Articles Posted in Pharmacy Errors and Children

People that regularly take prescription medicine or have received prescription medication in a hospital or clinic setting can appreciate the vital importance of best practices when it comes to receiving the medicine. Whether it is at the pharmacy or in the hospital, it is essential to be aware of safety measures that could make a major difference in the care you receive. Every patient deserves peace of mind when it comes to their medications, and to live free of the consequences of medical and pharmaceutical malpractice.

Incorrect or erroneous distribution or application of medications is surprisingly present in the United States. In fact, some sources cite a rate of one in five Americans experiencing a medical error while receiving health treatment. Unfortunately, Maryland is no exception to this trend, and Maryland residents should be aware of emerging best practices in the face of the increased computerization of pharmacies and hospital medication cabinets.

Illnesses Stemming From Medication Errors

Pharmacy errors are a serious cause for concern nationwide, with thousands of Americans suffering injury, illness, or death each year because of a negligently prescribed, prepared, or filled medications. Both state and federal regulators attempt to ensure compliance with pharmacy safety standards, however the regulators often fail to hold negligent doctors, pharmacies, and employees accountable in the event of an error. This point is demonstrated in a recently published story of a boy who suffered serious complications after consuming prescribed medication that was 14x stronger than intended or labeled.

According to the recently published report, the parents of a five-year-old autistic boy were alarmed when their child started reacting poorly to a medication that had been prepared by their pharmacy. The medication in question was a compounded mixture of several medications to assist the boy with sleeping. When the parents noticed the boy going into an unconscious sleep while standing shortly after consuming the medication, the boy was taken to a hospital, where he was treated for an overdose of a medication generally prescribed for high blood pressure. The boy ultimately recovered from the overdose, but the parents suspected that an error had occurred in the preparation of the medication.

The child’s parents reported the issue to the regulatory board in charge of medication error. The couple also performed some investigation of their own, paying out-of-pocket to have the formula tested in a laboratory, which revealed the error once and for all. Armed with the information, the parents sought accountability through the regulatory body, and were disappointed when neither the pharmacy nor any of their employees were disciplined for the dangerous mistake. Unfortunately, the regulatory agencies tasked with ensuring the safety of patients throughout the country are often staffed by supporters of the medical industry, who may have been lobbied by advocates for reduced accountability for medical and pharmacy malpractice.

Medication errors are an unfortunate yet common occurrence throughout the United States. While these errors can have deadly consequences, they are most dangerous to vulnerable populations such as older adults, pregnant women, and children. In Maryland, those who suffer a medication error may hold the responsible party liable for their losses. Children are a unique population in that they have little to no control over the medication they consume yet can face the most consequences after a medication error. Statistics indicate that over 50% of American children consume one medication or more every week, and one study revealed that almost half of caregivers gave an incorrect dose.

While a single dosing error of a common medication may not result in a significant injury, persistent errors can raise the likelihood of serious harm. In light of the growing concern surrounding pediatric medication errors, the American Academy of Pediatrics (AAP) published a piece on preventing home medication errors. The authors acknowledged that home medication errors commonly occur with liquid medications requiring preparations. Caregivers with reduced health literacy or limited English proficiency are at an increased risk for making an administration error.

In addition to home caregivers, health care providers may also be responsible for pediatric medication errors. Many health care provider practices enhance the occurrence of errors. Providers who do not include complete information related to indication, frequency, or duration, can affect how the caregiver administers the medication. Further, providers who fail to include a consistent dosage or conduct a thorough medication review may inappropriately prescribe medication.

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.