Articles Posted in Pharmacy Errors in the News

Pharmacists are responsible for ensuring that the prescriptions they fill are correct. Of course, this means that pharmacists must take care to provide patients with the correct medication, at the correct dose, and with the appropriate dosing instructions. To be sure, most medication errors involve an oversight involving one of these issues. However, according to a recent news article, a pharmacist in New Zealand recently provided one patient with a three-month supply of medication that was just one month away from being expired.

White PillsEvidently, a patient went to the pharmacy to fill a prescription of Ferrograd. When the pharmacist provided the patient with the requested three-month supply, the pills provided to the patient were to expire in one month. A few months later, the patient went back to refill another prescription. This time, the pharmacist gave the patient the wrong drug entirely. At this time, the patient double-checked her Ferrograd prescription and realized it was expired. She returned the prescription for a replacement.

The supervisory board found that the pharmacist failed to fulfill the duty that was owed to the patient, and it implemented an investigation into the pharmacy’s practices. The pharmacy explained that whoever dispensed the prescription wrote down the incorrect drug name and retrieved the incorrect pills from a similar-looking bottle. The pharmacist ended up acknowledging her mistake and providing the patient with a written apology.

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Pharmacy errors have been on the rise over the past few years. While there are many reasons why a pharmacist may give the wrong medication to a patient, one of the most commonly reported causes of pharmacy errors is look-alike and sound-alike drug names.

Medicine PacketsThe pharmaceutical industry relies heavily on marketing to sell medication. Once a medication is established as effective and becomes popular, other medications that perform a similar function may be released with similar-looking or -sounding names. This can create a dangerous situation when a busy pharmacist needs to fill multiple medications for drugs that all sound the same, each with its own dosing requirements and instructions.

The Government’s Efforts to Curb Pharmacy Errors

According to an article in a recent industry publication, the Food and Drug Administration’s Division of Medication Error Prevention and Analysis (DMEPA) has recently ramped up its efforts to review drug labels prior to FDA approval in hopes of decreasing the total number of errors due to look-alike and sound-alike drugs.

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While pharmacists are certainly busy medical professionals, there is no excuse to cut corners or to engage in any shortcuts that could potentially put a patient’s life at risk. However, despite the importance of a pharmacist’s role in a patient’s overall medical care, there are often lapses in care or judgment that put recovering patients at an increased risk of re-admission to the hospital. Similarly, even patients picking up routine medications are put at risk of serious complications when pharmacy errors are made.

Doctor's GearLegally, pharmacists have a duty to ensure that they provide a certain level of acceptable care. To be sure, this does not mean that a pharmacist can be held liable for every adverse drug reaction; however, when there is evidence that a pharmacist did not provide the adequate level of care, patients who suffered as a result may be entitled to monetary compensation for their injuries.

Proving that a pharmacist’s actions were legally deficient is not difficult in many pharmacy error cases, especially when the case involves allegations of the pharmacist providing a patient with the wrong medication or the wrong dosage of the correct medication. However, one of the most common areas in which plaintiffs run into problems is in establishing causation. Causation is an element in almost all pharmacy error cases that requires the plaintiff to establish that the defendant’s negligent act resulted in their injuries. In pharmacy error cases, this often requires the testimony of one or more medical experts.

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Last month, a jury in Massachusetts rendered a guilty verdict in a case brought against a pharmacist who had run a pharmacy that was tied to hundreds of cases of meningitis in 20 states. According to a national news source covering the case, the pharmacist was acquitted of murder charges but was convicted on several counts of “racketeering, racketeering conspiracy, mail fraud and introduction of misbranded drugs into interstate commerce with the intent to defraud and mislead.”

Mortar and PestleEvidently, the pharmacist ran a compounding pharmacy that would create custom-made medications. However, inspections conducted during the investigation revealed that the equipment used to create the medication was not sterilized, and ingredients used in the process had expired. In addition, prosecutors alleged that the pharmacist, as well as several of his employees, actively lied about the condition of the lab.

The medication created in the lab was shipped to 20 states and was tied to 700 cases of meningitis. It is believed that 64 people died due to the unsafe medication that was created in the lab, which was the deadliest meningitis outbreak in U.S. history.

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In most professions, when someone makes a serious error that affects the health or safety of another person, it becomes public knowledge. Indeed, we often read in the news about reports of doctors, police officers, and politicians who make questionable judgment calls. The fact that these lapses in judgment become public knowledge allows for the public to better understand the errors and encourages brainstorming about how to reduce those errors in the future through better policy-making and enforcement.

Mixed PillsPharmacists, however, do not face mandatory reporting requirements in much of the country. In fact, in most states, pharmacists are given discretion about when to report most errors. Interestingly, Maryland is ahead of the curve in requiring that certain adverse patient-related events, including medication errors, be reported within five days by medical professionals, including pharmacists.

The Seriousness of Pharmacy Errors

The Food and Drug Administration estimates that medication errors cause more than one death a day and injure over 1.3 million people annually. While not every prescription error will result in a serious injury or death, it is important to realize that the effects of a pharmacy error may not be immediately apparent. In some cases, medical experts are required to establish which, if any, consequences a patient who has been provided the wrong medication may face in the future.

