High Alert Drugs

CDC Discovers Shingles Vaccine Is Prone to Administration Error

June 8, 2018 | Lebowitz & Mzhen

Shingles is a viral disease characterized by a skin rash consisting of painful blisters that usually appear in a strip across a person’s face or body. While the symptoms of Shingles will usually go away within a few weeks, some experience nerve pain that can last years.

The disease is caused by a reactivation of the varicella zoster virus (VZV), the initial exposure of which causes chicken pox. The reason why the VZV virus reactivates is not widely understood by the medical community, although it is understood to occur more in the elderly and those with a compromised immune system.

There have been several vaccines created to prevent Shingles. As of 2017, a new vaccine called Shingrix was approved for patients over 50 years of age and can prevent most cases of Shingles. Once Shingrix was approved for use, it later became the preferred vaccine according to the Center for Disease Control (CDC). Unfortunately, it has been involved in Maryland pharmacy errors and errors in other states.

The Importance of Adequate Warnings on Prescription Medications in Maryland

February 8, 2018 | Lebowitz & Mzhen

Manufacturers of pharmaceutical drugs – like other products – are responsible for the products they market and release to the public. Some drugs pose a serious health risk due to potential negative interactions with other commonly taken medications, other medications are easily abused and can lead to dependence or addiction, and many pharmaceuticals can have serious side effects when taken improperly.

In general, the manufacturer of a medication is responsible to include an adequate warning, fully disclosing the risks involved with taking the medication. If a drug manufacturer fails to include an adequate warning with their product, they may be held liable for any injuries caused to those who take the medication through a Maryland product liability lawsuit.

Testosterone-Therapy Drugs

Testosterone-therapy drugs have been available for decades, and until recently, they have primarily been prescribed to younger men with low testosterone production. However, over the past few years, doctors have been prescribing testosterone-therapy drugs to older men. These medications, however, are not without their risks.

Recent Study Indicates that Type 1 Diabetes Patients Are at Especially High Risk of Experiencing a Medication Error

November 1, 2017 | Lebowitz & Mzhen

In the pharmacy world, it is well-known that diabetic patients are among those with the highest risk of being victims of Maryland medication errors. This is due mostly to the fact that diabetic patients are often required to take several medications in a very specific dose, as well as the fact that a failure to get the medication (or too large a dose of the medication) will likely result in an adverse health event.

According to a recent study, those patients who suffer from Type 1 diabetes are more likely than patients with Type 2 diabetes to experience a medication error. The study followed 671 diabetic adults who were admitted to the hospital. Researchers tracked the patients from admission until discharge and double-checked each administration of medication. As it turned out, about 30% of patients experience at least one error.

The most common type of error accounted for roughly 60% of all errors and was an error of omission. When this type of error occurs, a patient is not given the medication that they were prescribed by their physician. Other common error types were wrongly added medications and improperly administered medications.

Pharmacy Errors Involving High-Alert Medications

October 23, 2017 | Lebowitz & Mzhen

While all prescription drugs pose risks if taken in large quantities or by certain patients taking other medications, some medications have such a high likelihood of being involved in a Maryland pharmacy error that they have been labeled as “high-alert” medications. According to a recent industry news report, high-alert medications are those that have an increased probability of negative interaction when taken with another commonly prescribed drug, have serious side effects even when taken alone, or must be taken in very specific doses to ensure that the medication is effective.

While many types of medication are high-alert, some commonly seen high-alert medications in out-patient pharmacies are chemotherapy medication, pediatric solutions, insulin, and opioids. The list of high-alert medications in hospital pharmacies is similar and includes epinephrine and hypoglycemic agents. That being said, it is understood that insulin presents the highest risk of all medications, due to the various forms and doses of the drug as well as the high-risk status of many insulin patients.

The article details certain steps that pharmacies should implement when filling prescriptions for high-alert medications. For example, using system alerts whenever a pharmacist fills a high-alert medication triggers a cue for the pharmacist to provide additional counseling to the patient regarding the high-alert medication. System alerts may also be set to alert pharmacists to patients who present an especially high risk of being a victim of an error.

