Articles Posted in Pharmacy Errors in the News

Maryland residents may rush to get a COVID-19 vaccine when it becomes available. Yet, as companies race to develop a COVID-19 vaccine, questions about the risks of a vaccine have been raised. All vaccines carry some risk for residents of a Maryland medication error, and according to a recent news report, many experts have speculated on the heightened risks of a COVID-19 vaccine in light of a condensed development timeline.

Experts in the public health field worry that a condensed timeline for developing and testing the vaccine might mean that it is approved without proper data and analysis. Some of those fears appear to have merit. One vaccine testing candidate did not test in animals. Another experimental vaccine was approved for China’s military before trials were even completed. A significant number of people in one vaccine trial experienced a “medically significant” adverse event. Creating a vaccine in the span of a year is “unprecedented,” according to one expert working to develop a new vaccine platform.

Some experts worry that the vaccine will not be safe or effective. A vaccine might produce unintended side effects, for example. One adverse event that had been seen with vaccines for other viruses is an antibody-dependent enhancement (ADE). An ADE is an immune reaction to the vaccine that makes subsequent exposure to the virus more dangerous by generating antibodies that encourage the virus to replicate instead of neutralizing it. One scientist said that the rare side effects of a vaccine likely will not be discovered until after the vaccine is approved.

In this blog, we write a lot about Maryland pharmacy errors and the harms that can result from them. A lot of the time, Maryland pharmacy errors might not even be caught right away, and when they are, the individual affected may just decide to go deal with it individually with the pharmacy. Even if they decide to file a personal injury lawsuit due to the injuries they suffered, the case might not make the news or raise public awareness because the plaintiff is just focused on receiving compensation for their own individual injuries. Because of this, it is rare that there are public discussions about the errors that pharmacies make, and even rarer still that large retail pharmacy chains face consequences.

However, according to a recent news report, state regulators cited and fined CVS—the nation’s largest retail pharmacy chain—for conditions found at four of its pharmacies, including inadequate staffing and prescription filling errors. CVS was fined $125,000, a relatively small amount for the multi-billion dollar company. The fine, however, validated concerns that pharmacists and pharmacy technicians have about the risks of understaffing and pharmacy errors.

One of the errors found at a CVS pharmacy in the past year occurred when a developmentally disabled teenager received only one-fourth of his prescribed dose of an anti-convulsant medication. He ended up taking this incorrect dose for 18 days, during which he had uncontrollable and violent seizures. In fact, the seizures were so bad that he fell down and hit his head.

Most cases of pharmacy error involve negligent conduct and generally include careless mistakes. For this reason, punitive damages are rare in Maryland pharmacy error claims. Punitive damages are typically imposed to punish a defendant for their wrongful conduct and serve as a warning sign for others to dissuade them from engaging in such behavior.

In Maryland courts, to award punitive damages, a plaintiff has to show that a defendant acted with knowing and deliberate wrongdoing. A plaintiff must prove this by clear and convincing evidence—a higher standard than the preponderance of the evidence standard, which is generally applicable in civil cases. Thus, in many pharmacy error cases, punitive damages are not awarded because a plaintiff is unable to establish the defendant’s knowing and deliberate wrongdoing. The deliberate or intentional administration of the wrong drug is not a common occurrence. However, as a recent news report illustrates, it does occur.

Pharmacist Suspended After Purposely Giving Patient Wrong Drug

A pharmacist was recently suspended from practicing and fined after she purposely gave a patient the incorrect drug, according to one news source. Evidently, the pharmacist was working alone on a Saturday night, and a customer came in to fill a prescription for Suboxone for the patient’s opioid addiction. The pharmacist had already closed the safe where the drug was held and could not open it. The patient reportedly did not want to wait, and threatened to call the police. According to a report, the pharmacist became stressed and took some Apo-Prednisone pills and crushed them. Apo-Prednisone is commonly used to treat allergic reactions, arthritis, and severe asthma, among other conditions.

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As people across the United States and throughout the world have made adjustments due to the COVID-19 pandemic, and, likewise, Maryland pharmacies have done the same. For many pharmacists, they communicate with patients through masks and plastic barriers—if they communicate with patients at all. Medication pickups over the counter have also decreased, as many patients have shifted to other forms of delivery.

As in many other fields, pharmacies face new challenges pertaining to patient care and safety due to the COVID-19 pandemic. There has been an increase in prescriptions made over the telephone, as well as an increase in prescriptions being delivered by mail and through curbside pickup. These changes and others, implemented to maintain distance between people, can also lead to an increase in medication errors.

