Medication errors come in many packages. Drugs may have similar names and the order or prescription may be written wrong, written illegibly, or incorrectly transcribed. Drugs can sometimes be mislabeled. Doctors can wrongly prescribe a drug, or prescribe it at the wrong dose. Doctors and hospital pharmacists may fail to check drug interactions, resulting in serious side effects or even death. Doctors, nurses, or pharmacists may fail to note patient drug allergies. When a dose is calculated by a doctor or nurse to be given IV, the drug dose may be off by a factor of ten or more, simply by misplacing a decimal point.
1.3 million people have injuries that result from medication errors annually in the United States. The most common error is improper dosing of a medication, and in 1998, the FDA found that dosing errors caused 41% of fatalities resulting from medication errors. This study, published by the Institute of Medicine, titled To Err Is Human: Building a Safer Health System, found that medication errors accounted for more than 7,000 annual deaths at that time.
A study recently published in Pediatrics found that one American child was given the wrong medication every eight minutes, although many of these errors were caregiver errors. Every patient who receives a prescription for a medication is potentially at harm, despite the many benefits of effective medication management. Harm can result from giving the wrong medication at the wrong time or in the wrong dose. The dispensing system can malfunction in the hospital setting. Nurses who administer medications can be inadequately trained to do so safely. Doctors may ignore or overlook compromised kidney or liver function, failing to reduce doses or discontinue harmful drugs.
A definition of 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 healthcare 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.”1
Medications that are associated more commonly with death or severe adverse drug events are those medications that involve the central nervous system, the cardiovascular system, or cancer chemotherapy drugs. An adverse drug event is different from an adverse drug reaction. An adverse drug event is any injury that results from medication use. An adverse drug reaction is any response to a drug that occurs at a dose normally used for therapy that results in a noxious effect that is not the result of medication error.
The black box warning system that was established by the FDA in 1995 alerts doctors to the increased risks that are associated with some drugs. Medications with a black box warning often require specific laboratory monitoring. In nearly half the cases in one study, patients taking a medication with a black box warning were not monitored appropriately.
Other drugs with a black box warning should not be prescribed to certain high-risk groups. These drugs include Celebrex, warfarin, Avandia, Ritalin, and antidepressants. A list of drugs with a black box warning or post-market safety concerns can be found on the FDA Drug Safety website.
In my own family, my father was discharged from the hospital with a prescription for a medication that would have caused a fatal drug interaction with another medication he had been taking for a long time. This error was caught by the pharmacist at the outpatient chain. Another family member was given the incorrect instructions for Coumadin, or warfarin, and ended up taking 10x the dose, putting him at high risk for an intracranial hemorrhage. I caught that one quite accidentally when I happened to be on the phone with him. Even then, it took a good deal of convincing, as he stated, “This is the way my doctor wrote the prescription.”
Anyone who begins a new prescription should understand the drug and its effects, and any interactions with other medications they are taking. If your doctor has wrongly prescribed a medication or if you were a hospital patient who received the wrong dose or wrong medication with serious consequences, you should consult a Chicago malpractice attorney at Passen Law Group for a review of your records. If you were harmed, you may be eligible for compensation for your injury. Call us at 312-527-4500.