Pharmacy Error Injury Lawyer Blog

Side Effect Labels on Prescription Bottles May Help Reduce Injuries

March 18, 2009 | Lebowitz & Mzhen

The Food and Drug Administration is taking steps to warn consumers about potential drug side effects. The Maryland Pharmacists Association reports that sometime this year, the FDA will require all prescriptions to include a “side effects statement” that lists all of a drug’s potential side effects. The proposed labeling could appear on prescription containers and will advise patients to contact their health care provider and the FDA if they experience drug side effects.

Many of these side effects initially may be as minor as a runny nose or muscle stiffness. However, many of these insignificant annoyances can develop into more serious health concerns if a patient continues taking the prescription. To prevent more serious side effects, a patient should recognize any less serious side effects that might occur first and immediately contact their doctors. However, in order to take action, a patient has to know all of a drug’s potential side effects.

Listen to any radio or television commercial for the newest “wonder drug” and you’ll be shocked by the long list of potential side effects that the announcer speed reads before the commercial ends. Maryland medication error attorneys urge our readers to consult their physicians before taking medications so that they know a drug’s potential side effects.

Maryland Medication Error Prevention Checklist

March 11, 2009 | Lebowitz & Mzhen

Sometime ago, we posted an article on our Maryland truck accident blog that highlighted some of the steps accident victims should take if they are victims of a Maryland truck accident. Our Maryland pharmacy error attorneys have prepared a similar list to help our readers reduce their risk of injury caused by medication errors. We suggest that our readers do the following:

1. When you are given a prescription at the pharmacy, check the label very carefully especially checking the name of the medication and dosage;

2. if the prescription is a refill, examine the pills to ensure that they look like the pills from the prior prescription;

MRI Scans and Drug Patches with Metal May Cause Burns

March 9, 2009 | Lebowitz & Mzhen

The medication error attorneys at Lebowitz & Mzhen Personal Injury Lawyers recently learned that the Food and Drug Administration has warned consumers who use medicated skin patches to remove those patches before going through a MRI scan. According to the FDA, some patches contain metal which may heat up during an MRI and burn the patient’s skin. The FDA warns that the metal in many of these patches may not be visible to the patient and not all transdermal patches that contain metal have patient warnings printed on the box. The FDA is currently reviewing the labeling requirements to ensure that patients are adequately warned of this new danger.

Until this review is complete, the FDA suggests that patients who use medicated patches do the following:

• Before undergoing an MRI scan, tell your doctor that you are using a patch and why you are using it;

Monetary Bonuses Convince More Physicians to Use Electronic Prescription Programs

February 26, 2009 | Lebowitz & Mzhen

Recently, my father attempted to relive his glory days on the football field with unfortunate results. While attempting to imitate some of the great wide receivers of his day, he ruptured his Achilles tendon and required surgery. I accompanied him to one of his follow up visits to his doctor’s office and was surprised to see the level of technology the doctor used when treating patients. In prior posts, Maryland medication error attorneys have extolled the virtues of computerized prescription programs, but I was still surprised to see how efficient those systems are when used in the day to day operation of a busy doctor’s office.

The doctor who treated my father asked him a series of questions about how the surgical site was healing, his pain, and any other prescriptions he was taking, and examined my father’s range of motion. The doctor entered all of that information into a computer terminal in the examination room and returned, within minutes, with a print out that contained my father’s prescription. Additionally, the doctor’s office electronically sent the prescription ahead to a local pharmacy.

Last month, Medicare and certain private health care plans began paying doctors bonuses for using similar E-prescription software. The private health care plans provide doctors with extra payments for services along with free equipment, such as PDA’s, if they use computerized prescription software. Medicare’s bonus amounts to 2% of charges billed to Medicare for 2009 and 2010. This translates into approximately $1,700 to $3,500 a year per doctor. As a result of the new incentives, the number of doctors using E-prescription programs has doubled over the past year and, nationwide, nearly 70,000 doctors use these programs.

Electronic prescription programs not only reduce the risk of medication errors, but they also help lower patients’ health care costs by suggesting low cost generic alternatives to expensive name brand medications. In a recent study, researchers at a hospital in Milwaukee, Wisconsin discovered that E-prescription software saved patients a substantial amount of money by allowing more doctors to prescribe safe generic prescriptions.

