Articles Posted in Common Errors

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.

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.

Recently, the Pharmacy Times published an article detailing how pharmacy technicians can play a critical role in preventing pharmacy errors. Maryland pharmacy errors can cause serious injuries or illness, leaving those affected with potentially lifelong medical issues. According to the article, the role of pharmacists continues to expand to include more and more duties, meaning that pharmacy technicians are needed more than ever to fill in the gaps. Every year, there are approximately 7 million preventable medication errors. One of the most common errors is incorrect dosing—the Pharmacy Times writes that they make up about 37% of errors each year.

So how can pharmacy technicians help? The technicians are often the first line of defense and best suited to catch errors and prevent them from happening. They are often the ones who type up the prescription, and the ones who take prescriptions from the patient at the counter. They are uniquely situated to prevent pharmacy errors before they happen by double-checking medications.

One experienced pharmacy technician says that all technicians should use a set of “patient rights” while checking medications. Her five steps are designed to help pharmacy technicians systematically check for errors. First, a technician should ensure they have the right patient and ask them to identify themselves. Second, the technician should ensure they have the right medication. Third, the technician should make sure they have the right dose and instructions for how to take the medication. And finally, the technician should confirm the time of the last dose and frequency.

A recent article written by two medical professionals sheds insight into how and when prescription errors occur. According to the article, 7,000 to 9,000 people in the United States die each year as the result of a medication error. In addition, hundreds of thousands of other patients experience an adverse reaction or some other medical complication related to a medication. As we’ve written about before, these pharmacy and prescription errors can cause severe and life-threatening injuries to Maryland patients, so it is essential to be aware of them.

The article discusses the various types of medication errors. While doctors and pharmacists generally do a great job, sometimes errors do occur. A doctor might make an error when prescribing, for example, and may prescribe the wrong drug or the wrong dose. Pharmacists may give the medication to the wrong patient or accidentally tell the patient to take the medicine twice a day instead of twice a week.

These errors have three leading causes, as identified in the article. First, distraction, which accounts for nearly 75 percent of medication errors. Medical professionals are often busy and have many duties in a hospital. While speaking to patients, examining lab results, and ordering imaging studies, for example, they may be asked to quickly write a prescription. In these cases, when the job is done in haste, a medication error may occur—even with the best doctor. Second, distortion. Sometimes a doctor will prescribe a drug but use a symbol not widely recognized, or it will be translated improperly, and the actual drug administered will be slightly off. Last, illegible writing, as simple as it sounds, also leads to medication errors- a pharmacist may be unable to read what the prescription says and may thus use their best judgment and then administer the wrong medication.

When people experience medical issues, they will, understandably, rely on healthcare professionals to provide them with appropriate treatment. Individuals should expect that their medical providers quickly and accurately diagnose them and prescribe the correct treatment and medication. When someone suffers injuries after taking the wrong medication or dosage, the provider or pharmacist may be liable under Maryland’s medical malpractice laws. Although mistakes can happen, medical providers have a duty to provide their patients with necessary and appropriate medical care. The failure to provide a patient with correct medication can lead to serious and life-threatening illnesses.

About 20 years ago, the Institute of Medicine released its “To Err is Human” report, highlighting the importance of building a safer health system. However, medication errors continue to be a serious risk for patients throughout Maryland and the United States. As the report suggests, pharmacists play a critical role during the prescribing, dispensing, and administration of medication, and they must take steps to prevent medication errors. A recent news report summarizes some of the most crucial steps pharmacies can take to reduce the likelihood of a Maryland pharmacy:

Organize the pharmacy: The inherent fast-paced and intense nature of pharmacies can result in disorganized and chaotic work spaces. Pharmacists should have a system in place to ensure that patients’ prescriptions and medications do not become lost or misidentified. The Institute for Safe Medication Practices (ISMP) advises that pharmacies use consistent systems, such as bins or baskets, to separate different patients’ prescriptions and medications.

Medical errors are estimated to the third leading cause of death in the United States. Even when they are not fatal, these errors often have a profound impact on a patient’s life. While there are many different types of medical mistakes, Maryland pharmacy errors can be among the most devastating, especially for the elderly and young children.

