Medication Errors and Medical Malpractice: What You Need to Know

Most Americans will need pharmacists at some point in their lives. These professionals dispense medications that treat minor illnesses or manage chronic diseases. What happens when pharmacists give patients the wrong medications? What happens when a medication error physically harms or kills a patient?

Seven million people die annually from preventable medication errors, according to the National Institutes of Health. These mistakes cost the nation $21 billion in additional healthcare costs.

The Network for Excellence in Health Innovation (NEHI) completed a report called Preventing Medication Errors: A $21 Billion Opportunity. In their study, the organization reported:

  • Medication errors result in 3.8 million inpatient admissions and 3.3 million outpatient visits in the United States.
  • The Institute of Medicine estimates that 7,000 deaths in the U.S. occur annually due to preventable medication errors.
  • Preventable inpatient medication errors cost $16.4 billion annually.
  • Preventable outpatient medication errors cost $4.2 billion every year.

Medication errors can cause harm and physical injuries to a patient.

What Are Medication Errors?

The Institute of Medicine estimates that 7,000 people die annually in the U.S. due to preventable medication errors. The World Health Organization released a report on medication errors in 2016, defining a medication error as:

“Any preventable event that may cause or lead to inappropriate medication use or patient harm while medication is in the control of the health care professional, patient, or consumer.”

The National Reporting and Learning Systems (NRLS) conducted a six-year study on medication errors. The analysis reported were 525,186 incidents of medication errors from 2005 – 2010.

What Is Medical Malpractice?

Medical malpractice occurs when a hospital, doctor, or other health care professional injures a patient through negligence or an omission. The American Board of Professional Liability Lawyers says a malpractice claim must meet the following legal conditions:

  • There was a contractual doctor-patient relationship. A patient hires the physician and the professional agreed to care for the patient’s health.
  • There was a standard of care violation. The doctor must deliver a reasonable, professional level of care. The physician violates this requirement if he or she gave substandard care.
  • Negligence caused the injury. The patient should show an injury resulted from the healthcare professional’s negligent act or omission. Negligence means that the professional had a duty of care, he or she breached the duty, the breach caused harm to the patient, and that there were damages. “Causation” in this context means “but-for” causation–that the injury would not have occurred in the absence of negligence.
  • The injury caused significant damage. A patient must prove the physician’s actions caused specific injuries. If the patient’s damage is minute, the financial cost to litigate the claim may be worth more than the actual injuries.

Examples of medical malpractice include:

  • Surgical errors
  • Using an incorrect medication or dosage
  • Failure to diagnose the patient
  • Giving an unnecessary surgery
  • Providing a misdiagnosis
  • Operating on the wrong site
  • Providing substandard care
  • Premature discharge
  • Failing to analyze the patient’s history
  • Not ordering the proper tests
  • Failure to recognize symptoms

How Do Medication Errors Relate To Medical Malpractice?

Medication errors are a form of medical malpractice. Can a person sue a pharmacist for malpractice? Yes, if the medication error resulted in a serious injury. Unfortunately, the pharmacy technician is not the only one at fault. Rather, systemic issues in healthcare institutions cause these mistakes, according to NEHI:

“Preventable medication errors represent a significant source of wasteful health care spending. The causes of medication errors are complex and systemic, resulting from the fragmented nature of the care delivery system and the failure to effectively share and use health care data.”

A patient must meet four conditions to bring a medical malpractice case against a pharmacist:

  • The pharmacy has a duty to care for the patient. A professional must correctly fill the prescription as ordered by the doctor.
  • The pharmacy failed in its duty of care. A patient must show that the dispensed medicine was not the prescribed one. Medical experts can testify that the pharmacy made a mistake.
  • The plaintiff suffered harm because of this mistake. Additionally, they must show the medication error caused the injury.
  • The patient ended up with specific injuries due to the medication error. The error can result in long-term injury or death.

Causes of Medication Errors

The World Health Organization explains that:

“Medication errors occur when weak medication systems and/or human factors such as fatigue, poor environmental conditions, or staff shortages affect prescribing, transcribing, dispensing, administration, and monitoring practices, which can then result in severe harm, disability, and even death.”

According to the Food and Drug Administration, medication errors can occur anywhere in the distribution system. These areas include:

  • Prescribing medication
  • Repackaging drugs
  • Dispensing
  • Monitoring medicines

Common pharmaceutical errors result from a variety of factors. These include poor communication between staff members; ambiguous product names, directions, medical abbreviations, and writing; poor workplace training, procedures, or techniques; inadequate drug knowledge or experience; job stress; inefficient resources; patient misuse of medication due to unclear directions; and a lack of standardized protocols. Additionally, the organization cited similar drug packaging as a cause of medication errors.

Medications Involved in Drug-Related Errors

The Institute for Safe Medication Practices reports these as the top medication classes involved in routine errors:

  1. Narcotics/Opioids (7 percent)
  2. Antimicrobials (5.7 percent)
  3. Antipsychotics (4.6 percent)
  4. Anticoagulants (3.6 percent)
  5. Electrolytes (2.2. percent)
  6. Insulin (1.8 percent)
  7. Adrenergic Agonists (1.4 percent)
  8. Chemotherapy (1.3 percent)
  9. Neuromuscular Blockers (0.5 percent)

Five Common Medication Errors

There are five types of common medical errors related to pharmacy errors.

1. The Wrong Drug

According to Pharmacy Times, dispensing errors account for 21 percent of all medication mistakes. This situation occurs when a pharmacist gives the wrong drug to a patient. This medical error is America’s leading cause of pharmaceutical malpractice.