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Earlier last month, a news article discussed a recently filed case brought by a woman who was provided the wrong medication by a national pharmacy chain. According to the news report, the woman suffered from restless leg syndrome and was provided a prescription for Ropinirole by her physician. She called in the prescription to a nearby pharmacy, picked up her pills, and took them home. She took the first dose later that night.

PillsAfter taking the first dose of the medication she was provided by the pharmacist, the woman started feeling odd and suffering from serious nightmares. She explained that she was hallucinating and didn’t know what was going on, and it felt as though her limbs were detaching from her body. Her husband told reporters that his wife awoke in the middle of the night, telling him strange stories that did not make any sense.

On the next day, the woman’s daughter noticed that her mother was not acting normally and checked the pill bottle. Her mother’s name was on the outside of the bottle, and the correct medication name and dosage was on the front of the bottle; however, when she opened the bottle, the pills did not match the label. The bottle contained Risperdone, a powerful anti-psychotic used to treat schizophrenia. After the woman discovered the error, she was taken to the hospital and connected to an IV to flush her system.

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While doctors prescribe medication to patients, they have to rely on pharmacists to fill the prescriptions correctly, and when pharmacists are overworked, errors increase—putting patients at greater risk.

Medication BottleThere are a number of work conditions that may cause an increase in errors. For example, many pharmacists are required to fill a high number of prescriptions every hour. Some pharmacists claim they have too many prescriptions to fill in one shift in addition to receiving orders, talking to insurers, and counseling patients. A senior pharmacist interviewed for a recent report explained that some pharmacists are required to fill over 30 prescriptions an hour, which equates to two minutes per prescription. On top of that, pharmacists must also check for potential drug interactions for each prescription and counsel patients who have questions about their prescribed medications.

One study published in the American Journal of Health-Systems Pharmacy showed that overworked pharmacists lead to an increase in prescription errors. The study looked at prescription errors in a large hospital pharmacy and found the number of errors increased with the number of orders a pharmacist filled in one shift. Other pharmacists complain that they are required to fill general customer service duties in stores in addition to fulfilling their duties as pharmacists.

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Technological advances in medicine over the past 50 years have greatly benefited patients through the use of emerging treatments and technology-assisted procedures that allow doctors and other medical providers to provide better care to their patients faster and at a lower cost. As many parts of the medical field have rapidly progressed through the information age, certain areas of the profession continue to lag behind other industries, and this arguably prevents doctors and other medical professionals from giving their patients the best treatment possible. Medical record-keeping practices serve as an example of how the profession has not quite caught up with the rest of society, and patients can be harmed as a result.

KeyboardMany Doctors Still Use the Color-Coded Charts for Patients’ Medical History

A patient’s medical history contains some of the most important information that doctors need to know before diagnosing and treating a condition or prescribing medication. The patient’s “chart” provides a place for this important information to be recorded, and it has often consisted of an actual paper chart that is physically stored for each patient at a doctor’s office (often in some sort of color-coded folder that is stored behind the receptionist). Although this system has generally worked for the last 100 years that it has been in use, it is an obsolete relic of an older time that is due for replacement.

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Pharmacists are human, and like all other humans they are susceptible to making mistakes. The range of pharmacy errors is vast, from incorrect medications to improper dosing instructions, but the effects are always the same. The patient is put in grave danger of either not receiving their prescribed medication or ingesting a potentially harmful, unprescribed substance. In any event, despite the fact that most pharmacy errors are committed by well-intentioned pharmacists, when a patient suffers serious harm as a result of an error, a personal injury lawsuit may be an appropriate way for the patient to receive compensation for all they have been put through.

White PillsJust as there are many types of pharmacy errors, there are also many causes. One of the most common causes of in- and out-patient pharmacy errors is a pharmacist mixing up similarly named medications. In fact, a recent article in one industry news source discusses how two similarly named drugs, Venofer and Vfend, were recently the subject of a potentially serious pharmacy error.

Evidently, the pharmacist who made the error had filled a prescription for Venofer 200 mg earlier in the day. Once complete, the pharmacist placed the prescription in the “complete” basket and moved on to other projects. Later that day, the pharmacist came across another prescription, this time for Vfend. Having just filled a prescription for Venofer, the pharmacist misread the label and grabbed Venofer instead of Vfend. Both drugs were in a 200-mg dose, adding to the confusion.

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In order to reduce pharmacy errors, a hospital in Japan has adopted quality control procedures developed and used by Toyota, according to a recent article. The new procedures are intended to improve workflow among the hospital’s 30 pharmacists, who work in staggered shifts among racks and racks of prescription medications.

illsPrior to adopting Toyota’s safety measures, the hospital was known to have committed more than 10 pharmacy errors per month. After studying and implementing the new procedures, the hospital has reduced pharmacy errors by more than 50 percent.

Pharmacy errors are a worldwide problem, including in the United States. Common hospital pharmacy errors include giving patients the wrong dose of a medication, giving them the wrong medication altogether, or unintentionally giving them another patient’s medication.

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