Medical Malpractice News and Views


Welcome to our blog where we discuss current issues in medicine and law. We welcome your comments.

Medical Malpractice Secrecy.

March 30, 2020

Doctors and hospitals win 85% to 90% of the medical malpractice cases tried across this country.  This percentage holds true even when the facts strongly favor the patient.  Why can’t patients get a favorable verdict from their fellow citizens?  There are a number of likely explanations.

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One of the likely explanations is the successful campaign by the health care industry and its insurers to persuade the public that most medical malpractice cases are frivolous.  National and state legislators believe this, especially if they are Republicans.  They pass restrictive laws to take away patients’ rights in the name of saving the medical profession from frivolous suits.  Over and over again the public hears that medical malpractice suits are frivolous, even though, when the medical profession itself examines the issue, it finds that most of the suits have merit.

Every large verdict in favor of a patient is held up by the industry as further evidence of the unfairness of the system, even though almost all large verdicts get reduced later.  The reductions are never mentioned by the industry so as to leave the public with the impression of a runaway system.

Perhaps one of the most significant reasons the public believes these claims are frivolous is that the medical profession insists on secrecy whenever it settles a malpractice case.  Last week I wrote about a Florida case which was suddenly dropped by the plaintiffs with no reason given.  The most probable explanation was that the insurance company for the doctors had paid them off and insisted that they keep the payment secret.

Doctors and hospitals settle cases where their malpractice is clear and they are at risk of a large verdict, if they go to trial.  Of course, in the settlement paperwork they deny that they were at fault but, as the old saying goes, money talks.  They would not be paying hundreds of thousands of dollars, if they had done nothing wrong.

These are not cases where a runaway jury holds a doctor responsible where the doctor did nothing wrong.  These are cases in which the doctor has consented to a settlement and his insurance company has agreed to pay money to make the case go away.

Maybe if the public knew of these settlements, things would be different.  Maybe if the public knew that doctors, hospitals and their insurers were paying money for malpractice claims, they would be more inclined to believe that malpractice does happen and that many of these claims have merit.  It could not hurt to make these settlements public and at least the public would know who the doctors and hospitals are who are paying money to settle malpractice claims.  Making these settlements public won’t happen, however, without legislative action.  The doctors, hospitals and their insurers want to keep up the appearance that  no patients are being harmed by medical negligence and that claims to the contrary are frivolous.

Posted in disclosure of medical mistakes, Doctors, Hospital Negligence, Hospitals, Lawsuits, Malpractice caps, medical errors, medical ethics, Medical Malpractice, medical malpractice claims, medical malpractice damages caps, medical malpractice lawsuits, medical mistakes, Medical Negligence, plaintiff, Secrecy, tort reform, trial |

Malpractice Secrets in Florida.

March 23, 2020

Florida is one of the states in which the state legislature fell for the argument that there was a medical malpractice crisis that required taking away the rights of patients in order to protect doctors, hospitals and their insurance companies.  Millions were spent lobbying the legislature and, for those seeking special treatment at the expense of their fellow citizens, it was money well-spent.  Florida passed a number of laws which restricted patient rights in an attempt to end the “crisis.”

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One of the laws prohibited the adult children of people who died because of medical malpractice from seeking damages arising out of the death of their parent.  These damages continue to be allowed in Florida in cases that do not arise out of medical malpractice.  To be clear, only when it could be proved that a parent died because of medical negligence would this law come into play.  It basically tells the adult children of these malpractice victims that their losses are not worthy of compensation and they should just suck it up for the good of the rest of society.

Recently, the two adult daughters of a woman who was alleged to have died because of medical malpractice brought suit to recover for their emotional losses arising out of their mother’s death.  They contended that the statute eliminating their claims, while allowing similar claims in other death cases, violated the equal protection of the laws guaranteed by the Florida Constitution.

The defendants moved to dismiss the lawsuit on the grounds of the statute.  The trial court granted the motion and the daughters appealed to the Florida Court of Appeals.  The Court of Appeals held that the trial court acted correctly.  The appeals court judges wrote that they did so because of an earlier Florida Supreme Court case decided twenty years ago, which the Court of Appeals had to follow.  It did something else too.  It asked the Florida Supreme Court to reconsider whether there was still a malpractice crisis that required adult children to lose their rights.  It noted that twice in the last twenty years, the Florida Supreme Court had questioned whether there was still a “crisis” or not.

The case was on its way to the Florida Supreme Court when, out of the blue, the daughters announced that they were withdrawing their appeal and dropping the case.  They offered no explanation for their decision.  This means, of course, that the Florida Supreme Court will not be deciding whether there is still a malpractice crisis that supports the statute.  The state law will remain in effect.

