Articles Posted in Hospital Pharmacy Errors

When most people think of a pharmacy error, they think of a retail pharmacist providing the wrong drug to a patient who then takes it up to the register, checks out, and goes home to take the medication in their own home. However, this only accounts for a portion of the prescriptions that are filled each day in the United States. In fact, countless other prescriptions are provided to hospital patients and nursing home residents.

Unlike prescriptions filled at a retail pharmacy, prescriptions that are filled in a hospital have a few added layers of protection in place to prevent against the patient being provided the wrong medication. For example, after a doctor writes a prescription to a hospital patient, and the pharmacy fills the prescription, a nurse must obtain the medication and deliver it to the patient. This is a critical role that allows for the nurse to act as a final line of defense against serious or fatal prescription errors.

However, despite all the precautions in the world, sometimes errors will occur. When a prescription error does occur, it may result in very serious injuries or even death in some cases. Under Maryland law, the victims of these mistakes can look to the legal system for help through a pharmacy error lawsuit.

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Earlier last month, a new study was released that claims post-operation medication errors can occur in as many as one in every two patients. According to one local news source that covered the new study, the study was performed at Massachusetts General Hospital and looked at roughly 275 surgeries.

The results came back indicating that in the post-operation setting some kind of human error or “adverse event” occurred in about 50% of all patients. Prescriptions that were filled in the hospital showed an error rate of about 5%. Most of the prescription errors fell into several categories:  incorrect dosing, drug documentation problems, drug labeling mistakes, and improperly documenting patients’ vital signs. Researchers believe that about 80% of the errors they found could be classified as “preventable,” had appropriate measures been taken.

The researchers found that about 5% of those patients who were provided a wrong medication or dose had “negative effects” from the administration of the drug. Two-thirds of the errors were considered “serious,”and 2% of the errors were classified as “life threatening.”

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Earlier this month in Oregon, a jury awarded a man’s personal representative $12.2 million for the man’s injuries, which included severe brain damage after he was administered a dose that was 15 times stronger than prescribed. According to one local news report, the alleged medical malpractice took place back in 2011, when the man was provided medication to help his heartbeat stabilize.

Evidently, the anesthesiologist in charge of the man’s care provided him with a dose of 2,700 milligrams of amiodarone instead of the 150-milligram dose that was prescribed by the surgeon. As a result, the man suffered severe brain damage. The court appointed a conservator, who filed a medical malpractice case against the hospital, the anesthesiologist, and the agency that contracted the anesthesiologist to the hospital.

At trial, it came out that the anesthesiologist misread some figures on a hospital computer screen and grabbed three 900-milliliter bottles, thinking they were just 50-milliliter bottles.

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Back in 2006, Christopher Jerry lost his daughter when she died in a hospital after being provided an improperly dosed IV prepared by a hospital pharmacist. According to one recent news article, Jerry has since become an advocate to fix the errors he claims are inherent in the flawed system of pharmacies across the nation.

Evidently, back in 2006, Jerry’s daughter was diagnosed with a yolk sac tumor when she was about 18 months old. Her treatment was going well, and the cancer was nearly eradicated. However, during her final session of chemotherapy, she was given improperly dosed medication and passed away. On the day of the error, Jerry claims that the hospital pharmacy was under-staffed, the pharmacy’s computer wasn’t working, and there was a backlog of physicians’ orders waiting to be filled.

Since that day back in 2006, Jerry has collaborated with other advocates in the field to pass legislation in his home state of Ohio as well as several other states that requires a higher level of regulation for pharmacy technicians. At the time of his daughter’s death, anyone with a high school diploma or a GED could become a pharmacy technician and could end up dosing life-saving medication months later.

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Earlier this month, a local Canadian news source published an article about a hospital that admittedly provided substandard medical care to a patient but has since made serious efforts to provide better care. According to the report, the efforts were in response to the death of an 85-year-old patient who was being treated for a bowel obstruction.

Evidently, the attending nurse administered a prescribed narcotic intravenously rather than subcutaneously, as the physician had recommended. This resulted in the man contracting a case of pneumonia and passing away the following day. Initially, the medical examiner listed the man’s cause of death as “natural,” but as the examiner reviewed additional hospital documents the cause was changed to “accident.”

