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In April 2018, leading pharmacy trade magazine Drug Topics published a feature titled “Your 10 Worst Pharmacy Mistakes.” One pharmacists wrote about directing a parent to give a child a teaspoon of an opioid-infused cough suppressant instead of 1 milliliter. The mistake resulted in the child receiving a dose five times larger than prescribed, which could have killed the young patient.

Another pharmacist described how she believes she contributed to causing a co-worker’s death by dispensing powerful antibiotics to the individual right after the other woman went through a course of chemotherapy. Overusing antibiotics in cancer patients leaves them vulnerable to developing bacterial infections that will not respond to any medications.

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Each day, mistakes by pharmacists and pharmacy technicians put patients’ lives at risk. The dangers increase in hospitals and nursing homes, where nurses and medical assistants administer multiple medications to individuals who often cannot describe how a new dosage or combination of drugs affects them. And, of course, patients and parents in their own homes lack the expertise to immediately recognize if the have been instructed to take an overdose, prescribed a medication that interacts badly with one they already take, or dispensed a medication intended for a different person.

Harm results from patients receiving the wrong drugs, the wrong doses, and the wrong mix of medications. Waiting too long between doses can causes life-threatening problems; so can administering doses too close together. And when any type of error is made, the outcomes can be severe.

The Institute for Safe Medication Practices reported that the “types of injuries reported in 2016 affected every body system and include severe damage to the kidneys and liver, fatal cardiac events, cancer, potentially life-threating allergic reactions, as well neuropsychiatric effects such as depression, suicidal thoughts, and aggressive and violent acts.” This, according to the ISMP, means that “the therapeutic use of drugs constitutes a major public health risk of the same order of magnitude as illicit use of drugs or violent crime.”

Pharmacists have professional and legal duties to limit the potential harm to patients. Meeting these duties requires them to double-check all filled prescription orders before dispensing them, educating other health care providers on how to recognize and safely administer medications, and counseling patients and parents on how to use drugs safely. The duty of pharmacists also extends to closely supervising and checking on the work of the pharmacy technicians who actually do much of the work related to filling prescription orders.

Patients do have some responsibilities for protecting themselves, as well. For instance, they should always read pill bottle labels and look at refills. If they spot anything different from what they have seen previously, they should bring the discrepancies to the attention of the pharmacist.

But, as noted, many patients cannot advocate for themselves. They rely entirely on the skills and professionalism of pharmacy staff, as well as their medical care providers. When a wrong drug or wrong dose harms them, they have rights to report and file claims for medical malpractice.

The first step must be seeking emergency medical care. Make sure the ER team knows all the medications the patient is currently taking. Include a list of health supplements, and be prepared to discuss what the patient ate and drank throughout the day on which serious symptoms or side effects occurred.

Make sure a knowledgeable pharmacist or physicians who was not previously treating the patient reviews all that information. If the review turns up evidence of a medication error, it is time to consult with a Virginia medical malpractice attorney who has experience helping victims of pharmacy errors. A case may well exist if the negligence resulted in death, hospitalization or the need for ongoing medical care.

Holding negligent pharmacy professionals accountable protects other patients from similar mistakes and secures money to pay the bills that the pharmacist’s error imposed.

EJL

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