Articles Posted in Patient Safety

Maryland, along with every other state in the U.S., paused the use of Johnson & Johnson’s coronavirus vaccine last week after six recipients of the vaccine in the country experienced a rare blood-clotting disorder. Over seven million people have received Johnson & Johnson’s vaccine in the United States so far. The six people who experienced the clotting disorder were women between 18 and 48 and experienced the disorder within three weeks of receiving the vaccine. In those cases, the blood clots occurred in the brain, and the women all showed low levels of platelets. One woman died from the illness. In a step to reduce Maryland vaccine errors and adverse reactions, Maryland’s Department of Health decided to pause the use of the Johnson & Johnson vaccine in the state “out of an abundance of caution.”

The AstraZeneca vaccine, which has been distributed in Europe, also had cases of individuals with blood clotting, which were “very, very similar” to the Johnson & Johnson clotting cases, one expert noted. Both vaccines use similar technology. A government committee will meet to evaluate further use of the Johnson & Johnson vaccine. The Centers for Disease Control said that individuals who have received the Johnson & Johnson vaccine in the past month should reach out to their doctors if they have abdominal pain, shortness of breath, leg pain, or severe headaches. Health officials reported that the people who experienced the clotting disorder most commonly had a persistent, moderate to severe headache that started six days or later after receiving the shot.

Individuals who experience vaccine errors or adverse reactions may be able to recover compensation from the administrator or manufacturer of the vaccine in some cases. A Maryland vaccine error claim based on negligence requires a showing that the defendant owed the individual a duty, the defendant failed to meet the relevant standard of care, the defendant’s negligent conduct caused the individual’s injuries, and the individual suffered damages. These cases can be complicated and often must rely on the testimony of experts to explain the link between the error and the injuries the individual suffered. Victims of a vaccine or medication error may be able to receive financial compensation for past and future medical expenses, loss of wages and earning capacity, and other damages depending on their circumstances. A negligence claim in Maryland has to be filed within three years after the date of the injury.

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.

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.

Victims of Maryland medication errors may be dealing with the stress of the injury, medical bills, and wage losses—and filing a Maryland medication error lawsuit may not be at the forefront of their minds. However, victims have to be careful not to wait too long, because it could be too late.

The statute of limitations dictates the time in which any claim must be filed in Maryland. Failure to file a lawsuit within the applicable statute of limitations generally will result in the claim being dismissed, though there are some exceptions. Generally, the statute of limitations for a medication error claim in Maryland (and other personal injury claims) is three years. Wrongful death claims also have a statute of limitations of three years. The statute of limitations varies depending on the type of case and there may be exceptions in some cases. The statutes of limitations also can change if there is a change in the law so it is important to meet with an experienced medication error attorney who understands the statute of limitations that applies in a specific case.

The statute of limitations generally begins to run when an injury occurs, though it may start to run later in some cases. An experienced medication error attorney can help medication error victims properly file a claim within the applicable statute of limitations.

Amazon is one of the most valuable companies in the United States, and is getting even more and more utilization during the COVID-19 pandemic, as Americans order an increasing amount of things online, from groceries to pet supplies, books, and décor. Now, Maryland shoppers may be able to get one more thing from this giant retailer: their prescriptions. Last month, Amazon announced the launch of Amazon Pharmacy, a delivery service for prescription medications. The service would allow Amazon customers to purchase prescription drugs with or without health insurance, which Amazon claims will save them money, up to “80 percent off generic and 40 percent off brand name medications when paying without insurance.” Is is unclear, however, how Amazon Pharmacy could impact the prevalence of Maryland pharmacy errors.

While the potential savings on drug prices sound great, experts say that Amazon Pharmacy is likely not going to be a game-changer when it comes to the high cost of prescription medications.  Customers may enjoy some savings, but this online option is likely to work similarly to other online pharmacies and cannot solve the large and complicated problem of U.S. drug pricing. Still, professionals are watching to see what impact Amazon Pharmacy has and how many Americans utilize it for their medications.

Maryland pharmacy errors are a persistent problem, sometimes causing severe injury or illness. And, unfortunately, anyone who has ever ordered something online can tell you that online shopping does not always go off without a hitch—sometimes the wrong product or item can be sent, items can be swapped with others, or a package could get lost or never arrived. Pharmacy safety advocates should watch closely to see whether or not Amazon Pharmacy falls prey to the same errors that occur in pharmacies every day. It’s very possible that pharmacy errors continue to plague Maryland patients, regardless of where they get their prescription.

Laws vary from state to state regarding the authority of certain persons to dispense medication. In Maryland, physicians are permitted to dispense medication subject to certain regulations. Maryland physicians who are permitted to dispense medication must obtain a dispensing permit from the Maryland Board of Physicians. But the ability to dispense medication poses additional avenues of liability for physicians and raise concerns among some and may pose additional risks for Maryland patients, as one recent article showed.

The article raised the issue of whether physicians should be permitted to dispense medications. In an editorial in another paper, a writer had suggested that it is a good idea to have doctors dispense medications directly to patients, because it may be easier and cheaper for patients. Three doctors in Montana recently filed a lawsuit seeking to be allowed to dispense medications directly to their patients. Dispensing medication directly to patients is prohibited in that state. However, critics say that dispensing medication directly to patients raises serious medication safety concerns. In particular, there is a concern that there would not be a second review by a pharmacist of the prescription. There is also a concern about the lack of regulatory oversight, such as labeling, supervision, and storage.