The man’s family was upset with the level of communication and respect they received after their loved one’s passing. Initially, family members felt as though the administration was “obstructing every attempt” to get information about their loved one. In fact, a professional investigation into the hospital’s chief of staff concluded that he was “evasive and vague” when it came to the incident.

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The VA is getting some heat for the negligent filling of veterans’ prescriptions. According to a recent report by the Washington Times, one VA employee was terminated from his employment and in response filed an appeal, claiming that any errors he may have made were made by others in the Administration. Be that as it may, he then claimed that he was targeted for other, impermissible reasons.

The terminated employee pointed to several errors made over the course of the last few years, specifically a 2001 incident when a chemotherapy patient was given a fatal dose of his medication. To be exact, it was a dose that was five times what it should have been. The dismissed employee also submitted interviews with other VA employees, one of whom claimed that “errors might be pointed out, but in a global sense, nobody is going to be publicly identified and held out to dry for a mistake.”

This has led to a strong public reaction against the VA for failing to adequately discipline those employee’s who were negligent in the performance of their duties. However, even if the VA is unwilling to reprimand these employees, any victim of a pharmacist’s error may hold the responsible party liable by bringing a civil suit for damages.

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At the Children’s Medical Center in Dallas, Texas, 10 full-time pharmacists have been brought on to the staff to help combat medication errors in the emergency room. According to a recent report by NPR, the hospital views the addition of the pharmacists as a vital safety net.

As one emergency room physician put it, “Every single order I put in is reviewed in real time by a pharmacist in the emergency department prior to dispensing and administering the medication.” This is especially necessary in the emergency room, where there is no time to clarify what a doctor meant to prescribe.

The article also notes that medication errors are not necessarily caused by prescribing the wrong drug, although that is a large part of the problem. There are also thousands of cases each year where a patient is given a medication that they are allergic to or that reacts dangerously with another medication they are taking. Due in part to these reasons, medication errors are three times more likely to occur in children than in adults. In fact, one study found that nearly 25% of children’s prescriptions contain at least one error.

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Physicians and nurses owe a duty to all of their patients to administer the proper medication and provide a certain basic level of medical care. Most of the time, physicians do the best job they can making sure that the sick are well cared for, but on occasion a lapse in judgment can result in serious consequences.

Bethel v. United States of America

In a recent case from Colorado, a man was granted a verdict in excess of $10 million after he suffered severe brain damage as a result of medication error. The facts of the case were as follows:

Bethel, the plaintiff in the lawsuit, was under the care of the Veterans Affairs Medical Center when he underwent general anesthesia. He was to be cared for by a doctor as well as by a first-year resident. The resident prepared Bethel for surgery, but in so doing administered a paralytic drug instead of a sedative drug. At this time, the doctor was away attending to another patient.

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A new study, conducted in Irish hospitals and published in a British journal, reviewed the effectiveness of a “collaborative” model of managing hospital patients’ medications. The model, known as the Collaborative Pharmaceutical Care in Tallaght Hospital (PACT), involves close involvement of clinical pharmacists in all stages of patient care during their stay in the hospital. The study, which was uncontrolled, found that PACT resulted in a reduction in the rate of medication errors by more than three-fourths.

The study was published in the online edition of the British Medical Journal Quality & Safety on February 6, 2014. The researchers compared the benefits of PACT to “standard ward-based clinical pharmacy,” with a focus on adult hospital patients receiving acute care, who were prescribed at least three medications in the hospital, and who left the hospital alive. The study included 112 patients receiving care based on PACT, and 121 patients receiving standard care. They measured the rates of medication errors and of potentially severe errors per patient.

According to the description provided in the study, the primary goal of PACT is to reduce the rate of medication errors that commonly occur when a patient is transferred between doctors or departments within a hospital, or transferred from one facility or organization to another, by improving the process of “medication reconciliation” (MedRec). This involves comparing a patient’s current medication orders to the medications a patient has been taking in order to prevent omission of a necessary drug, inclusion of an unnecessary or dangerous drug, or incorrect dosages.

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