Articles Posted in Pharmacy Errors and Children

A 4-year-old was recently accidentally administered a COVID-19 vaccine when she was brought in to get a flu shot. According to one news article, the Maryland pharmacy error occurred when the 4-year-old girl went with her parents to a Walgreens pharmacy in Baltimore, Maryland. She was supposed to receive a flu shot but the pharmacist accidentally injected her with a dose of the Pfizer/BioNTech COVID-19 vaccine. The vaccine is not currently authorized for children younger than 12 years old and the vaccine for 5 to 11 year-olds, which is not yet authorized, only has about a third of the dosage given to the 4-year-old.

The girl’s parents did not know what to do and a nurse’s hotline and Poison Control “yielded few answers.” Researchers are still looking into the effects of COVID-19 vaccines on young children and toddlers, including at the University of Maryland School of Medicine in Baltimore. A representative from the U.S. Food and Drug Administration stated that vaccination providers are supposed to report vaccine administration errors to The Vaccine Adverse Event Reporting System, managed by the federal government.

Although no adverse effects were reported in this case, the case illustrates that other, possibly more serious, errors can occur. Medical errors and vaccine errors occur all too frequently. In the event of a Maryland pharmacy error, victims may be able to recover financial compensation for their injuries, which may include medical bills, lost wages, and other financial losses, as well as emotional suffering. In a lawsuit against the parties responsible for the error, a victim would have to show that the defendant(s) owed a duty of care to the victim, the defendant(s) failed to meet the standard of care required in that situation by acting or failing to act in some way, the defendant(s)’s wrongful act caused the victim’s injury, and the victim suffered damages as a result.

Medication errors occur every day and in most recent years, they have received significant attention from the media and have been the subject of many studies. But such studies often focus on adult errors rather than pediatric errors. Children may be at greater risk because of the additional calculations and variations in medication for children. A recent study with implications for Maryland medication error victims looked at the occurrence of ten-fold medication errors in children.

According to the article, results from the study were recently released after the two-year study was conducted on pediatric ten-fold medication errors. In one case, a professional administered an unintentional ten-fold overdose to a four-year-old child. The investigation looked at medication errors not just in prescribing, but also in dispensing and administering doses. A consultant explained that there are more steps involved to calculate a children’s prescription than an adult prescription. The dosing for children is often based on weight. Sometimes another calculation needs to be to convert medicine to a liquid formula and sometimes another calculation to adjust the concentration based on the specific product that is available.

The study showed that of the ten-fold medication errors that occurred during the study, the vast majority—76 percent—occurred during the prescription phase. Another 20 percent occurred while administering the medication and 4 percent while dispensing it. The study offered solutions to decrease pediatric medication errors, such as shifting medications from liquid form to tablet form but noted that not enough is known about such errors to give a clear solution.

The Pharmacy Times recently reported an issue that many parents are facing when administering ibuprofen oral medication to their children. Maryland medication errors can result in serious adverse side effects to infants and children taking cold and flu medication or pain relievers. In some cases, these errors result from a caretaker’s failure to read the packaging instructions. However, marketing errors increase the likelihood of a dosing error.

The report focuses on the two different concentrations of children’s and infant’s ibuprofen. The infant’s formulation is intended for babies aged 6-23 months, weighing between 12-23 pounds. The infant’s formation is 40 mg/mL, whereas the children’s formulation contains 20 mg/mL. The childrens’ formulation is intended for children aged 2-11 years or weighing 24-95 pounds. While companies rely on the consumer carefully reading the dosing and administration instructions, confusion often arises because of the similarities in packaging and labeling.

Pediatric hospitals and medical providers are becoming more aware of the confusion, and as such, parents are receiving education regarding dosage upon discharge. However, the Institute for Safe Medication (ISM) reported that medical providers had received several reports about medication mix-ups occurring after a child was discharged.

