Articles Posted in Common Errors

Medications not only have to be safe but also must contain sufficient warnings and instructions so that patients will know how to use them safely. A medication’s lack of clear instructions and warnings puts patients at risk. A plaintiff may bring a Maryland pharmacy claim against a drug manufacturer for failing to warn of the dangers of taking a medication.

Unless a danger is obvious and widely known, the medication must provide adequate warnings concerning the medication’s risks, such as known side effects. Warnings must also be clear and easy to understand. The medication also must include adequate instructions on how to take the medication safely. Courts will consider the knowledge and expertise of the average consumer that uses the medication. If a medication’s instructions are not clear enough or do not contain sufficient information so that consumers will know how to safely use the medication, the instructions are not sufficient, and the manufacturer may be liable for injuries that occur as a result.

In cases where a patient is injured due to a lack of sufficient instructions or failure to adequately disclose risks, the patient may be able to file a Maryland injury claim and recover financial compensation for the injuries. Successful plaintiffs may be able to recover financial compensation for damages including medical bills, psychological suffering, future medical expenses, lost wages, and more. One recent study revealed that at half of the patients were using inhalers incorrectly.

Medication errors are an unfortunate yet avoidable part of the healthcare system in the United States. While technology, training, and oversight aimed at reducing medication errors have improved over the years, these instances continue to occur. According to the Academy of Managed Care Pharmacy (AMCP), Maryland medication errors cost patients, consumers, and the healthcare system millions of dollars. Further, data indicate that medication errors harm over 1.5 million people each year.

Medication errors are preventable events that result in inappropriate medication use and patient harm. The events may stem from a healthcare professional’s conduct, a specific product, or a system. For instance, errors may stem from communicating prescriptions, dispensing or administration, marketing or labeling, or monitoring. Many errors stem from illegible handwritten prescriptions, missing information, incorrect drugs or dosage, orally transmitted prescriptions, or medication samples.

While advanced technology, reporting technology, and monitoring address some of the common causes of medication errors, there are fundamental issues with addressing systematic attitudes of blame and liability. Medication errors can result in serious formal punishment against the healthcare provider. These punishments can include fines, license suspension, or revocation. As a result, many healthcare providers focus on shifting blame rather than addressing the system issues that caused the error.

Pharmacies and pharmacists play a critical role in the stream of efficient healthcare in the United States. While advances in clinical therapies have resulted in life-saving measures for many people, pharmacies have become inundated with patients. As a result, Maryland pharmacies are more prone to engaging in medication errors. Medication errors are any error that occurs at any step along a patient’s healthcare treatment plan. These errors can occur when a clinician prescribes a medication to when the patient receives a refill. If a patient experiences an adverse drug event because of a medication error, they may recover damages from any negligent healthcare providers responsible for the error.

Adverse drugs events are a common yet preventable healthcare event. The Patient Safety Network (PSN) reports that healthcare providers have access to over 10,000 prescription medications, and almost one-third of American adults take five or more medications. Moreover, every year, adverse drug events make up approximately 700,000 emergency room visits. These errors occur to every type of patient, including those receiving care and treatment in the hospital.

Some groups of people are more vulnerable to medication errors. These groups include older adults, especially those who take several medications. Further, pediatric patients often experience medication errors because clinicians may fail to account for the patient’s stature before dispensing medications. Moreover, another notable factor is a patient’s socioeconomic status and literacy.

Pharmacy errors can occur at different stages of the process of prescribing and dispensing a medication. And although some pharmacy errors may be caught quickly or may have a short-time effect, others can be devastating for Maryland pharmacy error victims. To decrease the prevalence of pharmacy errors, many researchers have looked to documented cases to determine where and how changes can be made.

According to a recent article, the labeling and packaging of medication contributed to two recent pharmacy errors. In one case, the prescriber of a mediation had prescribed sacubitril-valsartan (Entresto), a multi-ingredient medication that combined two drugs. The prescriber listed the strength of the medication prescribed as 100 mg, which was to be taken twice a day. When the pharmacist was filling the prescription, the pharmacist saw that the medication did not include a 100-mg strength, so the pharmacist chose the closest choice—97/103 mg strength (97 mg of one drug and 103 mg of another). However, the prescriber had intended that the patient take the total amount of the 2 drug ingredients (49/51) with 100 mg total.

The patient’s doctor later increased the dose to 100 mg, which was to be taken twice a day. The pharmacist dispensed the same 97/103 mg medication and gave instructions to take two tablets twice a day. The patient had severe adverse effects and the error was discovered. The insert on the medication suggested that the total amount was the basis for clinical trials, but the label listed the ingredients separately. To make matters more confusing, other combination tablets are prescribed according to the strength of each drug rather than the total, such as carbidopa-levodopa (for example 25-100).

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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