As a medical malpractice lawyer, I am frequently asked to investigate claims arising out of prescription errors. Prescription errors can arise in a number of ways, including overdose, mis-filled prescriptions, dangerous drug interactions, failure to monitor patients for complications related to medications, failure to timely intervene when complications from medications arise, and failure to protect patients from drug allergies. Personal injuries and wrongful death arising out of medication errors often require an intensive investigation in order to determine who was responsible for the harm done.
In a hospital setting, a physician or nurse practitioner will write an order for prescription medications. Registered nurses (RNs) will obtain the medications from the hospital’s pharmacy and administer the medications during their shift at the times designated by the physician in the physician’s order. In this setting, errors can be made by any one of these individuals or from a combination of medical mistakes. Hospitals’ electronic medical records or medication ordering systems, such as Pyxis, can be programmed to provide alerts when there are dangerous drug interactions or the wrong dose of a medication is entered. Some patients have certain risk factors that make medications dangerous for that patient, including impaired kidney function, poor liver function and sleep apnea. There are many other conditions that can affect the safety of a particular medication for a particular patient. So, the hospital’s systems must be looked at, too.
In an outpatient setting, one person who is responsible in a hospital setting for safe medication practices is removed: the nurse. In this setting, greater reliance is placed upon the patient to make sure that medication provided by a pharmacist is the correct pill at the correct dose. However, many patients do not have the capability to safely monitor their own medications, particularly those individuals who are at greatest risk of harm from a medication error, such as the elderly or children. In these cases, the responsibility for safe prescription practices falls squarely on the physician and pharmacist.
To investigate a medication error case, a medical malpractice lawyer will want to obtain all of the relevant medical and pharmacy records including physician’s orders, nurses notes and the medication administration record (MAR). It is also important to review past medical records to determine the patient’s relevant medical history, including a list of active prescriptions, medication allergies and medical conditions that might make certain medications more or less potent.
When a medication error results in wrongful death, it is important to obtain an autopsy in order to narrow down the cause of death. An autopsy will typically include toxicology results when a medication error is suspected. Toxicology experts can play a vital role in lawsuits arising out of a prescription error. Finally, any investigation into injuries caused by dangerous drugs must include an investigation as to whether the medication is unnecessarily dangerous and subject to a product recall or ongoing class action litigation. Pharmaceutical companies are notorious for fudging study results and otherwise downplaying dangers associated with profitable medications. As a result, many dangerous drugs are on the market that do not include proper warnings or limitations on usage. Any medical negligence lawyer in Cleveland, OH investigating personal injury or wrongful death caused by a dangerous drug will review this aspect of the case.
Thanks to Mishkind & Kulwicki for their insight into medical malpractice and prescription errors.