Red Pharmacy

From time-to-time I get called by people whose pharmacist put the wrong pill in the bottle where the label says the name of the correct medication. Sometimes, they’re given the wrong medication entirely. I’m happy to report that in most of these cases there are no permanent ill effects, and I politely decline to handle the matter. But consumers should still be aware of the potentially deadly possibility of pharmacist error.

Each year, over 3 billion prescriptions are dispensed in the United States. Patients depend on these medications for their well-being, and it is important that the dispensing pharmacy accurately fills each prescription with the correct drug and dosage. However, pharmacists and pharmacy technicians are under enormous pressure to keep costs low by filling high volumes of prescriptions quickly.

All of this adds up to a shockingly high risk for injury due to pharmacy error. A recent investigation into prescription error identified several potential pitfalls:

The pharmacy dispenses a drug other than that which was prescribed;

The pharmacy fails to identify a potentially dangerous drug interaction;

A pharmacist fails to counsel the patient about the drug;

The dosage is incorrectly provided on the label.

These are just four possible types of pharmacy error. While some errors may not result in any harm to the patient, those that do injure the patient present a very serious safety concern. According to some studies, perhaps as many as one in ten prescriptions results in a significant adverse outcome. What causes these potentially fatal errors, and what can you do to protect yourself and your family?

Pharmacy error in both the local neighborhood stores and the hospital setting is on the rise. The consequences of pharmacy errors can range from harmless to fatal. More than 100,000 Americans die each year of adverse drug reactions, according to an article in the Journal of The American Medical Association. No one knows for sure how many of those deaths are the direct result of a pharmacy’s or pharmacist’s negligence, but we do know that a leading cause for prescription mistake is overworked pharmacists.

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Many pharmacies fill over 300 prescriptions a day and some pharmacists are being asked to fill thirty prescriptions an hour and work twelve hour shifts, sometimes back to back. This means that within two minutes, the pharmacist must fill the prescription, check for drug interactions, check for contraindications for use and also counsel the patient. It’s no wonder mistakes are being made.

In one study, fifty pharmacies in six cities throughout the United States were evaluated on their dispensing accuracy rate. The study found an overall accuracy rate of 98.3%. That’s equivalent to 77 errors per 4,481 prescriptions filled. The authors of the study concluded that prescription dispensing mistakes occur at a rate of four errors per day in a pharmacy filling 250 prescriptions a day. If you do the math – with over 3 billion prescriptions being filled annually – there are over 50 million prescription errors per year in the United States.

According to a recent University of London School of Pharmacy study, hospital doctors make mistakes in more than one in ten prescriptions written for children. Specifically, the researchers analyzed five London hospital pediatric wards over a two-week period and found errors in 13.2% of prescriptions written for children. Furthermore, when nurses were responsible for administering drugs, the researchers found that one in five drugs were incorrectly administered.

Luckily, pharmacists prevented most of the errors from causing harm by crosschecking the prescriptions. However, some of the incorrect prescriptions did get through and some young patients experienced complications. While most of these complications were not lethal, one child was prescribed medication for epilepsy that was ten times the correct dosage. Fortunately, the child received only one dose of the potent medication before the pharmacist caught the error and corrected the treatment.

Overall, the results of the study found 391 prescription errors with incomplete prescriptions being the most common mistake, followed by dosing errors.

A couple of high-profile incidents have underscored the threat to children. Recently, two of fourteen babies died after getting heparin overdoses. Unlike the case involving actor Dennis Quaid’s twins, those Texas newborns got the overdose as a result of an error at the hospital pharmacy rather than a labeling problem. The heparin dose turned out to be one hundred times stronger than was recommended.

Medicine mix-ups, accidental overdoses, and bad drug reactions adversely affect one out of fifteen hospitalized children. That means as many as 540,000 children are harmed every year,

according to another recently released study.

The researchers cite several reasons for the high number of errors in prescriptions for children, including the following:

*Many drugs used in hospitals have never been tested on children and are not in standard doses meant for children. Doctors should make dosage determinations based on a child’s weight.

*The high number of drug administering errors is attributable to the fact that children are often given injections instead of tablets. According to the researchers, injections require mixing up a solution to be injected. However, this is a time-consuming process.

By taking an active role in your health care and asking questions of your doctor and pharmacist, you may be able to avoid becoming a victim of pharmacy error. Here are some tips to help you keep yourself – and your family – safe:

Don’t be in a hurry;

Open your prescription in the pharmacy;

Ask questions – by law, pharmacists are required to provide counseling on all prescriptions they dispense;

Don’t assume everything is all right;

Be your own advocate or have someone you trust assist you;

Slow down, compare and take advantage of helpful resources such as the internet;

Pharmacy error is alarmingly common. Being patient and inquisitive can save your life.

If you do the math – with over 3 billion prescriptions being filled annually – there are over 50 million prescription errors per year in the United States.

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