New Insulin Use Guidelines Aim to Reduce Risk of Insulin Prescription Errors

October 2, 2017 | Lebowitz & Mzhen

Patients have to put a great deal of faith in their doctors, nurses, and pharmacists. We put our lives in the hands of medical providers. But medical providers can make mistakes just like anyone else. Since medication errors occur all too frequently, doctors, nurses, and pharmacists have to be vigilant in making sure that every patient is getting the right medication.

Proving Negligence in Medication Error Cases

To recover damages in a Maryland medication error case, a plaintiff must show that the defendant acted negligently. Negligence can be shown by demonstrating that the defendant was negligent in doing or failing to do something. A plaintiff must show the following elements: the defendant had a legal duty to use due care toward the plaintiff, the defendant failed to perform that duty, the plaintiff suffered damages, and the defendant’s failure to perform the required duty caused the plaintiff’s damages.

Examples of damages available to medication error victims include medical expenses, lost wages, physical therapy, and loss of earning capacity.

Court Prevents Plaintiff’s Expert from Testifying in Case Against Drug Manufacturer

July 3, 2017 | Lebowitz & Mzhen

Earlier this month, a federal appellate court issued a written opinion in a product liability case brought against the manufacturer of Zoloft, alleging that the medication causes birth defects. The court’s decision reviewed a lower court’s decision to prevent the plaintiffs’ expert witness from testifying. Ultimately, the court concluded that the lower court was proper to not allow the expert’s testimony.

The Facts of the Case

The plaintiffs were a class of people who collectively claimed that the medication Zoloft caused birth defects when taken early in a pregnancy. In order to establish their claim, the plaintiffs planned on presenting several witnesses to show that the ingestion of Zoloft actually caused the birth defects in their children. However, the court prevented one of the key witnesses from testifying, based on the novel method the expert used in arriving at her conclusion.

The plaintiffs then tried calling another witness in place of the one who was prevented from testifying. The drug manufacturer objected to this witness as well, and the court conducted a hearing to determine whether the expert’s testimony would be admissible.

Court Concludes Patient’s Own Actions Constitute Intervening Cause in Prescription Medicine Overdose Case

May 1, 2017 | Lebowitz & Mzhen

Earlier last month, an appellate court in Tennessee issued a written opinion in a case involving the death of a man who had overdosed on prescription medication. The court ultimately determined that the patient’s death was attributable to his own actions. The case was presented to the court as a workers’ compensation case, but the issue the court decided was relevant to personal injury cases involving allegations of pharmacy error and medical malpractice.

The Facts of the Case

The petitioner was the surviving wife of a carpenter who involved in an accident while on the job. As a result of the accident, the man’s doctor prescribed oxycodone, a powerful and addictive pain medication. The man took the medication as directed at first but then began abusing it. According to the court’s opinion, he would skip doses of the medication in fear that he would run out when he needed it. He eventually started to take the medication with alcohol to increase the medication’s effectiveness.

About two years after his accident, the man’s wife discovered her husband’s lifeless body in bed. The woman, through her deceased husband, filed for workers’ compensation benefits based on the fact that the original injury her husband sustained occurred while he was on the job. An autopsy reported the man’s cause of death as opioid toxicity, with contributing causes of hypertension, alcohol use, and tobacco use.

Most Common Pharmacy Error of 2016 Was a Pharmacist’s Dispensing of the Incorrect Drug

January 9, 2017 | Lebowitz & Mzhen

The Institute for Safe Medication Practices (ISMP) has released a report that discusses the most common pharmacy errors of 2016 and strategies to prevent these errors from harming patients in the future. The ISMP is an industry trade association containing pharmaceutical companies, doctors, pharmacists, and other medical professionals that regularly conducts observations and releases data related to prescription errors and the dangers these errors present to patients. According to the report, the most common type of pharmacy error committed in 2016 was dispensing the wrong medication to a patient, although other dangerous errors, including dosage and patient mix-ups, also ranked high on the list.