A statute of limitations, or the time period in which a claim must be filed, is generally strictly construed. In a Maryland pharmacy error case for personal injury or wrongful death generally has to be filed within the three-year statute of limitations applicable to those cases in Maryland. A medical malpractice claim generally has to be filed within five years of the date of injury or within three years of the date the injury was discovered, whichever comes first. This means that if a pharmacy error victim files after the statute of limitations has passed, the claim will be dismissed, regardless of the merits of the claim. The statutes are strictly construed because they are meant to limit the liability of defendants over an indefinite period of time to increase fairness and predictability.

However, there are some exceptions to the statute of limitations. As stated, if an injury was not known or discoverable until a certain date, the clock will not start running until that time (which may be a point of litigation in some cases). There is also an exception if the potential plaintiff was incapacitated and unable to file a claim while the statute of limitations was running. Similarly, a minor may not be expected to file a claim until they reach the age of majority. In any event, after any pharmacy error injury is incurred or discovered, it is essential to have the claim evaluated by an experienced attorney to determine the applicable statute of limitations.

Toddler Suffers From Alleged Pharmacy Error

Pharmacists are trained professionals. Yet, pharmacy errors occur with frightening regularity. According to a recent industry news report, there are at least 1.5 million preventable pharmacy errors each year in the United States. While many Maryland pharmacy errors are the result of a pharmacist mixing up the names of similar-sounding drugs, the dosing errors are also very common.

Math is a very important part of a pharmacist’s job. In fact, a life changing pharmacy error can be caused by a very simple mistake involving simple arithmetic. The aforementioned article explains several pharmacy errors and how easy they can happen. For example, one pharmacy received a prescription for a baby weighing 13 pounds, 5 ounces. The prescription called for 333 milligrams Amoxicillin suspension every 12 hours for 7 days. Thus, according to the prescription, the child would receive 666 milligrams of the medication per day. The general medication guidelines for Amoxicillin provide for up to 25 milligrams of medication per kilogram, given in evenly-divided doses ever 12 hours.

The proper way to fill the prescription is as follows: The child weighs 13 pounds, 5 ounces, or approximately 6.05 kilograms. By multiplying this number by 25, the daily dose for the child should be about 151 milligrams. Because the medication should be dosed twice per day, 12 hours apart, each dose should be about 76 milligrams.

Maryland medication and pharmacy errors of any type are concerning, but they are of particular worry when they affect children. Children’s immune systems are more vulnerable than adults, and they may lack the ability to articulate and explain what is wrong or what is happening to them, making errors more difficult to detect. Because children’s bodies are still growing, certain errors can also inhibit growth and have serious long-term consequences. While relatively rare, all parents should be on the lookout for pharmacy errors when it comes to their children.

To make this easier for parents, The Pharmaceutical Journal recently announced a new initiative focused solely on this problem: inviting researchers to submit articles on the subject to be published, increasing the availability of information on prevention and common errors. The Journal hopes to publish articles on how pharmaceuticals can improve the health of children, new policies that may prevent errors of this kind, and evidence-based best practices across all sectors.

The Pharmaceutical Journal explained in depth why this initiative matters. Most research on pharmaceuticals and drug administration focuses on adults, who can be studied more easily with less ethical concerns. However, children are not simply small adults, and the data collected on adult subjects cannot necessarily be translated to children, whose bodies, physiology, are remarkably different. For instance, drug doses, which are generally standardized across all adults, perhaps only differing due to weight or sex, have to be individually calculated for every child receiving the drug, based on their age, weight, body surface area, and clinical condition. This individualized calculation may lead to more errors. Additionally, the physiology of children is changing, meaning that old processes and procedures for calculating dose calculations may now be incorrect. Specifically, obesity is on the rise, with the number of overweight or obese children increasing globally. Because of this, pharmacists should be particularly cautious when treating children, and more information on the subject could help them do just that.

