Risky Pharmacy Practices Increase Medication Errors

An industry-wide culture of long hours, speedy service and staffing shortages contributes to millions of potentially serious medication errors in pharmacies across the United States, according to a recent investigative article by USA Today.

The story centers on 5-year-old Trey Jones who was mistakenly treated with a steroid never intended for use by children.  The child took the medication regularly for two months before a critical pharmacy error was discovered and the drug was discontinued.  Unfortunately, the medication caused the boy to erupt in fits of rage and triggered his early puberty, but as the article reveals, scores of other similar pharmacy errors across the nation have been implicated in equally severe adverse reactions and even fatalities. 

Investigative journalists contributing to this article reviewed lawsuits and pharmacy board disciplinary actions taken in 10 states to identify a dangerous culture of safety compromises including the following:

•"Too many prescriptions, too few pharmacists. Some stores fill so many prescriptions that pharmacists work long shifts with few breaks. In the case of Benjamin Goldberg, a North Carolina baby whose parents were given an antibiotic with instructions for five times the prescribed dosage, the state pharmacy board reprimanded a CVS pharmacy for filling prescriptions "at such a rate as to pose a danger to the public health or safety."

• An emphasis on speed. American consumers expect fast pharmacy service, and the chains try to meet that expectation. Walgreens guidelines obtained by USA TODAY say pharmacists need as little as two minutes to fill a prescription. That doesnt leave enough time to counsel patients about a new prescription, says William Kennedy, a former Walgreens pharmacist and union leader.

CVS monitors whether pharmacists meet goals for filling prescriptions by promised times and ensuring phones are answered swiftly. The Institute for Safe Medication Practices urged CVS to review whether the policies place "speed above safety" after a Massachusetts investigation substantiated 62 drug errors or other concerns.

• A reliance on technicians. Walgreens and CVS rely on lower-paid, lesser-trained technicians to help pharmacists by processing and packaging prescriptions. Although pharmacists by law must verify that each medication contains the right drug, dosage and directions, they dont always catch technicians errors. In Jacksonville, roofing contractor Terry Paul Smith died of a methadone overdose in 2001 about 36 hours after getting a prescription for which a dosage error by a Walgreens technician went unnoticed by a pharmacist.

Pharmacist incentive awards. At Walgreens, bonuses paid to pharmacists and pharmacy managers are based in part on increases in prescription volume. Until this year, CVS partly based pharmacists bonuses on their success in meeting company goals for filling prescriptions by the times promised to patients and for ensuring phones are answered promptly.

• Counseling gaps. All but two states require pharmacies to offer face-to-face counseling to most customers who pick up new prescriptions. But state records show CVS was cited at least once by the North Carolina Board of Pharmacy for failing to offer or provide counseling, and Walgreens was disciplined at least five times since 2002 for similar infractions in Oregon." 

Medication errors can have severe and fatal consequences.  If you think you or someone you know may be the victim of a medication error, you should seek medical attention immediately, being certain to let all medical personnel know that you suspect a medication error.  Take the remainder of the medication or its container and any prescription label with you if possible. 

Previously on the DC Metro Area Medical Malpractice Law Blog, we have posted articles related to:

  • A new survey indicating that many pharmacies with drive-through windows offer convenience at the expense of safety.
  • Evidence that 25% of all elderly patients receive incorrect or ineffective prescription medications.
  • FDA safety tips for buying prescription drugs on-line.

For information about your legal rights, please click here or call the law firm of Regan Zambri & Long, PLLC at 202-463-3030.

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