The National Patient Safety Foundation (NPSF) states that each year in the United States, pharmacies make over thirty million medication errors. Some errors are insignificant, while others have grave consequences, resulting in serious illness and death.
According to the NPSF, a medication error is defined as, “any preventable event which may cause or lead to inappropriate medication packaging, dispensing, or distributing which results in patient harm.”
Common pharmacy errors include:
- When the pharmacy gives you another patient’s prescription
- Medicine is labeled with your name, but has the wrong medication inside
- The medication label fails to indicate contraindications, side effects, or allergic reactions
- The pharmacist fails to clearly answer your questions about the medication
- The pharmacist dispenses your medication despite legitimate questions about its purpose, dosage, or contraindications with other medications you’re currently taking
- The pharmacist or pharmacy tech confuses one medication with another, because the medication names look or sound alike, e.g. Buprenorphin and Bupropion
Patients don’t have close relationships with their pharmacists like in the past. Yesterday’s patients have become today’s customers. With the exception of a few small businesses, today’s pharmacies are owned and operated by multi-billion dollar corporations. In one week’s time, there can be three or four different pharmacists behind the same counter in the same pharmacy.
Today’s pharmacies are more like fast food restaurants. You can speed through the car lane on your lunch hour. Unless you ask to speak with the pharmacist, it will be up to you to confirm the correct medication at the correct dosage. If it’s not in the pamphlet, you’ll need to go online and hope you can find information about the medication.
Why Medication Errors Happen
Overworked pharmacists and staff
Many pharmacists work 12 hour shifts, and are expected to fill between 300 and 450 prescriptions each day. In some of the busiest pharmacies, prescriptions are filled by “pharmacy techs,” some of whom aren’t paid much above minimum wage.
With the pressure to fill prescriptions as quickly as possible, mistakes by pharmacists will happen. Also, more and more medications are being made in generic form, so their shape, color, and size are easily confused by busy pharmacists and pharmacy techs.
Inadequate pharmacist and staff training
Many of today’s pharmacists receive less mentoring from experienced pharmacists when filling positions at newly built pharmacies. The store clerks behind the counter are paid little more than minimum wage, yet are charged with the all-important task of quickly identifying a customer’s medication, delivering it to the customer, and then ringing up the sale.
Pharmacist negligence in supervising pharmacy technicians
The pharmacist is supposed to advise patients about medications, including drug allergies and other contraindications, but it’s usually the pharmacist technician who measures the medications, labels med bottles, and dispenses them to customers.
In the past, pharmacy techs had to attend classes to receive their certification. But today, a growing number receive their training and certification online, resulting in lower quality tech training. Some pharmacists don’t have the time to provide their techs with the supervision they need. As a result, technician errors increase.
Poor communication between pharmacy staff and doctors
Communication between doctors and pharmacists is crucial, especially when there are questions about the type and dosage of medications. Today, doctors have little time to stop and have a conversation with a pharmacist. Pharmacists must fill as many prescriptions as they can, as quickly as they can, so they have little time to wait to speak with a doctor.
Because of the demands on doctors’ and pharmacists’ time, patients’ medication information is often communicated between doctors’ receptionists and pharmacy clerks. Along the way, mistakes are bound to happen, and the results can be disastrous.
Depending on automated systems to prevent all errors
Automatic computer generated refills, express prescriptions, and other modern day automation, results in thousands of medication errors each year. In an effort to make higher profits, pharmacies rely on sophisticated computer programs to determine times of refill, direct billing for medications, and to manage patients’ confidential information.
Older customers often have difficulty using the automated system, resulting in medications not being filled on time. This can cause patients to go several days without their medications.
Know Your Medications
To ensure you aren’t injured by a medication error, discuss with your doctor the type of medication she is prescribing. Ask about its purposes, side effects, allergic reactions, and possible contraindications (the effects of combining one medication with another). Because the size, shape and color of medications seem to change daily, it’s a good idea to ask your doctor to describe what your medication looks like.
Every doctor should have a Physician’s Desk Reference (PDR), which identifies every medication in existence, including their shape, color, size, and any inscriptions on them, along with color photographs of the meds. If you’re not clear about the description given to you by the doctor, ask her to show you its picture in the PDR.
Your Rights as a Victim of a Medication Mistake
If you’ve become the victim of a medication mistake, seek medical help immediately. Your health and well-being are most important. Then go to the ISMP website (Institute for Safe Medication Practices) and click on the “report errors” tab. ISMP is a non-profit organization dedicated to preventing medication mistakes.
The ISMP collects and analyzes reports of medication dispensing errors and the injuries they cause, which are then reported to the manufacturers and dispensing pharmacies. The ISMP also works with government agencies to help identify medication dispensing errors, their causes, and ways to eliminate future errors.
You can also write an email to the ISMP describing the pharmacy mistake. In your email, include information such as your adverse reaction to the medication, whether or not it was a pharmacy error, both the generic and brand names of the medicine, the dosage prescribed and actually dispensed, the way you discovered the mistake, and any recommendations you may have for preventing future mistakes.
If you’ve been injured by a medication error, you also have the right to a civil action against the pharmacy, and possibly the manufacturer. Even a minor injury like nausea, vomiting, dizziness, or other adverse reaction may be actionable. To be entitled to compensation from the pharmacy’s insurance company, you will need to be able to prove several legal elements:
- The pharmacy had a duty of care not to injure you (that’s normally assumed).
- The pharmacy breached their duty of care to you (the breach was the medication mistake – also referred to as “negligence”).
- The pharmacy’s negligence was the direct and immediate cause, to the exclusion of other causes, of your injury.
- As a result of the pharmacy’s negligence, you were injured (nausea, vomiting, hospitalization, stomach pumping, etc.).
- Your injury resulted in compensable damages, including hospital bills, out-of-pocket expenses, lost wages (if you couldn’t work because of the injury), and your pain and suffering.
Hold on to the medication bottle, the package it came in, and your receipt for payment. Try and get the name of the pharmacist and pharmacy tech on duty when your medication was dispensed. If your injuries were minor, such as 12 to 24 hours of pain and discomfort, you can probably handle your own claim.
To do so, locate the corporate headquarters for the pharmacy and send them a certified letter describing the mistake and how it injured you. Enclose copies of the medication label, your receipt, and a description of the reaction you had to the wrong medication. Include copies of your medical bills, emergency room medical records, and receipts for out-of-pocket expenses.
If you missed work, provide a letter from your employer, on company letterhead, describing the days and time you missed work, and the amount of wages you lost as a result. Tell them you expect to be compensated for the losses the pharmacy caused.
If you’re not satisfied with their response, you can file your case in small claims court, which will likely prompt a settlement. To defend themselves, the pharmacy corporation will have to hire an attorney. Often, it’s more economically practical for them to pay you a small amount than pay for an attorney.
When to Hire an Attorney
If your injury is more serious than 12 – 24 hours of nausea, vomiting, etc., and you had to be admitted to the hospital for treatment, you will need the advice and counsel of an experienced personal injury attorney.
An attorney will have to file a lawsuit, take depositions, issue subpoenas, and navigate court hearings. These are not matters you can handle on your own. Fortunately, most personal injury attorneys don’t charge a fee for an initial office consultation. Bring any evidence (medication receipts, hospital records, etc.) supporting your claim to the meeting. If the attorneys believe it’s worthwhile, they will accept your case on a contingency basis.
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Visitor Questions on Medication Errors
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