Articles Posted in Pharmacy Errors in the News

When a patient picks up prescription medication from a pharmacy, they assume that the instructions given to them on the medication are correct, and that the medication won’t harm them. But unfortunately, far too many Maryland patients are harmed each year as a result of a pharmacy error. One common type of error is failing to warn the patient about potential side effects that may occur, and when the patient should stop taking the medication because of those side effects.

Pharmacies have a duty to warn their patients about the common side effects of drugs and can be held liable in some instances for injuries sustained if they fail to warn. For instance, if a drug causes drowsiness and patients taking the drug are advised not to drive while on it, the pharmacy must warn patients of this. If not, they could be held liable for injuries resulting from a motor vehicle accident if it was caused by the side-effect of the drug. Plaintiffs bringing a negligence suit in these cases can recover monetary damages if they can prove the elements of a negligence suit: that the pharmacy had a duty to warn their patients, that they breached this duty, that the breach was the proximate cause of the injury, and that real damages were suffered as a result of the injury.

Recently, a state appellate court considered a case arising from this very type of accident. According to the court’s written opinion, the patient had purchased a prescription drug product at her local pharmacy. The bottle given to her with the product had instructions to “Finish All Of This Medicine Unless Otherwise Directed By Your Doctor.” The bottle did not include any warning to stop using the product if the patient developed a skin rash or other adverse reaction.

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;

People who have family members in Maryland nursing homes should closely monitor the health of their loved ones. While many nursing homes offer quality care that is provided by compassionate and caring staff members, that is not always the case. Too often, nursing home management tries to cut corners on staffing costs by keeping the number of nurses and other employees at a minimum.

Not only does this mean that there are fewer staff members to help care for residents, but it also places a heightened burden on employees. In turn, this increases the chance that staff members will forget to give a staff member mediation or provide them with the wrong medication when they are in a hurry to move on to another task.

According to a local news article, a nursing home recently agreed to pay the family of a resident who died while in the facility’s care $11 million after reports emerged that the home failed to provide the resident with necessary antibiotic medication. Evidently, the wife of the deceased resident received a letter in the mail six weeks after her husband’s passing, explaining that “there is some information that was not shared with you in regards to the death of your husband.”

As the population increases, more people are filling prescriptions. This results in an increased burden on Maryland pharmacists. Indeed, many experts believe that this increased workload is the leading cause of pharmacy errors. To help pharmacists efficiently fill prescriptions, many pharmacies rely heavily on technology, including e-prescribing, electronic databases, and software designed to bring pharmacist’s attention to potential adverse interactions.

For the most part, technology makes it possible for pharmacists to do their job. However, there is a concern that an overreliance on technology may put patients in jeopardy. According to a recent news report, all patient records were inadvertently deleted after an IT error at a university pharmacy. Evidently, the lost data included prescription and refill history and insurance information for all customers. Pharmacy staff estimate that the affected number of patients is somewhere around 50,000.

As a result of the error, the pharmacy’s databases must all be rebuilt. This requires pharmacists manually enter in all patient data, including insurance information and prescription history. Patients are being asked to call their physician and have them reorder all necessary prescriptions. For now, there have not been any reported pharmacy errors that have occurred as a result of the loss of patient data.

It is estimated that Maryland medication errors are responsible for up to a third of all preventable deaths in the state. Thus, encouraging safer prescription practices is a paramount concern among lawmakers. According to a recent news report, there is currently ongoing debate on whether imposing criminal sanctions against medical professionals who were found to be negligent would decrease the total number of errors.

Earlier this year, we covered a tragic case involving the death of a hospital patient after he was administered the wrong medication by an attending nurse. The nurse is alleged to have disregarded hospital protocol and overlooked several errors, ultimately resulting in the patient’s death. Although the state health department decided not to revoke the nurse’s license, the local prosecuting authority recently filed reckless homicide charges against her, claiming that her conduct was criminal. If convicted, the nurse could face years in prison.

The local prosecuting authority’s decision to pursue criminal charges against the nurse has triggered a discussion regarding the possible effects that imposing criminal liability against negligent nurses or pharmacists could have on Maryland pharmacy error rates. On the one hand, patient advocates argue that more accountability would increase the amount of care that nurses and pharmacists would provide to each patient. Because the leading cause of pharmacy errors is distraction or inattention, in theory, this would decrease the number of pharmacy errors.

Recently, the Institute for Safe Medication Practices (ISMP) issued a report asking that Maryland pharmacists, as well as pharmacists across the country, take additional precautions in the wake of a fatal 2017 pharmacy error. The ISMP is a nonprofit organization dedicated to reducing the number of pharmacy errors across the United States. In furtherance of that goal, the ISMP operates a voluntary error-reporting system. The ISMP then uses this data to work with pharmaceutical companies to eliminate the root causes of common errors such as similarly named drugs, confusing packaging, and dangerous device design.

