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As business practices across the board evolve, so does the pharmacy industry. And with brick-and-mortar pharmacies requiring high month-to-month operating costs, mail-order pharmacies are becoming more common as a way for some patients to save money on their costly prescriptions. With the increase in popularity of mail-order pharmacies, more and more people are getting experience dealing with these companies, which do not present any opportunity for face-to-face interaction.

The truth of the matter is that pharmacies – regardless of where they are based – have a duty to their patients to accurately fill all prescriptions. And if a mail-order pharmacy can save customers money on prescriptions by not needing to pay real-estate or rental costs, that is fine, but pharmacies should not cut corners when it comes to staffing or customer service. However, that is exactly what one woman experienced when trying to secure her husband’s necessary daily medications from one mail-order pharmacy.

According to a recent article by Forbes, customer service at some mail-order pharmacies may be so poor that it puts patients in danger of running out of necessary medication. The article details the plight of a woman whose husband had recently been diagnosed with Parkinson’s Disease. Aside from dealing with the life-changing realizations the diagnosis brought, the couple also had to find a way to ensure a steady supply of the husband’s extremely expensive day-to-day medications.

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Earlier this month, a federal appellate court issued an opinion upholding a lower court’s verdict in favor of a mother whose child was born with a cleft palate and lip. According to one news source covering the case, the young girl suffers from hearing loss and speech problems, and she has undergone approximately 14 surgeries to correct the condition. The plaintiffs claim that the girl has also been subject to teasing and bullying as a result of her appearance and speech.

The case was brought against a subsidiary of a drug manufacturing giant, Johnson & Johnson, and it alleged that the company failed to warn doctors that pregnant patients may experience a heightened chance of birth defects if they take Topamax during the first trimester of pregnancy.

A Drug Manufacturer’s Duty to the Public

In general, manufacturers of over-the-counter and prescription drugs have a duty to warn people who may take a drug of any potential serious side effects. Of course, not every side effect of a medication is known at the time of manufacture, so only those potential complications that are known about must be disclosed. However, if a company fails to warn patients or prescribing physicians of potential dangers associated with the medication, the manufacturer may be held liable for injuries caused as a result.

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Almost everyone has been to the pharmacy to fill a prescription at some point in their life. In fact, many people routinely visit the pharmacy each month to get their regular prescriptions filled for maintenance medications. Some of these frequent pharmacy customers have many different prescriptions of which the pharmacist must keep track. And in the case of some HIV patients, the varying doses of the prescribed medication adds yet another element for pharmacy staff to handle.

No matter how complex a patient’s prescription order may be, pharmacists are required to take their time with each order, ensuring that it is properly filled and labeled. In the case of some patients with complex prescription orders, like those diagnosed with HIV, this may mean a significant amount of work for the pharmacist, including fielding constant updates from a patient’s care providers about the patient’s status and current prescription requirements. With this increased workload, unfortunately, comes an increased chance that an error will be made.

HIV Patients Are Especially at Risk for Medication Errors

According to a recent article by an industry news source, a study may have come up with a way that can decrease the likelihood of medication errors in HIV patients. As with other illnesses, the transitional time between care providers is the most dangerous time for HIV patients. The premise of the study was simple:  increase the amount of face-to-face contact the pharmacist has with the patient. Specifically, the pharmacist would be present at the patient’s admission to the hospital as well as each day for some defined period.

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When someone is admitted to the hospital, they generally have a dedicated team of doctors and nurses attending to their every need. Hospital staff is in charge of writing prescriptions, filling them, and then administering the medication to the patient. However, the transitional period following a patient’s discharge from the hospital is another matter, when patients are often left on their own to ensure that the care and medications they receive outside the hospital are congruent to those that are received while under the hospital’s care.

The transition period between hospital care and outpatient care is a critical time during which medication errors often occur, according to one recent news article. In fact, this is seen as one of the most dangerous times for patients, who will likely be treated by a new team of doctors, nurses, and pharmacists.

The Sad Story of One Patient’s Experience with Hospital Discharge

Mrs. Oyler was admitted to the hospital after she was experiencing congestive heart failure. She was treated at the hospital, where she was prescribed eight new prescriptions. Upon her discharge from the hospital, the pharmacist overseeing the transition failed to accurately document all eight of the new prescriptions, leaving one off the list. The medication was called “metolazone.”

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Pharmacy errors are more common than most people realize, with approximately 7,000 deaths each year being attributed to medication errors. Many of these medication errors occur at retail and hospital pharmacies, where busy pharmacists scramble to fill thousands of prescriptions each day. Even a good-hearted and well-intentioned pharmacist can get overwhelmed by the workload and make a seemingly small mistake that can have enormous consequences for the patient.

Several pharmacies in Vermont are trying to do things a little differently in hopes of decreasing pharmacy errors. According to a recent NPR article, at least two pharmacies in this state are putting together daily packets of medication for their patients so that the patient does not need to open the pill bottles, which may number in the dozens, and keep track of the medication themselves. The packets are prepared 30 days in advance so that a patient can get all their prescriptions for the month in one trip to the pharmacy. The patients who receive this service are mostly elderly and take between 15 and 20 pills per day.

Of course, this system does give rise to concerns about accuracy. One pharmacist explained that a patient he was caring for recently went into the hospital and was taken off a certain cardiac medication. However, the pharmacy was not notified and ended up providing the patient with the pill, even though the provider had stopped prescribing the medication. The pharmacist, seeing this as a big problem with the system, also addresses this concern. Through increased communication with their patients’ medical care providers, pharmacists try and keep up to date with patients’ prescriptions so that a patient’s daily packets do not result in non-prescribed medication being provided to the patient.

