Articles Posted in Common Errors

Medical errors can occur at any time—but a recent study raises the issue of whether patients in Maryland are at greater risk for Maryland medical errors on weekends than during the week. The study looked at all medication errors reported by healthcare practitioners over a two-year period at one hospital. There were 2,626 medical errors reported during the two-year period that that hospital alone. The most common sub-category of medical errors was prescribing errors, which amounted to 55% of all medical errors.

The study found statistically significant differences between many sub-categories of medical errors in day shifts and night shifts during weekdays and weekends. The medical errors were higher during the weekdays than during the weekends. But during the weekends, medical errors during the night shifts were more common than during the day shifts. The highest percentage of prescribing errors occurred on weekdays during night shifts (amounting to 77% and 79% of all errors). The study noted that other studies had found higher rates of medical errors during night shifts.

The study’s findings demonstrate that timing is an important factor in improving the use of medication and enhancing patient safety. The study reiterated that medication errors “are a serious public health problem that threatens patient safety and imposes substantial costs.” Medication errors are defined by the U.S. National Coordinating Council for Medication Error Reporting and Preventing as “any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer.”

While many doctors and pharmacists work tirelessly to avoid pharmacy errors, unfortunately, errors still occur—sometimes, with devastating effects for patients. If a patient suffers injuries due to a Maryland pharmacy error, the patient may be able to seek financial compensation through a negligence claim.

The first step after discovering an injury due to a pharmacy error is to consult with an attorney as soon as possible. An experienced Maryland injury attorney can advise injured patients on what steps to take specific to their case and what deadlines apply. In general, the next step to take as quickly as possible is to find and hold on to evidence that may disappear with time, including medical records, medication bottles, photos, video surveillance, and more. Depending on the circumstances of the case, a patient may need to file a claim or a notice of the claim quickly as well. Each claim is subject to a statute of limitations, which limits the amount of time in which a claim may be filed. Depending on the circumstances of the case, there may need to be a substantial investigation done before and after a complaint is filed, including determining the names and entities responsible for the patient’s injuries who should be named as plaintiffs, the basis for the complaint, and alleged damages.

In a negligence claim, a plaintiff must show that the defendant had a duty of care toward the plaintiff, the defendant failed to meet that duty by acting or failing to act in some way, the defendant’s lack of care caused the plaintiff’s damages, and the plaintiff suffered damages.

The COVID-19 vaccine has been a welcome achievement for many. All individuals 12 and older living in Maryland are eligible to receive the COVID-19 vaccine and more than 6 million doses have been administered so far. But with the rate of vaccinations in the largest vaccination effort in U.S. history, COVID-19 vaccine-related errors do occur. According to one news source, an analysis of COVID-19-related event reports that were submitted to the Institute for Safe Medication Practices National Vaccine Errors Reporting Program from December 2020 to April 2021 reveals common COVID-19 vaccine errors:

Shoulder injury related to vaccine administration (SIRVA)

COVID-19 vaccines can be improperly injected into a patient’s shoulder joint instead of the deltoid muscle in the upper arm. This may occur due to a lack of training on the correct technique for administering intramuscular vaccines.

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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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.

Most Maryland residents find themselves visiting a pharmacy at one point or another. Medications—whether continual or short-term—are a big part of many people’s health and well-being. And ideally, pharmacists and pharmacies help to keep Maryland patients safe and healthy. But sometimes mistakes are made, and these pharmacy errors can cause significant harm to patients. In fact, Maryland pharmacy errors are more common than most people think and can happen to anyone. Recently, however, the Pharmacy Times published an online article about how specialty pharmacists play an important role in increasing patient safety.

Specialty pharmacies, according to the Academy of Managed Care Pharmacy, are distinct from traditional pharmacies and are designed to efficiently deliver medications that have special handling, storage, and distribution requirements. They are also designed to improve outcomes for patients that have complex, potentially chronic and rare conditions. Typically, patients taking specialty medications require more complex services than those required for a traditional drug, and so specialty pharmacists step in to meet those needs.

According to the Pharmacy Times, specialty pharmacists have a unique role in medication safety. Not only do they take responsibility for ensuring the safe and effective use of specialty medications, but they also play a strong role in promoting a positive safety culture within their specific pharmacy. One of the factors pointed towards as causing pharmacy errors is the culture within the pharmacy. Oftentimes, pharmacists are overworked, hurried, and stressed out, and they may sacrifice safety for speed or fail to engage in regular safety precautions. The Pharmacy Times reports that because specialty pharmacists, working with high-risk specialty medications, often incorporate robust programs to ensure proper medication usage and minimize the potential for error, can be really helpful in setting the tone and expectation for safety in typical pharmacy settings. Additionally, specialty pharmacists can encourage the actual reporting of errors within pharmacies when they do happen, which is critical for addressing the root cause of the problem and making sure the same errors do not continue to happen.

Medication errors occur all too frequently in the United States. They account for thousands of deaths each year throughout the country. They may be the result of negligent acts, such as failing to follow proper procedures, failing to communicate necessary information, and failing to verify the patient’s information, including any allergies. In a Maryland medication error case alleging negligence, a medication error victim must prove that the defendant owed the victim a duty by exercising a certain degree of care toward the victim, the defendant failed to meet the requisite standard of care, the victim suffered injuries, and the defendant’s conduct caused the victim’s injuries.

Medication errors can involve the improper administration of a vaccine. According to an analysis conducted by the Institute for Safe Medication Practices of reported vaccine errors in 2017, the majority of errors involved administration of the wrong vaccine. Other errors included expired vaccines, the wrong dose, the wrong age, the wrong timing, the wrong patient, the wrong route, and a component/vaccine omission. In some cases, a vaccine error may simply negate the effect of the vaccine, but other errors may cause injury and even death.

Victims of vaccine errors or other medication errors may be able to recover compensation for their injuries by filing a Maryland negligence claim. Victims often need an expert to testify to prove their case by establishing a link between the medical error and the victim’s injuries. Experts may also be able to testify concerning whether an error was made and who was at fault. Generally, a Maryland negligence claim must be filed within three years of the date of the victim’s injury. Plaintiffs in medication error cases may be entitled to recover financial compensation for medical bills, physical therapy, future medical expenses, loss of earning capacity, lost wages, and other damages.

Each year, medicine and technology get more and more advanced, leading to improvements in the quality and delivery of health care across the country. Despite these improvements, however, errors still occur in health care delivery, particularly regarding pharmacy and medication. In fact, Maryland pharmacy errors occur frequently, jeopardizing the health and well-being of patients. The Institute for Safe Medication Practices (ISMP) is a nonprofit organization that works closely with health care practitioners, institutions, regulatory agencies, professional organizations, and the pharmaceutical industry to create awareness of and provide education about medication errors and how to prevent them.

Every other week, ISMP produces a newsletter with timely information related to pharmacy error prevention. Looking at the newsletters from January 2020 through December 2020 provides important insight into the trends seen in pharmacy errors last year. Pharmacy Practice News recently provided a summary of these newsletters on their website.

In the Pharmacy Practice News summary, several key problem areas were identified. One was safety issues related to labeling, packaging, and nomenclature. For example, a pharmacist might mix-up two different medications that have similar labeling or names, giving the wrong one to the patient. Another area of concern was safety issues associated with order communication and documentation. For example, health officials searching for drugs by generic names and accidentally substituting non-substitutable drugs. Finally, there are problems involving drug information, patient information, patient education, and staff education. For example, two patients mixed up their insulin pens which looked alike but with different labels and manufacturers, meaning they gave themselves the wrong insulin, leading to hyperglycemia.

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