Pharmacies are busy places. Usually, professionals must fill dozens of prescriptions in an hour. They commit these errors for different reasons. Some pharmacists multitask, becoming distracted and giving patients the wrong drug. Others may accidentally switch the labels on two medications. Others dispense the wrong prescriptions, since many drugs have similar names and look identical. These pharmaceutical mistakes have tragic consequences.

The Widow’s Case: A real-life scenario occurred in Pennsylvania. A pharmacist dispensed the wrong medication to a 71-year-old widow. She received an antipsychotic medication, thiothixene (Navane), instead of her hypertension medication Norvasc. The woman sustained major emotional and physical damage. For three months, she experienced lethargy, tremors, and ambulatory dysfunction. The woman also suffered from mood swings and personality changes.

The widow continued to receive the wrong medication for three months. Health providers had many chances to intervene. None did. A doctor later diagnosed the widow with thiothixene-induced Parkinsonism. Physicians took the woman off the medication and her condition improved. The National Institutes of Health released a scientific study about her case.

2. The Wrong Prescription Dosage

According to the National Priorities Partnership and National Quality Forum, dosing errors account for 37 percent of all medication-related errors. Transcription mistakes account for 15 percent of all dispensing-related errors. This scenario occurs when pharmacists issue the right drug, but the wrong dosage. For instance, a pharmacy may receive a prescription for 10 mg pills but dispense 100 mg ones. Other transcription errors stem from poor penmanship, illegible handwriting, and carelessness. For example, a physician may misplace a decimal point.

The Gary Schmidt tragedy: These mistakes can yield catastrophic consequences. A recent example occurred at a Minnesota nursing home. A nurse gave oxycodone to Gary Schmidt, a North Ridge Health and Rehabilitation Center patient. He received a dosage 20 times higher than normal. Schmidt went into cardiac arrest within a few minutes of receiving the drug. He died before paramedics arrived.

The Minnesota Department of Health investigated the incident. They found the facility had no system to check patients for adverse reactions to medications. The health department also found the nurse at fault. The North Ridge Health and Rehabilitation Center paid a fine.

The ApothéCure Incident: A similar medication-error case occurred in 2007. Several patients died when ApothéCure Inc., dispensed 72 colchicine vials with incorrect dosages. This injectable medication prevents gout attacks caused by high blood levels of uric acid.

The FDA tested the Texas drug company’s vials and discovered some contained 640 percent higher than normal dosage levels. Some contained less medicine than described on the label. The U.S. District Court for the Northern District of Texas charged them with criminal violations of the Food, Drug, and Cosmetic Act (FDCA).

3. The Wrong Label or Directions

A healthcare professional can enter incorrect medication instructions into a computer. This results in a patient receiving life-threatening dosages. Additionally, the pharmacy can switch a drug’s warning label by mistake. Some pharmacists do not check the instructions to see if they are correct. These errors can sicken or kill a patient.

Mislabeling can result in medical professionals dispensing the wrong medication. Additionally, it can produce overdose or underdose mistakes, toxicity, and death.

The Ritedose recall: This issue affected Ritedose Corp. patients in 2011. The company mislabeled its 0.083 percent Albuterol Sulfate Inhalation Solution 3 mL unit-dose vials. This nebulizer drug helps manage acute asthma attacks. The foil packaging displayed the correct dosage of “2.5 mg/3 mL”. Their vials displayed the incorrect concentration of “0.5mg/3 mL” which could pose a health hazard. Ritedose Corp. recalled the medication.

Loretta Macpherson’s death: In another case, an Oregon hospital gave the wrong drug to a 65-year-old patient. Loretta Macpherson died after receiving a paralyzing agent instead of her anti-seizure medication. The mistake caused Macpherson to suffer cardiac arrest and brain damage. She later died. After the patient’s death, the hospital conducted a full review of its medication dispensing procedures.

4. Failure to Review Medications

Healthcare professionals must review their patients’ medications. Those who do not may in some instances harm or kill these patients. Nurses and pharmacists catch up to 70 percent of all medication errors.

What happens when professionals fail to catch these mistakes? Their patients can take medications that cause dangerous interactions with other prescriptions. Other patients might take drugs to which they are allergic.

John Beemer’s death: Drug allergies account for 11 percent of all preventable medication errors. A real-life example occurred in Kansas City Veterans Affairs hospital in 2017. John Beemer, an 84-year-old patient, died after nurses gave him cephalosporin. He was allergic to the drug. Beemer entered the hospital on April 6, suffering from shortness of breath. Doctors diagnosed him with pneumonia. The staff gave him Ceftriaxone, an antibiotic, then discharged him.

Beemer’s condition worsened. He developed Steven-Johnson Syndrome and Toxic Epidermal Necrolysis. These are skin conditions associated with cephalosporin allergies. The man developed pustular lesions on his face. He then died. The hospital’s own records indicated he was allergic to the medication.

5. Inadequate Consultation

All pharmacists should speak to patients about the prescriptions they are taking. Counseling patients may enable pharmacists to learn about these patients’ medications. It also alerts the pharmacists to possible interactions with other medications and side effects. This small step may be able to prevent many mistakes. Unfortunately, many pharmacists do not counsel their patients.

The Network for Excellence in Health Innovations found that patients who received follow-up calls were 8 percent less likely to suffer serious medication errors.

Seek Help from Experienced Attorneys

Medication errors sometimes cause physical injuries, and even death. The Dolman Law Group may be able to help. Are you the victim of pharmaceutical or medication error? Contact us for a free consultation or call us at our New Port Richey office at (727) 853-6275.

Dolman Law – New Port Richey
5435 Main Street
New Port Richey, FL