Lawyer Resources for Medication Errors

Errors in dispensing medicationMedication errors in inpatient medical facilities such as nursing homes are so commonplace that they are recognized as a common problem in the medical field. The facility’s medication error rate is identified by state inspectors who have to ensure that the error rate of medication errors be kept below an acceptable or standard percentage. While it is positive to note that state inspectors are keeping track, we also have to be realistic and wonder how many errors go unreported.

Dealing with these issues

It is true that minor medicine errors are inevitable. Especially when dealing with elderly patients, staff members may sometimes be confused about what medication is required. However, it is important to refrain from any severe medication errors. When looking at the definition, medication errors are mistakes that happen while administering or preparing medicine. This goes against accepted professional standards, manufacturer’s instructions, or doctor’s orders.

Examples of medication errors

To the untrained eye, it may be difficult to determine whether something qualifies as a medication error. However, once you have a better understanding of what constitutes a medication error, it is easier to be aware of them.

  • Splitting medications that should not be split – These include tablets, capsules, or other types of medication that specifically say, “Do not crush.”
  • Not having enough fluid – There are countless prescription medications that require the elderly patient to consume a certain amount of fluid when ingesting the medication. Improper hydration or not taking in fluid when taking the medication may actually cause harm to the patient.
  • Inadequate antacids or food – Just as some prescriptions require fluid, others require food. There are also medications that require the patient to take an antacid before ingesting the medication. It is important that the nursing staff ensure that patients follow the recommended guidelines regarding antacids, fluids, and food.
  • Not preparing the medication properly – There are a number of nursing home medications that require that it be shaken or mixed before the patient takes it. Without following the proper procedure, the resident is at risk of receiving too much or too little of the medication. For example, it is important to mix insulin suspensions without air bubbles before administering the medication.
  • Swallowing sublingual tablets – Sublingual tablets are administered by placing them underneath the tongue and allowing them to dissolve. However, some elderly patients will swallow these sublingual tablets instead. While once or twice might not be terrible, it is important that the staff recognize this is happening and address this as a reoccurring issue. Perhaps the medication needs to be altered to ensure proper ingestion.

Negligent errors

Because many nursing home facilities do not have enough staff members, it can lead to staff members feeling overworked or not paying attention to the small details. It may also cause them to feel rushed when administering medication. Some of the negligent medication errors include:

  • Outdated, or expired, elder medication order
  • Errors with lab work
  • Incorrect elder patient or documentation
  • Incorrect elder medication administration technique
  • Incorrect rate, duration, or time of medication administration
  • Using expired medication
  • Medication overdose or multiple doses
  • Medication dose omission or under dose

While a single wrong dosage is not likely to cause severe problems in most cases, if it happens consistently, it could lead to serious medical problems, possibly even death. If you suspect medication errors for your loved one, it is important to speak out to ensure that appropriate steps be taken to avoid these mistakes in the future.

Some of the most tragic cases of nursing home negligence involve medication errors.  Not just because the error results in a severe injury or death of a patient, but because the errors were indeed so needless.  Somewhere along the line from the time the doctors order was written to the time the medication was dispensed— or perhaps not– we frequently see errors made with respect to how medications are handled in nursing homes.  Even innocent errors made by nursing home staff can wreck havoc on fragile patients who require strict adherence to their doctors medication orders.

Death Related With Medication ErrorFor some reason, there seems to be a caviler attitude amongst some nurse some staff when it comes to dispensing medication to patients.  Perhaps it’s the brightly colored pills or the fact that many staff members have become so accustomed to seeing a large percentage of patients taking the same medications? Regardless of the underlying reasoning, staff must be as diligent in their approach to medication dispensation as they are with providing other types of medical care for patients.

A prime example of the sloppy attitude towards the the dispensation of medication occurred recently at a Minnesota nursing home.  After an investigation completed by state investigators, it was determined that a patient at Lake ridge Care Center missed 26 doses of a potassium replacement medication over a nine-day period.

An error by an institutional pharmacy, HealthDirect, is responsible for the death of a 94-year old patient at a New York nursing home.  According to New York Health Department reports, the woman was to receive methimazole, to treat her thyroid condition, but pharmacists at HealthDirect filled the prescription with metolazone– a significantly different medication used to treat blood pressure.