According to a recent industry news report, the new protocols can limit a pharmacist’s ability to identify and educate a patient, and it may make it easier to mix up patients with similar biographic information. Indeed, the Institute for Safe Medication Practices received regular reports of mistakes at pharmacy drive-throughs, even before the onset of the pandemic. For example, some prescribers use a pharmacy’s voice response system to call in prescriptions, which may not convey all information accurately. Additionally, physical barriers, such as masks and plastic barriers, when combined with an increased distance between pharmacists and patients, can also increase the chance of miscommunication.

During the COVID-19 pandemic, more and more people have been relying on delivery services and online retailers such as Amazon to supply them with their everyday needs and wants. Some popular products, such as face masks have even been on back order, as many individuals quarantined at home attempt the order them online. But Maryland residents may be surprised to hear that, in rare cases, the Amazon package left on your front porch may not be what you ordered at all. It could, instead, be the result of a major Maryland pharmaceutical error or package mix-up, like the package left on a California woman’s door earlier this month.

As reported by one local news source, a woman in California was recently excited to see an Amazon package on her front porch. As many of us would, she thought it was her order, which had been on back order and took a while to be delivered. Instead, when she opened it, she found something else entirely: seven bottles of powerful narcotics, including oxycodone, hydrocodone, and morphine, along with an invoice from the Drug Enforcement Administration (DEA). Of course, the woman wants to know how all of these powerful pills—literally hundreds—ended up in her Amazon package.

A DEA Special agent stated that he believes a pharmacy that was attempting to dispose of the drugs used a third-party shipper to send the package to Texas for proper disposal. However, the shipping labels may have been switched, leading to the unfortunate mix-up. Amazon, in a written statement, said it thought that perhaps the seller made the error, and instead of shipping the requested product they incorrectly included the drugs. Whatever the case may be, the DEA is investigating the incident. The drugs in the package are extremely dangerous, so the DEA wants to make sure there’s nothing more sinister going on.

Each year, 7,000 to 9,000 Americans die as a result of a medication error. About 1.3 million people are injured because of a medication error each year. When someone is injured because of a medication error, they may be entitled to financial compensation. A doctor, pharmacist, hospital, or another provider may be liable for their mistakes.

List Released of COVID-19 Related Medication Errors

The Institute for Safe Medication Practices recently published a list of medication errors related to the treatment of COVID-19 patients. According to one publication, the medication errors included in the list were: missed doses linked to rationing of personal protective equipment, lack of staff training in using a medicine bar code, hard-to-read remdesivir labeling, automated cabinets dispensing the wrong drug, and an inability to weigh patients to assure correct dosage.

For example, some hospitals have said that there was an increase in missed doses of medication to patients because staff was hesitant to enter patients’ rooms multiple times because they were worried they might run out of personal protective equipment. Some providers have also reported that the inability to weigh patients during telehealth visits can lead to incorrect dosages of drugs based on the patient’s weight. One hospital reported an error from an automated dispensing cabinet, where a nurse mistakenly selected and gave a COVID-19 patient a high blood pressure medication instead of a sedative, because the drug names were similar.

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Since early March, the COVID-19 pandemic has affected hundreds of thousands of Americans, including many Maryland residents. According to the Maryland Department of Health, there have been over 45,000 confirmed cases of COVID-19 in the state, although many other cases are probably unreported due to lack of widespread testing. At its worst, the illness requires hospitalization and medical treatment, and doctors and medical professionals have been working hard to treat patients as best they can. But a new report from the Institute for Safe Medication Practices (ISMP) sheds light on the concern of medication and pharmacy errors going on as doctors treat the pandemic.

According to the ISMP’s report, in the latest edition of its weekly Acute Care Medication Safety Alert, an unidentified hospital overdosed multiple COVID-19 patients due to confusion over drug labeling. The drug, Remdesivir, is an experimental treatment being used in a clinical trial for severe COVID-19 patients. The ISMP reported that the vials of the drug, however, were not clearly labeled, and that the information on it was crowded and in a small font. Exacerbating the confusion was the fact that the hospital stocked two different versions of Remdesivir, a powder and a solution, each 100 mg of the drug. The second vial was labeled 5mg/mL. These errors and confusion were not caught by the pharmacy technicians or the pharmacists, and eight patients were administered doses way above the standard.

