While prescription drugs may be an invaluable tools in the practice of medicine-- and can be used to treat numerous illnesses and diseases-- prescription errors can cause serious injury and death. About 1.5 million preventable adverse drug events occur every year in the U.S.
Pharmaceutical malpractice may occur in the following circumstances: 1) when a doctor prescribes the wrong medication or incorrect dose or 2) when a pharmacist fills the wrong medication or dosage. The National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) defines a medication error as:
A 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 health care 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.
Pharmaceutical errors can result in serious health complications including:
- Allergic reactions
- Organ damage caused by an overdose
- Infection
- Stroke
- Heart failure
- Death.
Knowing the serious nature of even the most modest pharmaceutical errors, doctors and pharmacists must follow strict regulations in order to prevent mistakes. In Illinois, the Pharmacy Practice Act (225 ILCS 85) regulates the practice of pharmacy in Illinois-- and importantly sets for practice guidelines to protect the public.
Though there are many different types of pharmaceutical errors, common problems include:
- Incorrect labelling
- Adverse drug side effects
- Incorrectly filling a prescription
- Filling medication with wrong medicine
- Failing to screen for incorrect drug reactions
- Improper instructions regarding usage
Some prescription medications have serious side effects that should be considered before taking them-- particularly in situations involving children. The doctor prescribing your medication should consider the pros and cons of prescribing the medication as opposed to leaving the condition untreated or prescribing a different medication. Further, the physician should take all factors into consideration including the child's height, age, and body weight.
When prescribing a drug with serious side effects, the doctor should consider the child's full medical history and information to determine whether the child can handle the side effects. Also, when filling a prescription order, pharmacists have a duty to advise you about any side effects that might accompany the use of the prescription medication as the side-effects may vary drastically by age.
Incorrect Prescription
Pharmacy errors / medication errors can result when there is a miscommunication of drug orders during the time the medication is prescribed and when it is ingested by the individual. While the reasons why the incorrect medication was given, can vary drastically, common problems may be traced to: poor handwriting, pharmacist confusion between drugs with similar names, misuse of zeroes and decimal points, confusion of metric and other dosing units, wrong dosage for the age of the patient and inappropriate abbreviations.
In order to prevent medication errors / pharmaceutical errors, doctors (and their staff) must take reasonable care in correctly and accurately writing prescriptions. One way to reduce the chance of prescription errors is to use electronic prescriptions, removing the risk of errors associated with poor handwriting. However, mistakes can still occur when a doctor types in the wrong prescription order. Therefore, doctors should take extra care when prescribing medications to ensure that no transcribing errors have occurred.
Medication errors can also occur when doctors take incomplete patient information. For example, the doctor might not know about the patient’s allergies, any other medications the patient is taking, previous diagnoses, and lab results. Doctors perform best when fully informed about the patient’s history and information. Doctors should ensure that they have a patient’s complete and up to date information before prescribing medication, in order to cut down on medication errors.
Incorrect Labeling Of Drug
Pharmacists must ensure that medications have correct labels before selling them to patients. Prescription medication labels should include:
- Name of the drug
- Dosage
- Time of day to take the medication
- Warnings while taking the drug.
Catastophic problems may arise when prescription medications are labeled incorrectly, you may end up taking the wrong drug, the wrong dose, the wrong time, or be unaware of warnings about what foods, beverages, or activities to avoid while taking the drug.
Particularly with children, even minor variances when taking medication may result in serious complications including liver or kidney damage or death or not receiving the full benefit of the drug’s intended purpose.
Even when pharmacists include the correct information on the label, they should go over the recommended dosage, procedures, and warnings to ensure that you understand how to safely and correctly take the medication. This is especially important with younger children who may process the drug substantially diffferent than an adult.
Incorrect Dosage of Phamaceutical Drugs
Prescription medications usually have more serious dangers associated with them than over the counter (OTC) drugs. Therefore, it is important that pharmacists issue the correct drug (the one the doctor prescribed) at the correct dose.
Errors in filling prescriptions can result from similar-looking pills, difficult to read physician handwriting, and rushed work at pharmacies. Pharmacists must exercise reasonable care when filling each and every prescription order to ensure that you receive the highest standard of care and avoid patient injury and death due to incorrect dosages of the medication
In Illinois, registered pharmacy technicians may, under the supervision of a pharmacist, assist in the dispensing process, offer counseling, and receive new verbal prescription orders (225 ILCS 85/9 – Registration as pharmacy technician). Depending on the pace of business at the pharmacy, these pharmacy technicians might not receive proper supervision to ensure the highest standard of care-- particularly when filling medication for children or infants.
Even slight errors related to improper dosage can also cause serious medical complications in children, either because you take too much or too little of a drug or even taking the wrong drug.
Adverse Drug Interactions
Sick children may be required to take multiple prescription medications, which are commonly prescribed my multiple doctors. However, problems can occur because the doctors prescribing these medications might not know about the other drugs your child is taking.
This can lead to serious complications stemming from drug interactions. Drug-drug interactions are not the only type of potentially dangerous drug interactions; there can also be drug interactions with foods, beverages, individual allergies and dietary supplements.
Three main types of adverse drug interactions include:
- Drugs with food and beverages
- Drugs with dietary supplements
- Drugs with other drugs
Drug interactions can reduce the effectiveness of drugs, cause unexpected side effects, or increase the action of a particular drug. Drug interactions with food and beverages might result in delayed, decreased, or enhanced absorption of a medication. Dietary supplements can also cause a variety of drug interactions.
The rate of adverse drug reactions increases significantly when a patient is on four or more medications. This is especially worrisome because almost 40% of Americans receive prescriptions for four or more medications.
Pharmacists filling prescriptions issued by multiple doctors are in the best position to detect and prevent adverse drug reactions. In order to avoid problems with drug interactions with your children it is usually suggested to use one pharmacy for all of your medications and keep a record of all prescription drugs, over the counter (OTC) drugs, and dietary supplements that you take.
Physician & Pharmacists Duty To Use Reasonable Care To Protect Children
Pharmacists and doctors have a duty to exercise reasonable care in prescribing and filling prescription drugs. When this duty is breached, serious injuries and even death can occur.
Children are particularly susceptible to injuries stemming from pharmaceutical medication errors because many older adults take multiple medications. Furthermore, many already ill children may see multiple doctors for specialized care to treat specific injuries or illnesses.
The increased number of prescription drugs and multiple drug providers can increase the likelihood for a pharmaceutical error. Children are also less able to prevent pharmaceutical errors because they may be unable to read or comprehend the labels and warnings on warning labels and they take medication at school or camp--- away from parental supervision.
If your child has suffered injury because of a pharmaceutical error, you may be entitled to bring a pharmaceutical malpractice medical malpractice claim against the pharmacist, pharmacy or doctor involved. Lawyers experienced in handling pharmacy error matters can help determine who the proper parties may be.
Situations involving severe personal injury, medical malpractice and other types of harm inflicted on children can pose a challenge both for the individual child and his or her family.