Additionally, by reducing the time a patient has to wait in a pharmacy to receive a prescription, E-prescription programs ensures that more Americans will fill the prescriptions their doctor’s prescribe. Fortunately, nearly all big box pharmacies and many independent pharmacies accept electronic prescriptions. This allows doctors, like my fathers, to forward prescriptions ahead of the patient and reduce the amount of time a sick or injured patient has to wait in a pharmacy waiting area.

Under the stimulus package, the government plans to invest $ 50 billion dollars over the next five years in technological advancements in health care. The Maryland medication error attorneys at Lebowitz & Mzhen Personal Injury Lawyers will carefully watch these advancements as they arise in the future.

External Resource

Wall Street Journal article

Reminder after Reading a Story from Institute for Safe Medication Practices (“ISMP”)

February 20, 2009 | Lebowitz & Mzhen

One of the sources of information that we read regularly is published by the Institute of Safe Medication Practices. Recently, the ISMP wrote about individuals who were using a dosage cap from one over the counter medication, to measure medication from another medication.

When the measuring cups were swapped as described above, the result was that the individual taking the medication received an overdose of medication. Just as a reminder, Maryland medication error attorneys at Lebowitz & Mzhen Personal Injury Lawyers recommend that measuring cups stay with the produce that they are designed to measure so that easily avoidable, but potentially dangerous, errors are avoided.

Children at Maryland Schools Rely on School Nurses for Proper Medication

February 17, 2009 | Lebowitz & Mzhen

As the parent of children in elementary school, I recently received a call from the school nurse who reported that one of my kids was sick. I was impressed with the professionalism and competence shown by the school nurse.

When I was in the nurse’s office, with children as young as age 5, I noticed how careful school nurses must be to make sure that these young children receive only the appropriate medicines. The nurses must make their decisions based upon their knowledge, training and experience, and must carefully consider the prior authorizations and advice given by the parents who might have anticipated school house illnesses of their children.

The Maryland State Department of Education has adopted policies regarding the role of school nurses as developed by the American Academy of Pediatrics (“AAP”).

Chewing Some Prescription Medications Can be Harmful

February 12, 2009 | Lebowitz & Mzhen

In litigating Maryland pharmacy error cases, our pharmacy negligence attorneys have learned some interesting facts about different drugs, their effects, and the proper manner they are designed to be ingested. Drug manufacturers design medications with a specific method of patient ingestion in mind. Some drugs are designed to be administered through an IV, some are slow release medications that must be swallowed, and others are specifically designed to be chewed and released quickly into the patient’s blood stream.

Other methods of ingestion also exist, for example, some drugs must be taken in form of eye, ear, or nose drops. Still other medications are designed to be absorbed through a patient’s skin.

The varying methods of drug transmission can be daunting and many patients place too much confidence in their pharmacist or doctor and fail to ask questions so that they completely understand their dosage instructions. The Institute for Safe Medication Practices published the story of a woman who suffered from similar overconfidence and died as a result of a negligently prescribed medication. The story is a warning for others to make sure they understand their dosage instructions.

A doctor prescribed an 83 year old patient Cardizem to control her blood pressure. The patient chewed the pills since the pills were too large to swallow. As a result, the patient’s heart rate slowed to dangerous levels, and the woman’s family contacted her pharmacist for assistance. The pharmacist suggested that the physician prescribe a form of the same drug that came in chewable capsules.

Months later, the patient returned to her physician for a check up and the physician put her back on Cardizem without warning the patient not to chew the pills. The patient subsequently began to chew the pills, over time became weaker and died three weeks later.

This story reminds us of the need to carefully question our health care providers until we fully understand the dosage instructions that come along with our prescriptions. According to the patient’s family, she was a smart and alert woman, who just put too much faith in her providers’ instructions and failed to ask questions.

In Maryland and D.C., People With Visual Impairment Suffer From Pharmacy Errors

February 9, 2009 | Lebowitz & Mzhen

Americans suffering from vision loss are at an increased risk for injuries caused by pharmacy errors. In a recent survey, the American Federation for the Blind (“AFB”) reports that nearly 20 million Americans suffer from some form of significant vision loss and many have suffered injuries due to their inability to read prescription names or dosage instructions. Maryland pharmacy error attorneys join the AFB’s call for Congress to take up legislation to develop safeguards for this class of citizens susceptible to medication errors.

As we have discussed in previous posts, medication instructions are notoriously confusing and difficult to read even under the best of circumstances. The AFB report is accompanied with personal stories describing how people with vision loss can suffer disproportionately from pharmacy negligence.

