Medication Error Attorneys

When Prescription Errors Constitute Negligence

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Whether in the home, doctor’s office, or hospital, medications are on the front line for treating illness and disease. With the vast use of medications for countless medical conditions, errors involving the use of medications can have tragic consequences. 

Adverse events involving medications have been reported as the number one cause of harm to patients in hospitals.  Among the injuries and deaths, approximately 25% are caused by preventable medication errors. 

Things Have Changed

In the past, errors like giving the wrong dose of a drug were rooted in illegible or misread handwritten orders. Over the last decade or more, hospitals and physician offices have shifted to electronic systems for ordering or prescribing medications. Orders are prepared and prescriptions filled electronically. Today, most hospitals use barcode medication administration systems that electronically crosscheck medications with the patient and their medical record. This technology can drastically reduce errors like giving medication to the wrong patient or in the wrong dose.

Common Medication Errors

Physicians and nurses are often distracted by constant demands and multiple responsibilities.  Today’s health care providers are still prone to make mistakes when ordering, prescribing or administering medications.  The following is a list of general and common types of drug related errors which can harm patients:

  • Ordering the wrong drug
  • Ordering an excessive dose of a drug
  • Ordering multiple medications with the potential for harmful interaction
  • Ordering or prescribing medications too close together in time
  • Failing to monitor a patient’s reaction to opioids, especially in those who are opioid naïve
  • Failing to recognize drug allergies or contraindications, such as liver or kidney impairment

Medication Errors Associated with High Risk of Injury or Death

Some medication errors cause more harm than others.  Just like other forms of medical errors, a preventable medication error must result in serious and permanent injury or death to justify the costs and challenges of filing a medical malpractice lawsuit.  Errors involving several commonly prescribed medications are more likely to harm patients given the medical conditions these medications are designed to treat or prevent, the potential for dangerous side effects, or both of these threats combined.

Anticoagulants

One common and serious medication error involves improper management of anticoagulation medications.  Hundreds of thousands of Americans depend on anticoagulants like Warfarin, also known as Coumadin. Warfarin and other forms of anticoagulant medications are often the first line of defense for patients with risk factors for developing disabling or fatal conditions such as acute ischemic stroke and pulmonary embolism.  Many patients on anticoagulants require regular monitoring of their blood to determine whether the anticoagulant is providing the desired therapeutic effect and the right time. 

Patients on Warfarin undergo frequent blood tests known as PT and INR. These lab tests measure the time it takes for a patient’s blood to clot.  Often, the results of these blood tests are overlooked and health care providers neglect to adjust their patient’s anticoagulant medication until it’s too late. When a patient’s PT or INR falls below the target range, the patient may be at higher risk of suffering a fatal or life-changing stroke. Patients whose PT or INR exceed the target range may also face the risk of severe bleeding or death.

Another anticoagulant, heparin, is frequently used to treat patients hospitalized with acute, life-threatening conditions that include ST elevated myocardial infarction, pulmonary embolism, and stroke or transient ischemic attack. It is critical that hospitals follow specific dosing guidelines, or nomograms, to tailor heparin administration for each patient based on factors such as the patient’s weight and the results of blood tests that measure clotting time within the patient’s blood.  Imprecision or oversight in the management of heparin therapy can mean the difference between life and death for a patient. 

Opioids

Opioid analgesics are essential medications for patients with acute or chronic pain. Opioids such as fentanyl, hydromorphone and morphine are ubiquitous for both short and long-term treatment of pain.  Yet the same physiologic response which can take the lives of those who struggle with addiction can take the life of a hospitalized patient. Hospitals, doctors, and long-term care facilities must recognize patients at risk for cardiorespiratory depression, whether from the use of opioids alone or in combination with other drugs.  Health care providers must employ strategies to assure vulnerable patients realize pain control and stay safe at the same time.

Insulin

Like opioids, insulin is considered “high alert” medication due to its association with significant yet preventable harm to patients.  Millions of Americans inject insulin for treatment of diabetes, making adverse events involving insulin a matter of great concern for health care providers and patients alike.  Patients with Type 2 diabetes depend on proper doses of insulin adjusted to their particular characteristics, such as weight, diet and their body’s sensitivity to the drug.  When insulin dosing or administration is mismanaged and insulin levels drop too low, cells in the body are unable to store or use glucose.  The patient will then develop a condition known as hypoglycemia.  Without access to glucose, the body’s cells are unable to sustain energy and function. When somebody becomes severely hypoglycemic, their brain may be deprived of energy necessary for it to function and survive.  