The Classes of Drugs Most Affected by Medication Errors

The ISMP study concluded that certain classes of drugs are more commonly associated with medication errors than others. According to a recent report discussing the results of the study, medication errors are most commonly associated with opioid narcotics, antibiotics, antipsychotics, and insulins.

More errors are committed in dispensing the correct dosage of opioid narcotic medicines than any other type of medicine. This is in large part due to the significant variance in tolerance and dosage from patient to patient. For example, a dose that is appropriate for one patient could cause an overdose in another, and pharmacists must ensure that they have the correct prescription information when filling these prescriptions. If something looks wrong, the pharmacist should contact the patient’s doctor directly rather than fill the prescription and provide it to the patient.

High-Alert Drugs Pose a Heightened Risk to Patients, Yet Many Hospitals Fail to Identify Them

October 24, 2016 | Lebowitz & Mzhen

The Institute for Safe Medication Practices (ISMP) creates an evolving list of high-alert medications that, while they are not necessarily more likely to be involved in an error, are especially dangerous if they are accidentally given to a patient. However, according to one industry news report, despite the availability of this list, many hospitals across the country do not have a readily accessible high-alert drug list or fail to take appropriate measures to ensure hospital staff is aware of the list.

The report notes that some medications are more commonly associated with pharmacy errors. For example, medications with sound-alike names or medications that physically resemble other medications are more likely to be involved in an error. Thus, the report suggests that hospitals create hospital-specific lists of medications that may be at a higher risk of being involved in an error, due to specific factors in play at a particular hospital. For example, if the physical location of two drugs near each other has resulted in numerous errors, hospitals should add both medications to a high-alert drug list and take additional precautions so that these medications are not inadvertently mixed up in the future.

The report also explains that remedial measures taken by some hospitals are not effective in reducing pharmacy errors. For example, relying on staff training without further follow-up does not have a significant impact on error rates. Similarly ineffective measures are high-alert lists placed on pharmacy bins, since these are often overlooked by busy staff members.

Court Holds Insurance Company Must Defend Lawsuit Against Medication Distributor

August 1, 2016 | Lebowitz & Mzhen

Prescription drugs are controlled by the government for a reason. Often, prescription drugs are dangerous if they are taken in conjunction with other medications, can more easily lead to an inadvertent overdose, and may easily lead to abuse because of their addictive qualities. Over the past few years, the court system has seen a number of lawsuits brought against various manufacturers and distributors of addictive prescription pain killers, claiming that the manufacturer or distributor too loosely controls the dangerous medication. In the most recent case of this type, a court held that the insurance company that covered a prescription drug distributor was required to defend against a case filed against the distributor, alleging that the distributor was negligent in continuing to provide large amounts of prescription medication to local pharmacies.

The Facts of the Case

The State of West Virginia has long been suffering from an epidemic of prescription drug abuse. The government of West Virginia filed a lawsuit against a drug distributor, claiming that the distributor was continually providing dangerous medication to “pill mills” across the state. A “pill mill” is a pejorative term used to refer to a pharmacy where loose regulation of prescription drugs results in many drug-addicted patients filling fraudulently obtained prescriptions.

The drug distributor had an insurance policy through Cincinnati Insurance Company. When the distributor got notice of the lawsuit, it asked the insurance company to help defend against the suit, based on the contractual obligations in the policy. Specifically, the insurance company was obligated to cover any lawsuit arising from a “bodily injury” caused by the distributor. However, the insurance company refused to defend the lawsuit, claiming that the compensation sought was for West Virginia, rather than anyone who suffered a true bodily injury. The court declined to make this distinction and found that the case was based on a claim of bodily injury. Thus, the insurance company will be required to assist the drug distributor in defending the lawsuit brought by the State of West Virginia.