In one situation, the legally blind parents of an infant nearly lost their child due to their inability to catch a pharmacy prescription misfill. The parents managed several prescriptions for their child, but they were unable to read the labeling on the bottles. A pharmacist misfilled the prescription with a medication that was potentially lethal to the child. Fortunately, the parents were able to catch the error before it was too late.

In another anecdote, a respondent to the survey explained that a negligent pharmacist dispensed twice the amount of insulin that the man’s prescription required. Since the respondent was not able to read the medicine’s label, he took a double dosage of insulin, passed out from hypoglycemia, and had to receive treatment at a local emergency room.

Currently, there is no federal or state law requiring that pharmacies provide medication dosage or side effect information in Braille. Unfortunately, the AFB reports that devices to assist the vision impaired with medication labeling are not widely available.

External Links

AFB Survey

Hospital Uses New Computer System to Reduce Pharmacy Errors

February 5, 2009 | Lebowitz & Mzhen

In earlier posts, the Maryland pharmacy error attorneys at Lebowitz & Mzhen Personal Injury Lawyers have discussed how computerized prescription entry programs decrease the risk of patient injury due to pharmacy errors. A study at the Norwalk Hospital in Norwalk, Connecticut is another example of how these systems work.

Recently, I spoke on the phone with a friend who lives in Norwalk and who is currently expecting her first child. As we talked about her child’s upcoming birth and the plans of her and her husband, she mentioned that the hospital where she is likely going to deliver her baby was in a local paper for being one of the safest in the nation. A recent newspaper article highlights how Norwalk Hospital in Norwalk, Connecticut employs a computerized prescription program that has, in part, helped earn nationwide recognition for patient safety. The computer system allows physicians at the hospital to electronically submit prescriptions with dosage instructions to the pharmacy, bypassing the necessity for doctors to write a hardcopy of the prescription. This procedures largely eliminates the possibility that the doctors’ handwriting will be misread.

Dr. Stephen O’Mahony, the associate chairman of medicine and a medical quality officer at Norwalk Hospital commented that, “With the old way we were doing things there was the chance of there being transcription errors, meaning a patient could get the wrong medication, but now there is no chance of [hospital pharmacists] reading it wrong.”

During the three years since the hospital introduced the computerized system, medication errors have decreased from an average of 13 errors per 1,000 patients to 2 errors per 1,000 patients. Additionally, the hospital has noticed a decrease in the length of hospital stays for Medicare recipients from an average of 7 days down to 5.7 days.

The electronic system not only prevents medication errors, it also uses a “best practices” approach to suggest the appropriate drug therapy for particular patients. For example, if a patient comes to the hospital suffering from a heart attack, the computer system will remind the doctor to prescribe aspirin. Also, when a doctor treats a person suffering from pneumonia, the system will prevent the doctor from discharging the patient until the patient has received a flu shot. With features such as these, the hospital’s computerized prescription program helps reduce the time patients suffer from their current aliments, and it also helps reduce the risk of further health problems.

External Links

Newspaper Article

New York Pharmacies to Provide Foreign Language Prescription Instructions

January 30, 2009 | Lebowitz & Mzhen

Maryland pharmacy error attorneys serve a number of clients who do not speak English as their first language. Some of these clients have raised the issue of not being able to receive prescriptions or dosage instructions written or spoken in their native languages from big box pharmacies. The attorneys at Lebowitz & Mzhen Personal Injury Lawyers believe that this shortcoming places a large number of citizens in danger of harmful pharmacy errors. According to the 2000 US Census, 667,357 Marylanders speak a language other than English in their homes.

As we discussed in an earlier post, Maryland pharmacists must provide medication counseling to patients when requested, and must provide written dosage instructions with prescriptions. Counseling and written instructions in English are useless to a pharmacy patient that has difficulty understanding the language.

Pharmacy Today reports that following an undercover investigation by New York Attorney General, Andrew Cuomo, Rite Aide and CVS have agreed to provide medication instructions in languages other than English at their New York locations. The investigation began after reports that pharmacies failed to provide side effect information and drug interaction warnings in patients’ native language. New York Rite Aid and CVS locations will now provide dosage and side effect information to patients in Russian, Spanish, Chinese, Italian, French and Polish. The companies also agreed to provide assistance using an over the phone translation service.

Our attorneys believe that Maryland pharmacies should follow suit and help ensure that all patients fully understand their medication dosage instructions and other relevant information.