While there is a risk of error any time a pharmacist fills a prescription, certain situations present an increased risk. For example, according to a recent news report, the following are a few of the most common medication errors.

Zinc overdoses: Zinc is a mineral that most people consume every day in their diet. Small doses of zinc are beneficial and may help fight colds. However, it is possible to overdose on zinc. In fact, in 2019, a two-year-old was almost given a fatal dose of zinc that was 1,000 times more potent than necessary when a physician prescribed 700 milligrams instead of 700 micrograms.

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Pharmacists at the country’s biggest retail chains have written letters to state regulatory boards in recent months alerting them to what they claim are chaotic workplaces that put patients at risk, according to a recent article. The pharmacists say that the pressures put on them require that they give shots, answer phones, mange drive-throughs, take payments, and make calls in addition to filling prescriptions and counseling patients. They say that these demands in addition to meeting corporate metrics are making their jobs unsafe for patients. According to the article, surveys of pharmacists in Maryland and other states reveal that they “feel pressured or intimidated to meet standards or metrics that may interfere with safe patient care.”

For example, internal documents from CVS showed that staff members were supposed to persuade 65 percent of patients that were picking up prescriptions to sign up for automatic refills, 75 percent to have their doctor contacted for a proactive refill request, and 55 percent to switch from a 30-day supply to a 90-day supply.

One pharmacist wrote that they were  a “danger to the public” in a letter to the Texas State Board of Pharmacy. Another said the situation is “absolutely dangerous” to patients. Such pressures have led to mistakes they say, including misfills. Some mistakes have led to devastating results, including dispensing a cancer drug instead of an antidepressant, leading to the woman’s death after six days of taking the medication, which allegedly led to organ failure. The family was offered a settlement in that case.

The Institute for Safe Medication Practices (ISMP) is warning pharmacists and medical practitioners about the potentially severe consequences of using abbreviations for drug names. Their recent report, submitted to the National Medication Errors Reporting Program, sheds crucial light onto one way in which patients could be injured by a Maryland pharmacy error—through miscommunications and mix-ups based on drug abbreviations.

For example, according to an article discussing the ISMP’s report, one commonly confusing abbreviation is “tPA,” which refers to “tissue plasminogen activator alteplase (Activase).” In one situation, an urgent order for alteplase for a patient in an intensive care unit (ICU) was sent to the pharmacy. A nurse from the ICU called the pharmacy to ask if the “tPA” was ready, but the pharmacist, who was newly hired and unfamiliar with the abbreviation tPA, thought the request was for “TPN,” or “total parenteral nutrition.” The pharmacist then told the nurse that the drug would be there in a few minutes, since they were currently mixing parenteral nutrition solutions.

Later that day, when the needed alteplase did not arrive, the ICU nurse called the pharmacy again. Another pharmacist answered, saw the urgent order in the database, and began to dispense a dosage of the drug. Unfortunately, in her rush, she forgot to mix the drug according to the protocol for inpatient use and was delayed while re-dispensing and mixing the drug. This delay, since the drug was already delayed due to the abbreviation mix-up earlier, led to the hospital calling a rapid response team for the patient in question.

When a pharmacist incorrectly fills a patient’s prescription, the pharmacist may be liable to the patient for any injuries that occur as a result of the medical error. However, in a Maryland pharmacy error lawsuit, a patient must be able to prove not just that an error was made, but that the pharmacist’s error caused them harm. While this may sound simple in theory, in practice the issues of causation and damages often raise significant hurdles.

Take, for example, a recent pharmacy error. According to a recent article, a patient was given a prescription for “Potassium Citrate ER 10 MEQ (1080mg) CR-TABS” after having a procedure to remove several kidney stones. The hospital printed out the correct prescription, and the patient took the prescription to be filled at a satellite location of the hospital pharmacy. However, upon taking it to the pharmacy, the patient was provided with “Potassium CL 10 MEQ 120.”

According to the man’s claim, the hospital’s pharmacy later called a local Rite-Aid to transfer the prescription, at his request. However, rather than calling in the correct prescription, the hospital pharmacy called in the Potassium CL 10 MEQ 120 pills. The man continued to take the medication for seven months, refilling the prescription each month. In total, the patient took the wrong medication for 10 months. During this time, the patient continued to form kidney stones, requiring additional treatment.

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