While medication overdoses receive the most attention, a lesser-known issue is underdosing, also known as underprescribing. This refers to a physician prescribing or a pharmacist administering fewer medications or a lower dosage than a patient needs. Underdosing can result in a patient failing to receive the treatment that he or she needs to manage symptoms or recover from a medical condition.
Failure to Optimize the Treatment Regimen
Underdosing occurs when a patient receives less of a drug or medication than the standard of care requires for a given diagnosis or treatment plan. This may occur due to a prescription error or a failure by the pharmacy to correctly fill the prescription. If a doctor prescribes a dosage that is less than the drug manufacturer’s instructions, the patient may not experience optimal results. The patient may relapse, for example, or find that his or her condition remains the same or worsens despite taking the drug.
For example, if a patient with diabetes does not receive enough insulin due to underdosing, he or she may end up experiencing hyperglycemia. Underdosing can also refer to a failure to adjust a patient’s dosage as necessary as a condition changes. For some patients, the medication dosage may have been appropriate initially, but they require increased levels of a drug as a condition worsens or changes. Failing to adjust the dosage accordingly can lead to an inadequately treated condition and a potential trip to the emergency room.
Omission of Potentially Useful Drugs
Underdosing or underprescribing can also refer to a patient not being prescribed the correct course of treatment at all. In other words, a doctor fails to prescribe an appropriate or necessary medication. Omitting a potentially useful drug from a medication regimen may exacerbate the patient’s condition. If a doctor fails to prescribe a medication that a reasonable and prudent physician would have under the same circumstances, and this results in harm to the patient, it could constitute medical malpractice.
Polypharmacy refers to utilizing multiple drugs to treat a single ailment or condition most effectively. Underdosing could lead to improper or ineffective polypharmacy for a patient. Studies have shown that patients with polypharmacy are at a greater risk of being undertreated for their conditions. For example, if at least a certain dosage of multiple types of medications is necessary to achieve the proper reaction and drug interaction, underdosing could throw the treatment regimen off course.
Can You File a Medical Malpractice Claim for an Underdose?
Underdosing can contribute to patient morbidity and mortality by intervening with proper care. A patient may not receive adequate treatment for his or her medical condition due to underprescribing. This can result in an ineffective treatment regimen, a non-optimized treatment plan or polypharmacy issues. The specific consequences of underdosing will depend on the patient’s condition, diagnosis, treatment plan and prognosis.
In some cases, there is justification for underdosing or underprescribing that is supported by medical evidence (“rational underdosing”). In such a case, a low dosage may not constitute medical malpractice. If medical expert testimony proves that another health care provider would have prescribed a higher dosage in the same or similar circumstances, however, the doctor could be held liable for underprescribing with a medical malpractice claim.
If you believe you are a victim of an underdose or underprescription in Philadelphia, contact a Philadelphia medication error attorney at Youman & Caputo for a free case evaluation. You may be able to recover financial compensation.