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Over the past few decades, the demand placed on Maryland pharmacies has skyrocketed. The workload of the average pharmacist has correspondingly increased. In an attempt to keep the system working efficiently, pharmacies have begun to rely more and more on technology to help with filling prescriptions. This includes checking for prescribing errors and potential adverse reactions.

One of the most notable advancements is the widespread use of electronic prescribing and medication administration. The concept behind electronic prescribing and medication administration is that doctors and pharmacists can electronically input a patient’s prescription rather than rely on a “paper trail,” as used to be the case.

As a recent article points out, however, there may be unintended consequences of the widespread use of electronic prescribing and medication administration. The study reviewed the pharmacy staff’s daily behaviors before and after the implementation of an electronic prescribing and medication administration system. According to researchers, the new system may be linked to an increase in medication errors — the study based this conclusion on several data points.

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Each time a patient is prescribed prescription medication, a physician has determined that the medicine is medically necessary for the plaintiff’s health. However, when a doctor prescribes a prescription, the doctor assumes that the medication that will ultimately be provided to the patient is exactly what they specified.

In the case of a Maryland pharmacy error, or a situation in which a medication is recalled, the medicine that a patient is provided is not what their doctor intended. As a result, there can be serious and potentially life-threatening consequences. If a patient is not given the medication that they were prescribed, the existing condition that necessitated the prescription will not be treated. This often leads to the worsening of symptoms.

Compounding the potential for injury is the fact that whatever medication the patient is provided may have been adulterated, contaminated, or contain other substances that can cause the patient injury or harm. Such a reaction may be due to an allergy, an adverse drug interaction, or an inadvertent overdose if too high a dose is provided.

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The last thing many patients think to do when picking up a prescription from their local pharmacy is to check the pharmacist’s work. However, given the startling rate of Maryland pharmacy errors, this critically important step should not be overlooked. Did the prescription provided by the pharmacist contain the correct medication? Was the dosage correct? Was the correct number of pills included in the prescription? These are just a few of the questions that patients must ask themselves when picking up a prescription for themselves or a loved one.

Of course, the burden to ensure that a prescription is accurate should not rest with the patient. And legally it does not; pharmacists have an obligation to fill all prescriptions accurately. However, because the repercussions of a pharmacy error can be so devastating, patients should do everything they can to avoid being the victim of a Maryland pharmacy error.

As mentioned above, pharmacists are medical professionals and – like doctors – they have a duty to their patients. This includes the responsibility to accurately fill all prescriptions, regardless of how long it takes. However, the realities of working in a busy pharmacy too often outweigh these practical concerns and pharmacists may fail to double-check their work for fear of getting too far behind. Not surprisingly, this drastically increases the risk of an error.

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Pharmacists are medical professionals and – although it is not always evident to patients – a significant amount of work goes into filling each prescription. Aside from making sure that the correct drug, dose, and amount of medication is provided to a patient, pharmacists are also responsible for ensuring the quality of the medicine being provided to patients, and for making sure that prescribed medication is suitable for the patient.

The vast majority of the time, pharmacists deal with controlled substances that have not just the power to help a patient, but also the potential for danger. Some of these drugs may have serious side effects or exact dosing requirements, and many of the drugs handled by pharmacists can be habit-forming or addictive.

A recent article discussed the lack of safeguards in one hospital pharmacy that allowed a physician to overprescribe painkillers in fatal or near-fatal doses to 34 patients. Typically, the hospital required a pharmacist to approve a prescription electronically before a doctor or nurse can access the medication cabinet and obtain the drug to give to the patient. In the event of an emergency, access to the medicine cabinet was allowed through a physician override. Evidently, physicians were able to access all types of dangerous medications, including fentanyl and Versed, without having to justify the circumstances of the emergency.

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Under Maryland law, most cases must be brought within three years from when the claim “accrues.” However, when someone ingests a dangerous medication, the potential harms of the drug may not be immediately apparent. This is true in both pharmacy errors, where a pharmacist provides a patient with the wrong medication, and also in cases involving dangerous prescription drugs that are marketed as safe. This raises the question, when to these Maryland pharmacy error cases accrue?

Maryland courts employ the “discovery of harm” method when determining when a claim begins to accrue. Thus, it is only when a plaintiff becomes aware of their injuries that the clock starts ticking. A recent federal appellate decision involving a dangerous prescription drug illustrates how courts engage in this type of analysis.

The Facts of the Case

According to the court’s recitation of the facts, in 1999, the plaintiff was prescribed Vioxx by her physician to relieve pain and inflammation. The following year, the plaintiff suffered “cardiovascular injuries” while taking the medication. However, the plaintiff’s doctor continued to prescribe Vioxx, and the plaintiff continued to take the medication. In 2002, the plaintiff discontinued the use of Vioxx.