While no adverse reactions or side effects had been reported when the ISMP’s report was published on May 14, delayed reactions may still occur, threatening the already ill patients’ health. But the story also sheds light on a potentially larger problem—overworked hospital staff, working around the clock to care for large numbers of COVID-19 patients, may be unusually fatigued, rushed, and distracted, making pharmacy errors such as this one more likely to occur. Even the smallest pharmacy error can have disastrous consequences—mixing the wrong drugs or giving an overdose can cause severe illness, injuries, or even death.

A recent article written by two medical professionals sheds insight into how and when prescription errors occur. According to the article, 7,000 to 9,000 people in the United States die each year as the result of a medication error. In addition, hundreds of thousands of other patients experience an adverse reaction or some other medical complication related to a medication. As we’ve written about before, these pharmacy and prescription errors can cause severe and life-threatening injuries to Maryland patients, so it is essential to be aware of them.

The article discusses the various types of medication errors. While doctors and pharmacists generally do a great job, sometimes errors do occur. A doctor might make an error when prescribing, for example, and may prescribe the wrong drug or the wrong dose. Pharmacists may give the medication to the wrong patient or accidentally tell the patient to take the medicine twice a day instead of twice a week.

These errors have three leading causes, as identified in the article. First, distraction, which accounts for nearly 75 percent of medication errors. Medical professionals are often busy and have many duties in a hospital. While speaking to patients, examining lab results, and ordering imaging studies, for example, they may be asked to quickly write a prescription. In these cases, when the job is done in haste, a medication error may occur—even with the best doctor. Second, distortion. Sometimes a doctor will prescribe a drug but use a symbol not widely recognized, or it will be translated improperly, and the actual drug administered will be slightly off. Last, illegible writing, as simple as it sounds, also leads to medication errors- a pharmacist may be unable to read what the prescription says and may thus use their best judgment and then administer the wrong medication.

Over the past two months, the COVID-19 pandemic has drastically changed the lives of individuals across the country, including Maryland residents. Experts say that in order to flatten the curve and beat the pandemic, more widespread testing is needed. Since the beginning of this crisis, test kits have been sparse, with many residents unable to get tested even if they feel ill. While there certainly is a need for more test-kits across the country, a recent story out of Washington state highlights that the need may be even greater than previously thought, as distributed test kits are being recalled for possible contamination.

According to a local news report, the Washington State Department of Health distributed 12,000 test kits to local health jurisdictions, tribal nations, and state agency partners across the state. However, the Department is now recalling these kits, after being alerted by the University of Washington Medicine that there may be possible contamination and a quality issue with them. The specific issue affects the viral transport media, which is the fluid that preserves the individual’s specimen as the test is transported. Healthcare workers noticed the issue when seeing that some vials of the transport media were an unusual color. While this issue is not at this time thought to pose a health risk to patients, the tests are still be recalled in an effort to be as safe as possible when dealing with this potentially deadly virus.

Washington state is working to replace the recalled tests as quickly as possible, but the recall comes at a terrible time, as the entire country is in dire need of tests. While it is still unclear how long this pandemic, or the related stay-at-home orders, will last, what is clear is the immense burden placed on health care workers and facilities, who are struggling to keep up with the increasing rates of infection. Unfortunately, this may mean that there is an increased risk of pharmacy errors or medical accidents occurring, which can result in catastrophic effects for Maryland patients.

The COVID-19 pandemic has affected almost all aspects of society for most – if not all – Maryland residents. Since the beginning of the crisis, necessary supplies have been in short supply. Indeed, healthcare workers have been forced to re-use supplies that are designated for a single-use and even rig their own masks because supplies were so low.

Among the newly raised concerns is a potential shortage of drugs that are needed to operate ventilators. Ventilators are machines that help those with COVID-19 breath while they are unable to do so themselves. According to a recent news report, when a patient requires a ventilator, a doctor or nurse must place a tube down the patient’s throat. To do so, medical staff need to give the patient sedative medication, pain killers, and, in some cases, medication to induce temporary paralysis. Evidently, in a letter to Vice President Pence, a spokesperson for the American Society of Health-System Pharmacists explained that ventilators “will be rendered useless without an adequate supply of the medications.”

The concern is that some hospitals are seeing demand for these drugs surge upwards of 600 percent. Part of the problem is that hospitals are attempting to secure a supply of the medication before they actually need it.

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