Posted by : Ed Lott, Ph.D., M.B.A.
Medical malpractice is as varied as the practice of medicine. Given how many people use prescription drugs and the numbers of people are involved in the process of getting that medication to the patient, negligence will arise all too often.
Nearly half of the US population uses a prescription medication, according to the Centers for Disease Control and Prevention (CDC). They report that 24% of the population uses three or more prescription drugs, while 12.6% use five or more. Patients at physicians’ offices are ordered or provided 2.9 billion drugs annually.
With all these medications and people mixing, mistakes will happen. What does “medication error” mean? An article in the British Journal of Pharmacology breaks down where in the prescription chain mistakes can happen.
A medication error is a failure in the treatment process that leads to or has the potential to lead to harm to the patient. These errors can be knowledge-based mistakes, rule-based mistakes, action-based slips, and memory-based lapses. Two subsets are:
- Prescribing faults: A failure in the prescribing (decision-making) process that leads to, or has the potential to lead to, harm to the patient. This includes irrational, inappropriate, and ineffective prescribing, under prescribing and overprescribing
- Prescription error: A mistake in the process or writing a prescription resulting in an incorrect instruction concerning one or more of the “normal features” of a prescription. A “normal feature” would be the patient’s name, the name of the drug, the formulation, dose, route, timing, frequency, and duration of administration
Another part of medication errors can come when the drug is provided to the patient. The wrong amount can be given, or the patient receives the wrong medication. The patient could also suffer severe reactions to a medication, even if it’s properly prescribed and given to the patient. If negligence was a factor, this might also be an area where a medical malpractice claim may be justified.
Errors occurred at multiple care levels, according to an article in the Journal of Community Hospital Internal Medicine Perspectives, including prescribing, initial pharmacy dispensation, hospitalization, and subsequent outpatient follow-up.
- Adverse drug events (ADE) result in more than 3.5 million physician office visits and 1 million emergency department visits annually year
- More than 7 million patients are impacted by preventable medication errors, resulting in almost $21 billion annually in costs
- The average hospital patient has at least one medication error each day
- About 30% of hospitalized patients have at least one discrepancy on discharge medication instructions
- The elderly and those with limited access to health care services, low health literacy, low socioeconomic status, and language barriers may be affected more often
- Elderly patients are two to three times more likely to visit a physician office or emergency department, and seven times more likely to require hospitalization, due to ADEs
- Language barriers are associated with medication errors/ADEs
- 1 in 30 hospital admissions of elderly patients are due to an ADE
- ADEs cause a third of total hospital adverse events
- Half of all medication events that happened to hospitalized Medicare patients in 2008 were considered preventable
- High-risk medications include anticoagulants, opioids, insulin, and anti-diabetic agents
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