One-third of adults in the United States take 5 or more medications daily and there are over 10,000 prescription medications from which clinicians can choose, all of which have their own dosages, instructions, and routes of administration.
Medication errors, sometimes called adverse drug events, are one of the most common preventable medical mistakes in all medical care settings. They occur in both the outpatient and inpatient setting as well as during the transition from inpatient to outpatient. Medication errors are estimated to account for 700,000 emergency departments visits and 100,000 hospitalizations each year. In addition, a staggering 5% of hospitalized patients experience a medication error. Medication errors are likewise common in nursing homes and other long-term care facilities.
While most hospitals, long-term care facilities, pharmacies and physician offices have the required policies in place to avoid medication errors, these errors continue to happen because of system flaws, failure to follow proper safety procedures, human error, and poor safety culture.
There are four general types of medication error: Ordering, Transcribing, Dispensing, and Administration.
Ordering errors occur when the clinician fails to select the appropriate medication or proper dose, frequency, route of administration or duration. In patients with drug allergies or sensitivities, the wrong medication can have severe consequences, including death. Likewise, the ordering physician must be aware of potential drug-drug interactions and contraindications in particular patients.
Transcribing errors can take several forms. In a paper-based prescription system, an intermediary (pharmacist, pharmacy technician, hospital clerk or nurse) must read and interpret the prescription correctly. Poor handwriting, misinterpretation or a misplaced decimal point can easily result in the administration of the wrong medication or an over or under dosage. In a computer-based system, similar errors can occur if the prescription is not accurately entered into the system or is misinterpreted by the person filling the prescription.
Dispensing errors involve the delivery of the wrong medication or dosage. Dispensing errors occur when the prescription is proper but the pharmacist fails to deliver the correct medication in the correct quantity, dosage and/or form. Dispensing errors can also occur as a result of the pharmacist failing to check for drug-drug interactions and allergies, as is required.
Administration errors occur when the correct medication is not supplied to the correct patient at the correct time by the correct route of administration. This includes not only the delivery of pills to a patient but also the hanging and administration of IV medications. In a hospital or long-term care settings, medication administration is usually a nursing function, but can also occur in surgery and/or anesthesia setting.
Medication errors cause injury or death in many ways. The wrong medication delivered in the wrong way can have devastating consequences. For example, in the DiTore case, a surgeon injected a young woman undergoing routine sinus surgery with the wrong drug because the nurse had mixed up the drugs and the doctor and patient care team had failed to follow safety protocols involving communication and drug labeling designed to prevent such mix-ups. The patient went into cardiac arrest and suffered permanent brain damage. Andy Youman represented the family in the resulting Montgomery County case, which ended in a $5.1 million jury verdict.
Medication errors can also result in overdosages, under dosages, allergic reactions, or a number of other avoidable, unintended consequences.
It is important to find an attorney who knows and understands how medication ordering, transcribing, dispensing and administration work in various medical settings and the right questions to ask in medication error cases. The attorneys at Youman & Caputo have significant experience in these cases and the results to show for it. If you or someone you know has suffered a medication error in Pennsylvania or New Jersey, contact us, we are here to help.