Articles Posted in Pharmacy Errors and Children

A pharmacist’s mistake in providing the wrong medication to a patient is always a serious concern, but never is it more serious than when the patient is a child. Children are much more susceptible to suffering serious or fatal side effects when given medication that was not prescribed to them. In fact, the manufacturers of many medications specifically state that the drug is not intended for the use of minors. It is therefore extremely important that pharmacists and parents do everything they can to ensure that a child is not given the wrong medication.

However, pharmacists are human, and busy ones at that. They often fill hundreds, if not thousands, of prescriptions each day. This constant flow of work can create an increased chance that something will break down in the system, and a child will be provided the wrong medication. However, the concern is not only that a child will be given the wrong medication altogether. Children are also at risk for serious injury or death if the dose they are provided is not correct.

When a pharmacist does make a mistake, and a child is harmed as a result, that pharmacist and the pharmacy employing him may be held financially liable in a negligence lawsuit. Despite what the media and the pharmacy industry may say, the ultimate burden is not on the parents or those who administer the medication to the child. The burden remains on the pharmacist.

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Late last month on Halloween, a Canadian pharmacy accidentally provided medication used to treat bipolar disorder to young trick-or-treaters who visited the store. According to one local news source that covered the story, seven children are known to have actually taken the medication in place of candy. However, all of the pills were located before they were consumed by the children.

Evidently, the pharmacy had a candy bin out on the pharmacy counter so that young trick-or-treaters could help themselves as their parents conducted their business. However, at some point in the day, a customer who was visiting the pharmacy to fill her 17-year-old son’s prescription for quetiapine and divalproex inadvertently dropped the medication on the floor prior to leaving.

Another customer, thinking she was preventing a potential mix-up, picked up the medication off the floor and put it on the counter, next to the candy bin. Shortly afterward, a pharmacy employee saw the pills sitting next to the bin and then dumped them into the candy bin. Seven of the individually wrapped pills were given out to children over the course of the day before management discovered what had occurred.

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Earlier last month, the major pharmaceutical company GlaxoSmithKline was named as a defendant in a lawsuit brought by the parents of a child who was born with a birth defect after his mother took medication produced by the drug manufacturer during pregnancy. According to one national news source, the drug, called Zofran, was initially approved for treating nausea in cancer patients after they received chemotherapy. However, over the years, the drug started to be prescribed to pregnant women looking to lessen the effects of “morning sickness.”

Evidently, the couple filed suit in federal court in Ohio. They allege that the manufacturer marketed the drug for “off label” use to pregnant women back in the 1990s. Shortly after this time, the company allegedly started to get complaints from mothers who took the drug during pregnancy. They were reporting that their babies were being born with heart defects and kidney malformations. In fact, subsequent research has shown that mothers who take Zofran have twice the chance of giving birth to a child with a severe birth defect.

This lawsuit is not unique. In fact, there have been several dozen similar lawsuits brought by parents of children who have been born with severe birth defects after their mothers took Zofran.

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Earlier this month, a CBS news affiliate published an article discussing pharmacy errors broadly and also focusing in on the fact that Walgreen’s Pharmacy is currently facing several lawsuits based on the alleged negligence of their pharmacists. According to the report, just this year two serious pharmacy errors have occurred at Walgreen’s stores across the country.

The first was a five-year-old boy who was somehow provided with anti-psychotic medication rather than his normal allergy medicine. Not only was the provided medication the wrong one, but the dose was ten times stronger than that which should be used for a child his age and size. The boy took two doses of the unprescribed medicine before his parents noticed the mistake. His parents told reporters that “he couldn’t breathe, he couldn’t talk” after taking the two doses. His parents were later told by doctors that if they had given him one more dose they may have lost their son.

The second situation involved a 15-year-old girl who was allegedly given schizophrenia medication instead of simple antibiotics. After getting home and taking the medication, she experienced blurred vision and a racing heart. The girl’s mother told reporters that, as she stood by her daughter’s side that day, she was afraid she was going to lose her. Thankfully, both patients recovered from the medication errors.

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When children are sick, they rely on their parents to provide them with the medical care and medication that they need. Most of the time, parents are able to determine what their child needs and can provide it to them on their own. However, since children’s bodies are so small, a dosing error can easily occur if a parent is not careful.

A recent article written by one of the pharmacists at the Poison Control Center at the Children’s Hospital of Philadelphia goes over some things that parents can do to help ensure that they do not accidentally administer too much, too little, or the wrong type of medication to their children.

