measure the correct dose for that client. But that initial client left the room and the other client stepped forward and was waiting when the pharmacist returned to the counter with the measured dose.

The pharmacist did not follow protocol and say the client’s name when handing them the dose, and instead handed the incorrect dose to the client, who took it. The dosage the client took was 75mg, almost seven times higher than his usual dose of 11 mg. Afterward, before the client left, the pharmacist realized his mistake, but still allowed the client to drive himself home. Later on, the client received a call from a nurse, who had been informed of the error, telling him he needed to seek emergency medical attention immediately due to the risks posed by the increased dose. He was kept at the hospital for a bit but fortunately suffered no long-term complications.

Maryland pharmacy errors can range in their severity. Some may be harmless—a mistake is made when filling a prescription, but it does not really make a difference to or harm the patient. For example, the wrong version of a drug might be given, but the two drugs are substitutable. Or the instructions are messed up, telling the patient to take the drug every morning instead of at night, but it does not really matter so long as it’s only taken once a day. In these cases, individuals may not even know that there has been a mistake. But sometimes, pharmacy errors can be far more serious. Individuals given the wrong drug, the wrong dosage, or the wrong instructions, for example, may face significant bodily harm, or severe illnesses. In some cases, the mistakes may even be fatal.

For example, take a recent tragedy where a pharmacy error allegedly caused the death of an 82-year-old woman. According to an article covering the incident, the woman died on New Year’s Eve 2020, just hours before the world rang in 2021, after being wrongly sent antidepressants instead of her regular prescription for weeks. The woman’s caretaker found her semiconscious after one of his breaks and discovered that the drug she was supposed to be taking—the water retention drug furosemide—had actually been the antidepressant fluoxetine. The pharmacist had mixed up the drugs, which both started with the letter F. While researching the drug she had been taking—fluoxetine—it was discovered that internal bleeding was a potential side effect. And tragically, the patient died from an upper gastrointestinal hemorrhage, thought to have been caused by the pharmacy error.

The family is, understandably, heartbroken. The woman’s son, speaking to a reporter, says that the family feels “very let down because you put your faith and trust in pharmacies and the medication that they deliver.” To have that medication inadvertently kill your loved one is an unimaginable tragedy. While the family did receive a letter from the pharmacy saying that they made a mistake, that letter does not do anything to bring back their loved one. Unfortunately, nothing can. However, the family stated publicly that they are looking into bringing legal action against the pharmacy. While it cannot fix the awful situation completely, many families choose to file wrongful death lawsuits in situations like this one to recover financially for their loss. The monetary damages awarded in these lawsuits can ensure the family does not have to worry about finances while mourning their loved ones, and can cover medical bills, funeral and burial costs, and more.

It is no surprise that the COVID-19 pandemic has taken a major toll on the United States’ health care system. All areas of the system—from hospitals to local clinics and even pharmacies—are struggling, as staff are overworked, underresourced, and overly stressed one year into the pandemic. Of particular concern to Maryland residents are the potential impacts on pharmacists and pharmacy errors. When pharmacists are struggling, they are more likely to make careless errors and cause significant harm to patients, who may not realize the mistake until it’s too late. And, according to a recent NBC News article, pharmacists across the country are voicing concerns about the current state of their work, and what it might mean for patient safety. The most important part? These concerns started before COVID-19, and are likely to continue even once the virus is behind us as well.

According to the NBC News article, the past decade has led to an increase in work for pharmacists across the country, but fewer staff members to complete it. An estimated 155,000 pharmacists working at chain drugstores over the last decade have found themselves pushed to do more—work faster, fill more orders, and juggle a wider range of tasks—with fewer and fewer staff members. The pace expected from them is not only unmanageable but dangerous, as patient safety may suffer from pharmacists too exhausted or distracted to follow all safety protocols. NBC News spoke specifically to 31 pharmacists and pharmacy technicians in 15 states, who reported on 12-hour shifts so busy they didn’t have time to go to the bathroom and on rushing to complete their job but making mistakes along the way. The pandemic has made things even worse, as pharmacists now have additional duties with COVID-19 testing, deep cleaning constantly, and vaccinating patients.

Pharmacy errors can range from small, like miscounting the numbers of pills in a bottle, to potentially deadly, such as combining drugs with dangerous interactions or administering the wrong medication at too high a dosage. Maryland residents should be on the lookout for these errors to avoid any potentially harmful consequences. Specifically, those picking up prescriptions should always make sure that the medicine is the correct one, that the dosage matches the labeling in the instructions, and that they understand when and how to take the drug. But, if an accident does occur, patients should not presume it was their fault for not checking thoroughly enough or catching it themselves. Maryland state law allows patients to hold negligent pharmacies responsible for the harm they’ve caused, and patients can recover significant monetary damages through a Maryland pharmacy error lawsuit.

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