Pharmacy Error Blamed For Death Of Nursing Home Patient In addition to the error my by the pharmacy, additional errors were made by Cayuga County Nursing Home when they administered the wrong medication to the woman over the course of 18 days.  Shortly after the woman received the incorrect drugs, she died due heart problems brought about by kidney failure.

Following the woman’s death, her family initiated a lawsuit against the nursing home due to the errors they made with respect to administering the wrong medication.  In the course of the lawsuit, it only was then discovered that the pharmacy errors were also likely to have contributed to her death.

A Minnesota nursing home has been cited by the state’s Department of Health after investigators determined that staff at the facility failed to provide prescription medication to a patient who was admitted to the facility for short-term rehabilitation.

The investigation was triggered in response to a complaint following the stroke-related death of an elderly woman who was admitted to Lakeshore, Inc. for short-term rehabilitation.  The woman was admitted to the nursing home in order to gain enough strength so she could return back to the assisted living facility where she lived.

Medication Error NeglectDespite the fact that that the facility knew the woman had a history of strokes and was prescribed Coumadin for approximately 10 years prior, staff at Lakeshore never administered the Coumadin, nor did they administer the necessary blood tests to test the drugs effectiveness.

senior-coupleWe’ve all heard about how it may be in your best interest to avoid a hospitalization on a holiday or during a weekend, when senior staff tend to be off.  However, a new study suggests that you may want to avoid a trip to the hospital completely during the month of July. As recently reported by Julie Deardorff of the Chicago Tribune, a study from the Journal of Internal Medicine determined that the patient death rate from medication errors was 10% higher in July than in other months. Perhaps the most reasonable explanation for the spike in medication errors at hospitals was due to the fact that July is when the more than 20,000 fresh medical school graduates begin their residency programs and begin to work on real patients for the first time.  Further, in addition to a lack of experience, many residents are encouraged to work excruciating hours without proper oversight from more experienced physicians. For nursing home patients, this fresh crop of residents can be especially problematic due to the fact that many patients are not capable of communicating effectively or providing a list of the medications they currently take. Of course, it would be foolish tell anyone to avoid a trip to the hospital simply because a new resident may be present.  However, I think this study reinforces the need for families to be advocates for their loved ones and speak up if they have a question or suspect the care provided is inadequate. Hat tip to Medical Malpractice Attorney, John Yannone for his support.

Related:

Medication Aides In Nursing Homes: A Push To Save Money Or Improve Patient Care?

Screen-shot-2010-07-01-at-2_33_47-PMFollowing a three week trial, jurors in Michigan awarded the family of a deceased nursing home patient $4.85 million.

The nursing home negligence lawsuit alleged Mercy Memorial Nursing Center was negligent in administering morphine, a commonly prescribed pain medication, to a man who was admitted to the facility for physical therapy following a non-displaced hip fracture.

A coroner’s report concluded that the man died from ‘morphine intoxication’– essentially an overdose of the medicine.

Picture-332Following a medication-error related death and other medication-related problems that resulted in patient injuries, Minnesota Department of Heath investigators concluded that Fair Oaks Lodge in Wadena, MN was guilty of neglect and other federally mandated nursing home standards.

The ‘major medication errors’ occurred within 16 days of one another.  According to the State’s investigative report:

  • A medication aide mistakenly gave an Alzheimer’s patient drugs for her central nervous system, the heart and anti-psychotic medication all of which resulted in an immediate drop of her blood pressure.  Despite being rushed to the emergency room, the elderly woman died three days later.

Picture-321In times of need, locating necessary information regarding the legal rights and resources for nursing home patients can be difficult and imposing.  In this respect, we are proud to introduce a new resource for patients, families and practitioners looking for a concise compilation of information regarding nursing home laws.  Nursing Home Injury Laws, provides every states’:

  • Nursing Home Laws
  • Medical Malpractice Laws

Picture-218Prescription drugs are invaluable tools in the practice of medicine, used to treat numerous illnesses and diseases. However, prescription errors can result in serious injury and death. In the United States, about 1.5 million preventable adverse drug events occur every year.

Pharmaceutical malpractice can occur when a doctor prescribes the wrong medication or incorrect dose or when a pharmacist fills the wrong medication or dosage. The National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) defines a medication error as:

“A medication error is any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer. Such events may be related to professional practice, health care products, procedures, and systems, including prescribing; order communication; product labeling, packaging, and nomenclature; compounding; dispensing; distribution; administration; education; monitoring; and use.”