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Earlier this month in Michigan, a teenager’s family discovered that he had been taking the wrong prescription for almost a whole month after they noticed that his mood was off and his schoolwork declining. According to a report by one local news source, the teen was prescribed medication for his ADHD that he was to take daily. However, when he went to fill the prescription, he was instead provided a generic version of Singulair, an asthma medication.

The teen’s parents noticed that he was acting off once he started taking the medication. He was “extremely feisty and bitey and moody, extremely moody, and his school work just went downhill, everything went downhill.” But the parents didn’t know what was wrong. At first, they thought that he was not getting enough of the medication, and that his dosage was off because he had grown since the dosage was last adjusted. It wasn’t until the teen’s mom looked at the bottle when she took it to get refilled that she noticed a problem.

Evidently, the bottle had the teen’s first name on it and his last initial, but it was for an entirely different patient. Making matters even more confusing, the correct address and prescription label was on the bottle. When they first filled the prescription, the teen’s mom trusted her son to take his medication as he should. In fact, he was doing fine taking it as needed until this setback.

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In a newly released study by Pediatrics, it is reported that there are an astronomical amount of child medication errors that are occurring outside the hospital setting. According to one article that summarized the report, there are almost 64,000 medication errors annually in the United States involving children under the age of six. Twenty-five percent of these errors occur in infants under the age of one.

The report explains that each year, there are about 200,000 medication errors that occur outside of hospitals, and about 30% of these errors involve children under six. This comes to one medication error every eight minutes. Of course, the study can only deal with reported medication errors. The actual number of errors is expected to be much higher, since only a fraction of errors are reported.

Liquid medications are by far the biggest culprit when it comes to medication errors, resulting in a whopping 89% of all errors. As far as what was causing the error, the breakdown is as follows:

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The United States is one of only three countries in the world that does not use the metric system in practice. While the official system of measurement in the States is the metric system, in reality, no one really uses it. However, this can cause a problem when children are given medication by their parents that requires knowledge of the metric system.

In a recent study by Pediatrics, it is shown that about 40% of parents make a mistake—whether it be over- or under-dosing—when converting from the metric system to the American Standard System. The article proposes switching the United States over to the metric system, which would require a complete overhaul.

The article notes that most pharmacies use the standard system when providing dosing instructions. However, the pharmacists themselves use the metric system to dose the medication. This creates the necessity of a “margin of error” that all pharmacists must tolerate. However, such a margin of error can lead to over-dosing, under-dosing, and medication poisoning.

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In a frightening story out of North Houston earlier this month, an eight month old child was given painkillers instead of cold medicine by a local pharmacy. According to a report by a local news source, the child’s parents took her to the doctor complaining of a persistent cough and cold. The prescribing doctor called in a prescription to a local Walgreen’s pharmacy for the infant’s condition.

Upon picking up the prescription from Walgreen’s and giving it to her daughter, the woman’s mother noticed that the infant fell asleep immediately, one time with her eyes rolling back into her head. It wasn’t until about a week later that there was a knock on the door by a Walgreen’s pharmacy technician explaining to the mother that they had accidentally provided her daughter with adult-strength codeine instead of the cold medication prescribed by the girl’s doctor.

Walgreen’s acknowledged the mistake, taking ownership immediately. In fact, the company issued the following statement regarding the error:

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Earlier this year in Crystal Lake, Illinois, a five-year-old boy ended up taking a dangerous dose of an anti-psychotic drug when the pharmacy gave the drug to his mother under the auspice of a treatment for his allergies. According to a report by the local NBC affiliate, the young boy, Ali Ahmed, was in need of medication for his allergies, and a prescription was called in for him at the local Walgreen’s pharmacy.

When his mother went to pick up the prescription, she picked up what she thought to be the allergy medication that her son’s doctor had called in. However, the pharmacist gave her Halperidol instead, a dangerous anti-psychotic drug used primarily to treat adults with serious mental health issues.

Luckily, the boy’s parents only gave him a small dose of the wrong medication. After young Ali took the medication, he slept for two days straight. After waking, he had a small snack, and his neck began to flare. Emergency personnel were called, and eventually the flare went away. However, as soon as the neck flare went away, he began to act strangely and then fainted. His parents called the boy’s doctor, who told them to take him to the hospital immediately.

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