Regrettably, adverse events related to the prescription and administration of insulin are frequent and too often fatal. In fact, insulin may be responsible for 33% of deaths involving medication errors. (U.S. Department of Health and Human Services 2014).

Antibiotics

Another form of preventable medication error is the basic error of omission.  For example, antibiotics can bring patients from the brink of an overwhelming bacterial infection. Yet, patients with signs or symptoms of infection are often prematurely discharged from emergency departments or urgent care settings without antibiotics or inadequate antibiotics.  In spite of signs or symptoms of potential blood infection, patients are permitted to go home because they may “look” stable to the treating physician.  Regrettably, these patients can rapidly decline and often die at home while the results of laboratory testing are pending and before they can fill a prescription for the antibiotic that could easily save their lives.

Guidance from Health Care Institutions

Health care providers are well aware of the enormous threats posed by medication errors.  Patient safety organizations like the Institute for Safe Medication Practices (ISMP) and the U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion work to identify the most common mistakes related to medications and find ways to prevent such needless harm from occurring over and over again.  ISMP recently identified some of the most persistent yet preventable medical errors involving medications that cause serious harm or death to patients.  Such errors include:

  • Choosing the wrong medication because its label looks the same as the correct medication;
  • Nurses administering the wrong medication due to misheard verbal or telephone communication;
  • Removing medications from automated distribution cabinets without a pharmacist reviewing the order, and often, without review by a physician as well.

Another frequent preventable medication error cited by ISMP involves a drug called tranexamic acid. Tranexamic acid is normally used to prevent heavy menstrual or post-operative bleeding.  Too many patients are dying during common procedures like fixation of a broken bone or child birth because their spines were injected with tranexamic acid instead of an anesthetic to control pain.  Many of these tragic deaths are caused when health care personnel either misread a label or confuse the glass capsule, called an ampoule, containing tranexamic acid with that containing the anesthetic based on their similar size and appearance. 

Investigation of a Medical Malpractice Lawsuit Based on Medication Error

The attorneys of Meyers Evans Lupetin & Unatin have uncovered medication errors as the root cause of many medical malpractice lawsuits.  Investigation of a medical malpractice lawsuit involving a medication error often begins by gaining an understanding of the cause of injury or death. Clues can be found in the results of tests coinciding with the time of injury or death such as toxicology reports, microbiology reports, or bloodwork. 

In some cases, identifying a medication error as the cause of harm is like placing pieces of a puzzle.  There may be no test to directly connect the death or specific injury with a medication error.  Nevertheless, evaluation of the patient’s medical history, medical treatment prior to the time of injury or death, and the physiologic mechanism of harm often leads us to discover a medication error as the source of the injury or death in question. 

Our attorneys discover many cases based on the failure to monitor patients for known medication side effects.  Hospital staff may administer the correct dosage of medication in a safe manner, yet they frequently fail to recognize or respond when dangerous side effects arise.  Dangerous side effects of medication could come in the form of a life-threatening allergic reaction, anaphylaxis or respiratory depression or arrest.

Trust Us to Uncover the Medication Error at the Root of Your Case

When a monitor shows worsening vital signs just minutes after a patient receives medication known to cause respiratory depression, yet nobody is aware of the problem until a nurse finds the patient non-responsive and without a palpable pulse, somebody made a mistake.  This scenario occurs too frequently, often because somebody changed the setting on the patient’s vital sign monitor to prevent an alarm from sounding or silenced the alarm altogether.  In some cases, nurses are busy taking care of other patients and nobody responds to an audible alarm.  Such preventable harm related to an adverse drug reaction should never occur.

When a patient dies in spite of timely diagnosis and treatment of pulmonary embolism, we focus on whether that patient was properly managed with heparin.  If the heart rate, blood pressure, and respirations in a patient sedated on Benzodiazepines are abruptly abnormal moments before the patient is found in cardiopulmonary arrest, we look to the record identifying when each and every medication was administered and the dosage for clues to what went wrong and how. And if a patient dies from scarring of his lungs only months after starting a new medication to control an irregular heartbeat, our suspicion turns to whether pulmonary fibrosis, a known side effect of the medication, could have been prevented with earlier monitoring and discontinuance of the medication.  Our law firm has dealt with each of the above scenarios while representing people whose lives were changed forever due to a medication error.  If you need to find out whether you or a loved one were seriously harmed by a preventable medication error, please contact us.

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