These pharmaceutical errors can result in serious health complications including allergic reactions, organ damage caused by an overdose, infection, stroke, heart failure, and even death. Doctors and pharmacists must follow strict regulations in order to prevent mistakes. In Illinois, the Pharmacy Practice Act (225 ILCS 85) regulates the practice of pharmacy in Illinois.

Types of Pharmaceutical Errors

  • Adverse Drug Side Effects
  • Incorrectly Filling A Prescription
  • Incorrect Labeling
  • Incorrect Dosage
  • Drug Interactions
  • Incorrect instructions regarding usage

Drug Side Effects

Many prescription medications have serious side effects that should be considered before taking them. Some serious and common side effects include: allergic reactions, heart problems, liver and kidney failure, weight gain/loss, and psychological effects. The doctor prescribing your medication should consider the pros and cons of prescribing the medication as opposed to leaving the condition untreated or prescribing a different medication.

When considering whether to prescribe a drug with serious side effects, the doctor should consider your full medical history and information to determine whether you can handle the side effects. Also, when filling a prescription order, pharmacists have a duty to advise you about any side effects that might accompany the use of the prescription medication.

Incorrect Prescription

Medication errors can result when there is a miscommunication of drug orders. This can involve poor handwriting, confusion between drugs with similar names, misuse of zeroes and decimal points, confusion of metric and other dosing units, and inappropriate abbreviations. As many people know, doctor’s handwriting is often times little more than a scrawl or scribble.

Doctors must take reasonable care in correctly and accurately writing prescriptions. One way to reduce the chance of prescription errors is to use electronic prescriptions, removing the risk of errors associated with poor handwriting. However, mistakes can still occur when a doctor types in the wrong prescription order. Therefore, doctors should take extra care when prescribing medications to ensure that no transcribing errors have occurred.

Medication errors can also occur when doctors take incomplete patient information. For example, the doctor might not know about the patient’s allergies, any other medications the patient is taking, previous diagnoses, and lab results. Doctors perform best when fully informed about the patient’s history and information. Doctors should ensure that they have a patient’s complete and up to date information before prescribing medication, in order to cut down on medication errors.

 

Incorrect Labeling

Pharmacists must ensure that medications have correct labels before selling them to patients. Prescription medication labels should include the name of the drug it contains, the amount to be taken, the time of day to take the medication, and any warnings while taking the drug. When prescription medications are labeled incorrectly, you may end up taking the wrong drug, the wrong dose, the wrong time, or be unaware of warnings about what foods, beverages, or activities to avoid while taking the drug.

These mistakes can result in serious complications including liver or kidney damage or death or not receiving the full benefit of the drug’s intended purpose. Even when pharmacists include the correct information on the label, they should go over the recommended dosage, procedures, and warnings to ensure that you understand how to safely and correctly take the medication. This is especially important with older adults who may be unable to read the label.

Incorrect Dosage

Prescription medications have more serious dangers associated with them than over the counter (OTC) drugs. Therefore, it is important that pharmacists issue the correct drug (the one the doctor prescribed) at the correct dose. Errors in filling prescriptions can result from similar-looking pills, difficult to read physician handwriting, and rushed work at pharmacies. Pharmacists must exercise reasonable care when filling each and every prescription order to ensure that you receive the highest standard of care and avoid injury.

In Illinois, registered pharmacy technicians may, under the supervision of a pharmacist, assist in the dispensing process, offer counseling, and receive new verbal prescription orders (225 ILCS 85/9 – Registration as pharmacy technician). Depending on the pace of business at the pharmacy, these pharmacy technicians might not receive proper supervision to ensure the highest standard of care.

These mistakes can also cause serious medical complications, either because you take too much or too little of a drug or even taking the wrong drug. Many prescription medications treat serious illness and disease, and besides the risks associated with taking the wrong drug or the wrong dose, are the risks associated with not treating the illness or disease that prompted your doctor to give you a prescription in the first place.

Adverse Drug Interactions

Many people, especially older adults, take multiple prescription medications, which are commonly prescribed my multiple doctors. However, problems can occur because the doctors prescribing these medications might not know about the other drugs you are taking.

This can lead to serious complications stemming from drug interactions. Drug-drug interactions are not the only type of potentially dangerous drug interactions; there can also be drug interactions with foods, beverages, and dietary supplements.