Vaccinations are incredibly important to the health and safety of the human population. In fact, vaccinating one’s child is one of the most critical things that a parent can do to protect them and others from many diseases. However, as with any medication or injection, vaccinations do come with some slight risks of Maryland pharmacy errors and injuries or even death.

Understanding the risks and the importance of vaccinations, Congress enacted the National Vaccine Injury Compensation Program in 1986 so that those affected by vaccine-related injuries or the vaccine-related death of a loved one can petition to receive compensation for the tragic incident. Vaccine injury claims can only be litigated through this system, administered by the Office of Special Masters of the U.S. Court of Federal Claims. In the 43 years since the system began, $4.2 billion in compensation has been awarded to claimants.

There are two ways to qualify for compensation under the program. The first, and easier, way is to establish an injury listed on the Vaccine Act’s injury table that occurred within a designated period after the vaccine was received. If this can be shown, causation is presumed, and compensation is awarded. Injuries on the table include anaphylaxis, chronic arthritis, shoulder injuries, and paralytic polio.

For a parent, almost nothing is scarier than having your child be sick and in need of hospitalization. Unfortunately, parents across Maryland face this reality every day, relying on children’s hospitals and wards to protect their infants and children. Hospitals are supposed to keep their patients safe and take care of them to the best of their abilities, but, tragically, sometimes mistakes happen, jeopardizing the health and livelihood of young patients. One common type of mistake is pharmacy errors, when the incorrect medication or dosage is given to one or more patient. These errors are particularly concerning when the patients are infants or children, particularly vulnerable and potentially unable to communicate when something feels wrong.

When pharmacy errors happen, the results can be tragic, potentially leading to severe health concerns or even death. That risk is increased when the mistake is not immediately discovered, but rather continues to happen. For example, a children’s hospital in Cincinnati recently admitted to mistakenly giving several patients a wrongly mixed batch of blood pressure medication. According to a local news report covering the tragic incident, one of the victims affected is an 11-month-old baby, who received 54 doses of the incorrectly mixed drug. Each dose was ten times stronger than required, and although the infant survived, he suffered kidney damage as a result.

The hospital has not released much additional information. At this time, it is unknown how many other patients received the incorrect medication, for how long, or what adverse outcomes occurred. The hospital has also not made clear whether the incorrectly mixed medication was created in its own pharmacy or received from an outside supplier.

One of the best ways to prevent Maryland pharmacy errors is to double-check all medications are accurate before taking them. Of course, children cannot check their own prescriptions, and rely on their parents to do so. However, most parents reasonably assume that the medicine given to them by a pharmacist is correct. A recent news report illustrates that it is not always the case.

According to a report by the New York Times, at least 17 children in Spain suffered a rare disorder called “werewolf syndrome,” also known as hypertrichosis, in which they grow hair all across their body. Evidently, the children were all prescribed medication to treat heartburn. However, the medicine was mislabeled, and the children’s parents were given a drug to treat hair loss. In all, 17 children were affected by the medication mix-up. Medical experts told reporters that the hair should start to fall out within three months of when the children stop taking the medication.

Apparently, several pharmacies were sent minoxidil, the main ingredient in many prescription and over-the-counter hair-growth treatments, instead of omeprazole, which treats acid reflux. The medication originated from India; however, it is unclear where and how the error occurred. Spanish authorities are currently investigating the error, and trying to learn more about how it happened so future mistakes can be prevented.

Although the Center for Disease Control (CDC) does not currently list medical errors as a cause of death, medical errors claim more than 250,000 lives per year. If listed among other causes of death, this figure would be the third leading cause of death in the United States, behind heart disease and cancer. Not surprisingly, Maryland pharmacy errors are among the leading causes of death in the state.

While there are many types of medical errors, one of the more common types is a prescription error, or pharmacy error. A pharmacy error occurs when a patient brings a prescription to a pharmacy to get filled and the pharmacy provides the patient with something other than what they were supposed to receive. Most commonly, prescription errors involve one or more of the following errors:

  • The wrong medication;
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