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Any time a pharmacist provides a patient with the wrong medication, there is the possibility that there will be serious, potentially life-threatening consequences. However, when the victim of a Maryland pharmacy error is a young child, the risk that the error will result in serious injury or death significantly increases. And while parents should check all labels and all accompanying literature to ensure that an error has not occurred, the duty ultimately rests with the pharmacist to accurately fill a prescription.

In many cases, after a child is given the wrong medication the parent will quickly realize that there has been an error because their child will exhibit symptoms. However, some symptoms may not arise immediately, and may take days, weeks, or even months to arrive. Generally speaking, a Maryland pharmacy error victim has three years to bring a claim under the statute of limitations. The statute of limitations may be tolled from the time of the error to the point where the patient realizes that she suffered injury. Additionally, if the patient is a minor, the statute of limitations is tolled until the day before the minor turns 18 years old. However, just like most things in life, it is not a good idea to wait until the last minute to file a claim.

Newborn Baby Given the Wrong Medication by Local Pharmacy

Earlier this month, a local news article reported on a pharmacy error that allegedly occurred at a CVS pharmacy. Evidently, a mother picked up what she thought was a prescription for her newborn daughter’s acid reflux. The mother gave the medication to her daughter for two weeks before realizing that the drug the pharmacist provided her was actually a steroid. During the period when the newborn was taking the unprescribed steroid, she was vomiting, swollen, not sleeping and cried more often than usual.

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Medication errors are believed to be one of the leading causes of death across the United States. Indeed, there have been countless studies focusing on the causes of pharmacy errors and the best ways to reduce them. However, the fact remains that medication errors result in over 3.5 million hospitalizations each year, with over a million of those to the emergency room.

The exact number of patients harmed by Maryland pharmacy errors is difficult to determine. In part, this is due to the lax reporting requirements. In Maryland, as is common across the United States, pharmacists are not required to report most of their errors, and do so only voluntarily.

According to a recent investigative report, pharmacy errors are routinely swept under the rug and kept out of the public eye. The report recounts the case of a man who died after ingesting the wrong medication that he obtained from his local pharmacy. The man’s autopsy report confirmed that the pills on the bottle did not match those which he was prescribed. However, pharmacist “neither admitted or denied” the allegations, and was ultimately fined $3,000.

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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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A significant number of Maryland prescription drug injuries are caused by opioid use and abuse. Over the last decade, the number of deaths that were related to opioid medications has dramatically increased from about 35,000 in 2007 to over 70,000 in 2017. In an effort to curb these stark statistics, experts began to consider why opioid abuse has become more prevalent over the past few years and what new law or policies could help decrease opioid abuse.

One idea that is starting to gain traction is the concept of partial-fill prescriptions. Under a partial-fill prescription policy, patients who are prescribed certain high-risk opioid medications are given only a few days’ worth of medication at a time. The idea behind the policy is that if patients are given fewer pills they will be less likely to take more than they need. Additionally, proponents of a partial-fill policy hope that it would reduce the number of people who sell some or all of their medication.

According to a local news report, Tennessee recently enacted a partial-fill policy under which patients would only be provided some of their medication on their first visit to the pharmacy. Patients could obtain the rest of their medication, if needed, by returning to the pharmacy once they run out of medication. Under the new policy, pharmacies are responsible for inputting patient data into a state-wide database.

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Maryland personal injury plaintiffs risk having their cases dismissed if they fail to file their claims within the applicable statute of limitations. In a recent case before a state appellate court, the court dismissed the pharmaceutical claim for failing to timely file a claim.

The plaintiff had filed a lawsuit against pharmaceutical companies, alleging that they were liable for his gambling and other losses because he suffered from obsessive-compulsive disorder as a result of taking Mirapex. Mirapex is an FDA-approved medication used to treat Parkinson’s disease, which the plaintiff began taking in 2006 to treat his Parkinson’s disease. After taking it for two years, he told his doctor that he was experiencing increased compulsive behaviors, including gambling. His doctor told him there was a possible association between Mirapex and compulsive behaviors. The plaintiff raised the issue with his doctor several months later. The plaintiff’s family eventually learned of substantial debts resulting from his gambling, at which point the doctor told the plaintiff not to take Mirapex anymore, advising him to use other therapeutic options instead.

When the plaintiff filed the lawsuit against the drug’s manufacturers, the companies claimed that the lawsuit was time-barred, arguing that the plaintiff filed the case after the two-year statute of limitations for personal injury claims under state law. The plaintiff did not dispute that he knew or should have known that he had been wronged by the defendant by April 23, 2008, after discussing the effects of Mirapex with his doctor on more than one occasion. However, he did not file the claim until December 2010. The plaintiff argued that the statute of limitations was tolled until July 2010, because he continued taking Mirapex until that time, and because “continuing violations” are not time-barred. Under that state’s law, a personal injury claim must be filed within two years. However, under what it calls the “continuing accrual” principle, in continuing or recurring liability cases, “a cause of action accrues each time a wrongful act occurs,” which means that the statute of limitations begins again for that act.

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