A grand jury in Kern County, California recently asked an emergency juvenile shelter to report on how its staff handles prescription and over-the-counter medications for children that are sheltered there. It also called on the county’s Department of Human Services to make a registered nurse available at the shelter 24 hours a day. The grand jury’s actions came after news of medication errors appeared, along with allegations that the shelter is violating state regulations by having staff members provide medications to children without oversight by medical professionals. The dispute has also sparked a debate over semantic issues of who may “dispense” medications.
The A. Miriam Jamison Children’s Center is a 24-hour emergency shelter for “abused, neglected and exploited children” operated by the Kern County Department of Human Services. It provides temporary shelter for children in the protective custody of law enforcement or social services. Over the past year, news of several errors in providing medications to children at the shelter reached the director of the Department of Human Services. Errors have included incorrect doses of medications and incorrect medications. No serious injuries have been reported, but the risk of injury is certainly present. Children have had to go to Kern Medical Center (KMC) because of medication errors at least twice.
After officials put an employee on administrative leave for a medication error, some shelter employees began to refuse to handle medications for children. The Service Employees’ International Union (SEIU) also stepped in, arguing that employees who were not registered nurses could not legally give medications to children under state nursing regulations. Additionally, the shelter reportedly has an agreement with KMC, which sends nurses to the shelter for children’s medical issues, that shelter employees will not deal with children’s medications.
The grand jury’s investigation centers around state regulations and the shelter’s agreement with KMC, but it has also sparked a debate over exactly what activities by shelter staff are prohibited. State law says that only registered nurses may “dispense” or “administer” medications. Pharmacists “dispense” medications by counting and packing pills. Nurses “administer” medications by giving doses directly to patients. The Department of Human Services argues that shelter employees do not do either of these, but rather “deliver” medications to children by taking them from a labeled container, following the container’s directions, and giving them to the children to take.
Presumably this definition would keep the liability on the nurses and pharmacists for properly measuring, counting, and labeling medications, and then providing correct instructions for their use. Still, the difference between “administering” and “delivering” medications under these definitions may not be entirely clear. The question of liability for an injury from a medication error may prove difficult to establish. Nurses and pharmacists have very specific legal duties, by virtue of their licenses, to provide diligent care with medications. The shelter has a duty to provide for the children in its care, but the nature of that duty is less clear because of its lack of professional credentials and its status as a government agency immune from suit.
The Maryland pharmacy error attorneys at Lebowitz & Mzhen have extensive experience in assessing liability and damages for injuries caused by medication errors and assisting people in obtaining compensation. For a free consultation to review your case, contact us today online or at (800) 654-1949.
More Blog Posts:
Layoffs of School Nurses Lead to Concerns About Medication Errors, Pharmacy Error Injury Lawyer Blog, February 15, 2012
NCL Campaign to Improve Medication Adherence and Patient Safety, Pharmacy Error Injury Lawyer Blog, May 15, 2011
DEA Fights Prescription Drug Errors and Abuse with National Take-Back Initiative, Pharmacy Error Injury Lawyer Blog, September 28, 2010