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Medication errors are a major cause of serious injury and death in the United States. In fact, it is estimated that at least 7,000 Americans die each year due to medication-related issues. Many of these are due to patients being provided the wrong drug or wrong dose by their pharmacist. Of course, the pharmaceutical industry and pharmacies themselves are strictly regulated by the United States government, but it is largely left to the individual pharmacist how they go about doing their job on a day-to-day basis. While some pharmacists certainly implement fail-safe protocols to ensure they are error-free, others are more fast and loose, creating an increased risk of a serious or fatal medication error.

The Food and Drug Administration (FDA) is the government body responsible for the oversight of pharmacies nationwide. According to one industry news source, the FDA has recently issued specific protocols for pharmacists and drug manufacturers to follow so that they can reduce the chance of causing a serious pharmacy error.

One of the issues the FDA sees as a major problem is the fact that many medications with vastly different purposes share similar names. This can lead to a situation in which a busy pharmacist inadvertently grabs the wrong medication and provides it to a patient. To help alleviate this, the FDA recommends that pharmacy staff should “write down the prescription and then read back the medication name, strength, dose, and frequency of administration for verification.”

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Whenever a person is injured after using a dangerous product, they are able to file a product liability lawsuit against the manufacturer, and potentially others in the chain of commerce who handled the item. In the case of dangerous medical products, sometimes there are many people who suffer the exact same or very similar injuries. In these cases, a class action lawsuit may be the best option for the injured patients.

Class Action Lawsuits in General

Generally speaking, class action lawsuits are beneficial for plaintiffs because they allow a large group of plaintiffs to argue their case together. Of course, this can save on legal costs, and it can also help the individual plaintiffs in their negotiations with the defendant manufacturer. However, class action lawsuits are not always appropriate.

One of the biggest hurdles to proceeding with a class action lawsuit is “certifying” the class. Before a class of plaintiffs can proceed against a defendant in a single case, the court must certify them as an official class. There are many requirements in order for a class to be certified, but one commonly argued issue is whether the injuries are similar.

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Drug manufacturers make billions of dollars each year from marking up medications that cost mere pennies to make but are often sold for hundreds, if not thousands, of dollars. While the manufacturing cost of most medication is relatively low, the reason consumers end up paying a high price for prescription drugs is based on other behind-the-scenes costs, including research and development as well as the cost of a potential problem with the drug resulting in a recall or significant lawsuit against the manufacturer.

Indeed, all pharmaceutical manufacturers have a duty to ensure that the product they release into the stream of commerce is safe when taken as advised by the company or a physician. Of course, companies may not necessarily always be held liable when an injury results from the abuse of one of their medications. However, when a medicine is taken properly, and an unanticipated adverse effect results due to unsafe manufacturing, the manufacturer may be liable to patients who suffered as a result. These cases are called product liability lawsuits, and they are commonly brought against the manufacturers of dangerous medications.

Proving a Product Liability Lawsuit

As with all personal injury lawsuits, it is the plaintiff’s burden to prove a product liability case. However, pharmaceutical manufacturers may be held to the legal standard of “strict liability” when it comes to a dangerous product. Under a strict liability theory, the plaintiff does not need to show negligence on the part of the manufacturer and must only show that the dangerous drug manufactured by the defendant was the cause of the plaintiff’s injuries. There are several types of product liability lawsuits, however, and an attorney should be consulted for specific advice.

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Whenever a patient is given the wrong prescription, or even the incorrect dose of a prescribed medication, the results can be devastating, depending on the medication provided as well as the individual patient. Children and the elderly are at a heightened risk for developing serious or fatal symptoms after a pharmacy error, so it is especially important that these individuals are hyper-vigilant when it comes to double-checking their pharmacist’s work.

Anyone who has been to a pharmacy recently likely agrees that pharmacists are busy people. They are often responsible for hundreds – if not thousands – of prescriptions each day, often involving similarly named medications prescribed for drastically different ailments. It is only natural that every now and again a pharmacist will mix up two patients’ medications, or inadvertently grab the wrong medication and provide it to the patient.

When these mistakes happen, most of the time they are caught before a serious injury results. However, elderly patients with many prescriptions may forget to double-check the medication prior to taking it. If a serious injury occurs as a result, the pharmacy where the prescription was filled may be held liable in a Maryland pharmacy error lawsuit. Of course, pharmacists don’t make these mistakes on purpose, but when an oversight is made, it is the patient who pays the price.

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While many pharmacy errors are the result of an overworked or distracted pharmacist who provides the patient with the incorrect drug, there are a certain number of errors made each year due to prescription drugs being mis-labeled or mis-packaged by the drug’s manufacturer. In these cases, it is likely that the pharmacist on duty double-checked the prescription and provided the patient what he or she thought to be the correct medication, but due to a mistake that occurred before the pharmacist ever had control of the medication, the patient was provided with the wrong medication.

Of course, drug manufacturers have a duty to properly package their products, as well as to include all relevant and necessary warnings on the packaging. When a drug leaves the manufacturer’s control with incorrect labeling, there is often little other parties can do to catch and fix the error. There are some circumstances, however, in which such an error will not likely excuse the pharmacist, and these are when the pharmacist has the occasion to see the unpackaged medication or is otherwise made aware of the error.

Not all packaging errors result in the patient being provided the wrong medication entirely. In fact, according to one recent news report, mis-packaged birth control medication resulted in over 100 unplanned pregnancies. According to one news source reporting on the 2011 recall, the order of the pills was reversed in the packaging. This resulted in a much higher chance of pregnancy.

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