There are three main types of drug interactions:

  • Drugs with food and beverages
  • Drugs with dietary supplements
  • Drugs with other drugs

Drug interactions can reduce the effectiveness of drugs, cause unexpected side effects, or increase the action of a particular drug. Drug interactions with food and beverages might result in delayed, decreased, or enhanced absorption of a medication. Dietary supplements can also cause a variety of drug interactions, and with fifty percent of American adults using dietary supplements (vitamins, minerals, amino acids, herbs or botanicals) on a regular basis, the risk of negative drug interactions is high.

For example, St. John’s Wort can reduce the concentration of medications in the blood; Vitamin E can increase anti-clotting activity and cause increased risk of bleeding when taken with blood-thinning medication; Ginseng can enhance the bleeding effects of aspirin and ibuprofen; and Ginkgo Biloba can decrease the effectiveness of anticonvulsant therapy. Drug-drug interactions can cause adverse drug reactions.

The rate of adverse drug reactions increases significantly when a patient is on four or more medications. This is especially worrisome because almost 40% of Americans receive prescriptions for four or more medications.

Because pharmacists fill prescriptions issued by multiple doctors, they are in the best position to catch potentially harmful drug interactions. However, some people use more than one pharmacy for their drug needs. Therefore, in order to avoid problems with drug interactions, you should use one pharmacy for all of your medications and keep a record of all prescription drugs, over the counter (OTC) drugs, and dietary supplements that you take.

Nursing home staff must take extra precautions when distributing new prescription medications to nursing home residents. Many nursing home residents are on multiple medications for a variety of physical and mental conditions that are best treated with prescription drugs. These residents might be under the supervision of multiple doctors, and it is the nursing home’s responsibility to ensure that the doctors are aware of all the resident’s medications and changes in condition in order to avoid serious medical complications.

Physician & Pharmacists Duty To Use Reasonable Care

Pharmacists and doctors have a duty to exercise reasonable care in prescribing and filling prescription drugs. When this duty is breached, serious injuries and even death can occur. Elderly adults are particularly susceptible to injuries stemming from pharmaceutical medication errors because many older adults take multiple medications. Furthermore, many older adults see multiple doctors for specialized care to treat specific injuries or illnesses.

The increased number of prescription drugs and multiple drug providers can increase the likelihood for a pharmaceutical error. Older adults are also less able to prevent pharmaceutical errors because they might be less able to read the labels and warnings, be less able to understand the medication labels, and might be unable to provide doctors with a complete list of medications or medical information. Many older adults, especially those in nursing homes, rely on other people to fulfill their prescription needs. Therefore, additional care and caution must be taken when prescribing medications to older adults, especially those who rely on nursing home staff for medications and activities of daily living.

If you or a member of your family has suffered injury because of a pharmaceutical error, you can bring a pharmaceutical malpractice or negligence action. In addition, if the worst occurs and the pharmaceutical malpractice results in the death of a loved one, you may also be entitled to bring a wrongful death action.

Speak to our experienced pharmaceutical error lawyers about your case for free today.  Nationwide service.  (800) 926-7565

Resources:

FDA: Avoiding Drug Interactions

National Coordinating Council for Medication Error Reporting and Prevention

Adverse Drug Event Reporting: The Roles of Consumers and Health-Care Professionals

Illinois General Assembly – 225 ILCS 85/9 Registration as pharmacy technician

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Picture-262After discovering multiple health and safety problems, Florida officials have suspended the admission of new residents to Emeritus at Crossing Pointe– a Florida Assisted Living Facility.

A September inspection of Emeritus revealed:

  • An 82-year-old patient who died after staff failed to provide her heart medication for four days

Picture-215I was glad to see criminal charges have now been filed against Pamela Ott, the Administrator at Kern Valley Healthcare District, after several employees of the facility allegedly used psychotropic medications to control the behavior of patients with Alzheimer’s and dementia.  Ott is now facing eight felony counts of elder abuse.

The instances of nursing home abuse allegedly occurred between August 2006 and January 2007 when the employees intentionally over-medicated residents with anti-psychotic drugs at Kern Valley Skilled Nursing Facility to keep them quiet and make them easier to handle.

As the administrator of the Kern Valley Healthcare District, Ott was responsible for supervising the operation of a small community hospital and skilled nursing facility in Lake Isabella, CA.

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