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Prescription 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. (888) 424-5757
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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