Pharmacy errors can occur at different stages in the process. Having a pharmacist dispense and administer the medication means that the pharmacist can act as a check on errors that can occur when prescribing medication. Allowing a doctor to prescribe and dispense a medication means that there would likely be no second person reviewing and checking for errors before the medication reaches a patient. Prescribing errors can, of course, cause significant harm to patients.

Maryland pharmacy errors occur when a patient is given a prescription drug that is flawed in some way. It may be the incorrect drug, or the incorrect dosage, or it may be that the instructions are incorrect, causing the patient to take the drug too often, not often enough, or at the incorrect times. Because prescription drugs are often powerful and dangerous if taken incorrectly, pharmacy errors can cause severe illness or injuries, especially if they are not caught for a significant period of time.

Patients can protect themselves from Maryland pharmacy errors by carefully reading the drug labels and prescription information every time they pick up a prescription. These labels not only provide important information on safe and proper medication use; they also can help the patient check for errors. For example, the information provided with the prescription often indicates what the medication looks like, by describing it as “small white pills” or “red oblong capsules.” Patients should compare this information to the actual medication they receive, to ensure there has not been a drug mix-up.

Additionally, the information included with the prescription explains how to use the drug and drug interactions. This information should be compared with instructions given by your doctor or pharmacist. If there’s a conflict, it’s safest to call your doctor or pharmacist to clarify. The information on drug reactions can also help patients avoid a common pharmacy error—doctors prescribing a medication that has an adverse interaction with another medication the patient is already taking. If you are already taking any form of medication, even if it’s over the counter, it is best practice to read the information on drug interactions provided with your prescription drug to make sure there are no problems.

It’s no secret that the COVID-19 pandemic has overwhelmed the health care system. High rates of infection and death have sent thousands of Americans to hospitals and health care clinics, most of which were already busy treating patients before the pandemic. The country’s medical providers and health care workers are working hard every single day to try and help people and combat the virus, but the sheer amount of work and stress they are under may take a serious toll on their mental health and their ability to perform the job effectively. Recently, a hospital nurse spoke to the Institute for Safe Medical Practices (ISMP) about the impact that COVID-19 is having, and what he said has implications for how the pandemic may increase Maryland pharmacy errors.

According to an article detailing his experiences and report, medication errors have been increasing in his hospital. Because nurses are working long hours with critically ill patients in a stressful, hectic, and overwhelming work environment, medication errors are more common. However, it is likely that this pattern is not isolated to just hospitals. The entire health care system is overwhelmed right now that it is likely that the rise of medication errors is also occurring in other settings, including pharmacies.

Pharmaceutical errors can be just as dangerous as errors occurring in hospitals. Many Maryland residents rely on their local pharmacy for their medications, but when pharmacists and pharmacy technicians are stressed out and overwhelmed they may make significant errors, such as providing the wrong dosage of a medication, or even the wrong medication altogether. With the COVID-19 pandemic, pharmacies may be overwhelmed by more calls from patients than usual, or requests for more prescriptions as individuals stock up. They may also be short-staffed if a pharmacist or technician gets sick or needs to stay home to take care of a family member. All of this can negatively affect Maryland residents, who rely on pharmacists to fill their prescriptions correctly and likely to not expect to be injured from taking prescribed medicine.

The COVID-19 pandemic had changed the lives of almost every American in too many ways to count. Among those who have been the most impacted by the pandemic are medical workers, including pharmacists. Pharmacies have seen surges in volume as more people are more frequently visiting doctors and obtaining prescriptions for all types of health conditions. As the demand on pharmacists increases, so does the risk of a Maryland pharmacy error.

The Institute of Safe Medication Practices has released a list of tips that pharmacists should follow to decrease the risk of error during these challenging times. The tips are broken down into three categories:

Preventing Pharmacy Errors

When it comes to preventing Maryland medication errors, the Institute of Safe Medication Practices recommends pharmacists take the following steps:

  • Keep certain IV infusions standardized to a single concentration or dose, when possible.
  • Use visually identifiable premixed solutions for common infusions.
  • When dispensing a nonstandard concentration or a paralyzing agent, be sure to clearly label these infusions.
  • Implement frequent safety meetings and create processes for pharmacy members to double-check solutions before administering infusions.

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Maryland residents may rush to get a COVID-19 vaccine when it becomes available. Yet, as companies race to develop a COVID-19 vaccine, questions about the risks of a vaccine have been raised. All vaccines carry some risk for residents of a Maryland medication error, and according to a recent news report, many experts have speculated on the heightened risks of a COVID-19 vaccine in light of a condensed development timeline.

Experts in the public health field worry that a condensed timeline for developing and testing the vaccine might mean that it is approved without proper data and analysis. Some of those fears appear to have merit. One vaccine testing candidate did not test in animals. Another experimental vaccine was approved for China’s military before trials were even completed. A significant number of people in one vaccine trial experienced a “medically significant” adverse event. Creating a vaccine in the span of a year is “unprecedented,” according to one expert working to develop a new vaccine platform.

Some experts worry that the vaccine will not be safe or effective. A vaccine might produce unintended side effects, for example. One adverse event that had been seen with vaccines for other viruses is an antibody-dependent enhancement (ADE). An ADE is an immune reaction to the vaccine that makes subsequent exposure to the virus more dangerous by generating antibodies that encourage the virus to replicate instead of neutralizing it. One scientist said that the rare side effects of a vaccine likely will not be discovered until after the vaccine is approved.

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