In the United States, 1.5 million preventable adverse drug events occur every year —many of which result in permanent injury or death. Studies have demonstrated that the majority of medication errors are the result of errors made during by nurses or physicians related at the administration of medication. 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.”
In the nursing home setting, some of the more common medication errors include:
Failure to Consider Adverse Side Effects of Drugs
Many prescription (and over-the-counter) medications have serious side effects that should be considered before taking them. Some serious and common side effects include: allergic reactions, heart problems, liver and kidney failure, weight gain/loss, and psychological effects. 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. Similarly, the staff in a nursing home, should monitor patients to help detect adverse reactions as quickly as feasible.
Administering The Incorrect Prescription
Medication errors can result when there is a mis-communication or misunderstanding of drug orders. These errors may be due to: poor handwriting, confusion between drugs with similar names, misuse of zeroes and decimal points, confusion of metric and other dosing units, and inappropriate abbreviations. Doctors must take reasonable care in correctly and accurately writing prescriptions and staff must similarly confirm medication types and dosages when in doubt.
Medication errors can also occur when doctors take an incomplete medical history from a patient. For example, the doctor might not know about the patient’s allergies, any other medications the patient is taking, previous diagnoses, and lab results. Nursing homes should help treating physicians by ensuring that they provide the physician with accurate medical charts.
Incorrect Medication Dosage
Prescription medications have more serious dangers associated with them than over the counter (OTC) drugs. Therefore, it is important that nursing home staff issue the correct drug (the one the doctor prescribed) at the correct dose. At many nursing homes and medical facilities, medications are administered via a ‘medication cart’ where many similar-looking pills are stored. Consequently, staff in nursing homes must check and re-check before administering medication to assure the patient receives the proper dosage.
Medical complications may arise when patients are administered too much or too little of a drug. Many prescription medications require must be taken at a specific time, staff must be aware of these administration parameters and dispense the medication accordingly.
Adverse Drug Interactions
Many older adults, 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 you are 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, and dietary supplements.
There are three main types of drug interactions:
- 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, and with fifty percent of American adults using dietary supplements (vitamins, minerals, amino acids, herbs or botanicals) on a regular basis, the risk of negative drug interactions is high.
Liability for Medication Errors
Medication error cases can frequently be some of the more complex cases due to the fact that a variety of parties may be responsible for the error(s). In some cases, liability may be imposed on the physician, nursing home and pharmacy involved in the incident. Consequently, in order to fully investigate each parties culpability, it is important to speak with a lawyer experienced in handling medication error cases as soon as feasible after the event.
Related Articles:
One the most prevalent trends in the senior care industry is the emergence of nursing home alternatives such as assisted living facilities and group homes. While the facilities offer many perceived advantages compared with traditional nursing homes, there are significant differences in terms of the care that they are capable of providing.
The most significant difference between nursing homes and assisted living facilities is that nursing homes are indeed medical facilities that are intended to provide patients with skilled nursing care. Depending on the states licensing requirements, some assisted living facilities may provide their residents with assistance while taking their medication….
Some of the most tragic cases of nursing home negligence involve medication errors. Not just because the error results in a severe injury or death of a patient, but because the errors were indeed so needless. Somewhere along the line from the time the doctors order was written to the time the medication was dispensed— or perhaps not– we frequently see errors made with respect to how medications are handled in nursing homes. Even innocent errors made by nursing home staff can wreck havoc on fragile patients who require strict adherence to their doctors medication orders.
For some reason, there seems to be a caviler attitude amongst some nurse some staff when it comes to dispensing medication to patients. Perhaps it’s the brightly colored pills or the fact that many staff members have become so accustomed to seeing a large percentage of patients taking the same medications? Regardless of the underlying reasoning, staff must be as diligent in their approach to medication dispensation as they are with providing other types of medical care for patients….
Sometimes I see nursing home negligence cases where a facilities errors stem from the fact that staff fail to pay attention to an initial physician order or care plans developed by the facility for a patients care. Perhaps the order itself was ambiguous, or perhaps the writing was illegible? But what happens if a physicians order is just plain wrong?
Certainly, in cases where orders are ambiguous, illegible or downright suspect, it is up to the nursing home staff to clarify the orders with a supervisor at the facility or to take it upon themselves to confirm the order with the patient’s physician. Put another way– staff can not leave their common sense at the door when implementing patient care….
Following a medication-error related death and other medication-related problems that resulted in patient injuries, Minnesota Department of Heath investigators concluded that Fair Oaks Lodge in Wadena, MN was guilty of neglect and other federally mandated nursing home standards.
The ‘major medication errors’ occurred within 16 days of one another. According to the State’s investigative report:…
An error by an institutional pharmacy, HealthDirect, is responsible for the death of a 94-year old patient at a New York nursing home. According to New York Health Department reports, the woman was to receive methimazole, to treat her thyroid condition, but pharmacists at HealthDirect filled the prescription with metolazone– a significantly different medication used to treat blood pressure.
In addition to the error my by the pharmacy, additional errors were made by Cayuga County Nursing Home when they administered the wrong medication to the woman over the course of 18 days. Shortly after the woman received the incorrect drugs, she died due heart problems brought about by kidney failure….
Resource:
Related Publications
About Jonathan Rosenfeld
Jonathan Rosenfeld is a lawyer who represents people injured in nursing homes and long-term care facilities. Jonathan has represented victims of nursing home abuse and neglect throughout Illinois and across the country. Jonathan’s reputation as an aggressive advocate for the…