The Error

According to the ISMP report, a patient was admitted into the ICU with a headache and vision loss. An MRI was conducted, and it was determined that the patient had a hematoma of the brain. The patient was transferred, and a full-body scan was ordered. While the radiologist was explaining the procedure to the patient, the patient indicated she had claustrophobia. The radiologist requested the patient be given a dose of Versed to help with her claustrophobia.

Evidently, the patient’s primary nurse requested that a radiology nurse provide the patient with the medication. The radiology nurse declined, stating that the patient would need to be monitored after administration of the drug. The primary nurse indicated she would send another nurse to the radiology department to monitor the patient after she was given the medication.

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Pharmacy errors can be the result of any number of failures in the medication delivery system. More often than not, however, Maryland pharmacy errors are the result of human error. One of the most commonly cited causes of prescription drug errors is when a pharmacist provides a patient with a medication that has a similar name to the medication the patient was prescribed. In the pharmacy industry, these medications are referred to as look-alike sound-alike (LASA) drugs

According to the Food and Drug Administration, LASA medications are involved in about 41% of all fatal pharmacy errors. An example of two medications that are commonly mixed up and have been placed on the list of LASA medications are Aricept (a drug designed for Alzheimer’s disease), Azilect (an anti-depressant used to treat Parkinson’s disease), and Aciphex (a prescription used to treat acid reflux and stomach ulcers).

Of course, pharmacists have a duty to ensure that they are providing their patients with the correct medication in the right dose. Needless to say, when a pharmacist fails to fulfill that duty, a patient can be exposed to serious risks. In many cases, the symptoms of a pharmacy error are immediately evident; however, that it is not always the case. In some situations, it may take days, months, or even years to discover the extent of the harm caused by an error.

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Each year, it is estimated that there are approximately 700,000 medication errors resulting in over 100,000 patient hospitalizations. The pharmacy industry realizes that this is a major problem, and for decades has been taking steps to reduce the rate of prescription errors among retail and hospital pharmacists. Most recently, a representative from the Institute for Safe Medication Practices (ISMP) gave a lecture discussing common types of pharmacy errors and what pharmacists can and should do to guard against them.

Medication errors occur due to a breakdown somewhere along the line; from when a physician writes a prescription to when the pharmacist provides it to the patient. According to a recent industry news report detailing the speaker’s comments, she claimed that pharmacy errors occur throughout various points in the process, and pharmacists should take precautions every step of the way.

The ISMP representative discussed that there are several situations in which an error was more likely to occur. For example, when a pharmacist is dealing with drug shortages, vaccines, improperly or unlabeled medication, and insufficient drug allergy alerts, the rate of error was highest. The pharmacist detailed three of the most alarming prescription errors that she was made aware of over the past year, including:

  • A patient who was prescribed 25 mg of hydralazine rather than the prescribed medication, hydroxyzine;
  • A child-patient who developed Parkinson-like symptoms after being provided with an improperly diluted dose of risperidone; and
  • An elderly Alzheimer’s patient who was given both a 5mg and 10 mg dose of donepezil at the same time rather than the prescribed 5mg dose for four weeks to be followed by the 10mg dose afterward.

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Over the past decade, the U.S. has seen a dramatic increase in the number of deaths as a result of opioid use and abuse. Indeed, according to the most recent government statistics, over 35,000 people die each year as a result of opioid overdoses. Roughly half of these deaths are caused by prescription painkillers. These figures represent a nearly three-times increase over previous years.

The recent rash of opioid deaths has called into question the medical profession’s reliance on these drugs to treat pain. Notwithstanding the well-understood dangers of opioid use and abuse, opioid painkillers are still prescribed in record numbers each year. Not surprisingly, given the number of prescriptions filled each year, there are a significant number of pharmacy errors involving opioids.

Regardless of the type of medication involved, pharmacists have a duty to ensure that a patient’s prescription is filled accurately. This means not only making sure that the correct drug is provided to the patient, but also providing the proper dose and instructions. When pharmacists make an error involving a drug as dangerous as an opioid painkiller, there is a high likelihood that the patient could accidentally overdose.

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Medical professionals, such as doctors, nurses, and pharmacists, are human, and as a result, it is expected that they will, on occasion, make mistakes. This does not mean that they are bad people or have a malicious intent behind their actions; the vast majority of medical errors are results of a system that places too heavy a burden on medical professionals.

Putting aside the lack of intent to cause harm, the reality is that Maryland pharmacy errors do cause a significant number of patients to suffer serious injuries each year. According to a recent study by Johns Hopkins University, there are over 250,000 pharmacy errors each year. However, according to a recent news report discussing the new study, the actual rate of pharmacy errors may be much higher than originally thought.

The reason for the potential disparity, the article claims, is the manner in which physicians, funeral directors, coroners, and medical examiners fill out death certificates. Evidently, it is common practice to use broad categories when referring to someone’s cause of death. This, in effect, groups preventable medical errors that were results of human or computer errors in with other non-preventable causes of death. As a result, the reported instances of preventable pharmacy errors are difficult to determine.

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