Common Errors

Proving Causation in Maryland Pharmacy Error Cases

June 9, 2021 | Lebowitz & Mzhen

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.

How Can You Prove Causation in a Maryland Pharmacy Error Claim?

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

Common Sources of Maryland Pharmacy Errors

May 31, 2021 | Lebowitz & Mzhen

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.

Your Rights After a Maryland Medication Error

May 22, 2021 | Lebowitz & Mzhen

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.

Burnout Among Pharmacists Increases Risk of Medical Errors for Maryland Patients

April 27, 2021 | Lebowitz & Mzhen

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.

The Role of Specialty Pharmacists in Preventing Maryland Pharmacy Errors

March 11, 2021 | Lebowitz & Mzhen

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.

Maryland Patients Should Be on Look Out for Vaccine Errors

March 4, 2021 | Lebowitz & Mzhen

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.

What Do Vaccine Error Victims Need to Do to Recover Financial Compensation?

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.

Maryland Pharmacy Errors: 2020 Year in Review Shows Need For Further Error Prevention

February 24, 2021 | Lebowitz & Mzhen

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.

What Were the Top Maryland Pharmacy Errors for 2020?

February 10, 2021 | Lebowitz & Mzhen

While the COVID-19 pandemic was understandably the most reported and challenging topic in medicine and healthcare during 2020 (and maybe for 2021, as well), it is important to remember that Maryland pharmacy errors—both COVID-19 related and not—have continued to occur with alarming rates.

Pharmacy errors occur when some mistake is made between the time a prescription is written and the time a patient takes the medication. These errors can come in many different forms. For example, the pharmacist may provide a patient with the wrong medicine or the incorrect dose.

Now that 2020 has come to an end, reflection on the mistakes of the past year is possible. The Institute for Safe Medication Practices (ISMP) recently released a list of the Top 10 medication errors and hazards that occurred in 2020. Factors influencing the list include frequency of problems, the significance of the consequences to patients, and the potential for the errors to be avoided or minimized. ISMP recommends that these ten errors be top priorities in the new year.

Wrongful Death Claims After a Maryland Medication Error

February 3, 2021 | Lebowitz & Mzhen

In the tragic event of a death after a medication error, the family of a Maryland medication error victim may be able to file a wrongful death claim against those responsible. Maryland’s wrongful death statute generally allows for a claim to be filed by a spouse, parent, or child of the victim. If no spouse, parent, or child exists who may file a wrongful death claim, another person may file who was related to the victim by blood or marriage “who was substantially dependent upon the deceased.” Maryland’s Wrongful Death Act is intended to provide an avenue for family members of the victim to recover compensation for their losses by allowing them to recover for acts that would have entitled the victim to recover compensation if the victim had not died.

What Is a Pharmacy Error Wrongful Death Claim?

In wrongful death claims, the defendant or defendants may blame the victim or argue that the medication error did not cause the death. Just as in Maryland negligence cases, if the victim survives, a wrongful death claim can be barred if the decedent is found to be partially at fault for the error. A defendant may also argue that another medical condition or factor caused the person’s death. The plaintiff has the burden of proving all the elements of the case by a preponderance of the evidence. A wrongful death claim generally must be filed in Maryland within three years of the victim’s death.

Cases Reported of Drug Mix-ups During Spinal Injections

Three cases of accidental spinal injection of tranexamic acid were recently reported on by one news source. The tranexamic acid was reportedly used instead of a local anesthetic because the wrong container was used by accident. In one case, an anesthesiologist used tranexamic acid instead of bupivacaine and recognized the error right away, but the patient had already begun to experience seizures. In another case, the patient again received tranexamic acid instead of bupivacaine and experienced seizures, and was placed into an induced coma for several days. In the last case, the patient received tranexamic acid instead of a local anesthetic but also experienced seizures and extreme pain. Tranexamic acid given in the spine in place of anesthetic can be extremely harmful and has a mortality rate of about 50%. Survivors may experience paraplegia, seizures, ventricular fibrillation, and permanent neurological injury.

Three Potential New Pharmacy Errors That May Affect Maryland Patients

January 6, 2021 | Lebowitz & Mzhen

While Maryland patients often trust their pharmacies to give them the correct prescription medication and dosage, pharmacy errors, unfortunately, do occur consistently throughout the state. These errors can take various forms—such as incorrect dosage or incorrect medication—can be harmless or cause severe injuries and illness. Currently, there are three known pharmacy errors repeatedly happening across the country, reported by the Pharmacy Times. Maryland patients should be on alert for these errors that may affect themselves or their family members.

The first is an error occurring with rapid-acting insulins. According to the Pharmacy Times, errors have been reported due to searching for rapid-acting insulins by generic name, which has caused mix-ups between two insulins that pharmacists may think are the same but are not. The authorized generic version of a new type of insulin has a different onset of action after the injection, and some different ingredients. It cannot be used as an exact substitution for the brand name, although some are prescribing it that way, which may cause issues as patients use it.

The second error is a dispensing error in fentanyl. Transdermal fentanyl patches are placed on the skin. Sometimes, when writing the prescription, there can be multiple confusing numbers that lead to mix-ups. For example, one prescription read “fentanyl patch 72-hour 50 mcg/hour,” with mcg/hour being the dosage or strength of the patch. But the pharmacy employee who entered this prescription into the computer read “fentanyl patch 72,” which led him to mistakenly select a 75 mcg per hour patch instead of 50. This dispensing error can lead to stronger dosages of fentanyl being given to patients.