So, what happened?  The clues suggest only one answer.  The insurance company for the doctors being sued paid off the daughters so the Supreme Court could not hear the case and decide whether to keep the statute or hold it unconstitutional.  As is always the case, the insurance company would have required the daughters to agree not to disclose the fact of payment or its amount as part of the settlement.  Whatever amount the insurance company paid, it was a lot less than it would have had to pay in the future defending cases brought by adult children and in damages, if those adult children won at trial.  This was probably a very smart move by the insurance company but it deprived the people of Florida of their opportunity to have the Supreme Court reconsider the constitutionality of this law.

The situation in Florida is similar to that in many states.  The medical industry floods the legislature with money and tales of a “crisis” that is driving doctors out of the state and the legislature passes statutes “reluctantly” taking away patient rights “for the good of the state as a whole.”  The “crisis” is usually nothing more than the regular stock market cycle.  When the stock market goes up, insurance companies invest the premiums they receive and receive income from those investments.  They can, and often do, reduce premiums to encourage growth in the knowledge that they are making money on the invested premiums.  When the stock market drops, the insurance companies, which are no longer getting big returns on their investments, raise premiums to compensate for the decrease in income.  This is the perfect time to go to the legislature and complain that malpractice suits are out of control and are the reason for the premium increases.

Even worse is the fact that once those statutes are on the books, they are zombies.  They never die.  They stay on the books long after the alleged crisis has passed.  California is a good example.  In 1975, 45 years ago, the legislature passed a law capping non-economic damages for medical malpractice victims at $250,000.00 in response to a malpractice “crisis.”  Over the years, the health care industry has been successful in opposing any change in the cap number, despite the fact that $250,000.00 in 1975 is worth almost $1,200,000 in today’s dollars.  What was unfair in 1975 is even more unfair today but the law lives on and on and on.  Don’t let this happen in your state.

 

Posted in Doctors, Hospital Negligence, Hospitals, Lawsuits, Malpractice caps, Malpractice costs, medical ethics, Medical Malpractice, medical malpractice cases, medical malpractice claims, medical malpractice damages caps, medical malpractice lawsuits, Medical Negligence, Secrecy, tort reform |

Patients Aren’t The Only Ones Being Injured By Our Health Care System

March 16, 2020

I have written from time to time about the priority our health care system gives to making money.  The most important goal for our health care system should be addressing the health issues of the patient.  Instead, making money is often the most important goal, at least if we are to judge priorities by the way the system is set up and operates.   Not only are patients harmed by this emphasis on profit, so are the doctors themselves.

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Most doctors are caring people who entered the medical profession to help people.  When they find the health care delivery system’s emphasis on profit preventing them from helping their patients or actually injuring their patients, they suffer what psychiatrists call “moral injury.”

The term “moral injury” derives from the military where it was coined to describe the emotional and physical injury suffered by a soldier after committing or observing or failing to prevent acts which run against their deeply held moral beliefs.

Moral injury is what doctors feel when, for example, they see their patients being charged for services they don’t need or when the system actively prevents them from delivering the care they know their patient needs.  The result is burnout and it causes the most caring and sensitive to leave the medical profession altogether.  Almost half of physicians report feeling burnout and the suicide rate among physicians is twice what it is among the general population.

The health care system’s drive for profit is seen in many ways.  It is very apparent, according to physicians, in the emergency department.  In many emergency departments, a physician acts as a triage person, deciding who needs to be seen when and ordering tests.  The triage physician may only see the patient for a few minutes, leaving more thorough examinations and assessments to other doctors who will see the patient after the patient leaves the waiting room.

By using a physician as a triage person, many hospitals are able to charge a facility fee that they cannot charge until a person is seen by a physician.  The tests that the triage physician orders may turn out to be completely unnecessary once a more thorough history is taken and even a basic physical examination is performed.

Among the problems which make the emergency department a problem location for moral injury are patients who are stranded in the emergency department for long periods while awaiting transfer to other facilities, patients who use the emergency department for their primary care and patients who become suicidal while awaiting mental health transfers.

Many emergency department physicians leave the emergency department because they can no longer be a part of what they consider to be an operation in which making money takes precedence over patient care and which leaves many patients with unnecessarily large medical bills.

I can sympathize.  It must be hard to know what your patient needs and how to help that patient but to be prevented from doing anything about it by a system that more about making money than it is about patient care.  We deserve a better health care system but with the big money involved in health care today and the lobbying power that buys, a better future is a long way off.

 

Posted in Doctors, Fee for Service, Health Care Costs, Health Insurers, Hospitals, medical charts, Medical Costs, medical ethics |

Thank You, Doctors, Nurses and Other Health Care Providers

March 11, 2020

In this blog, I often point out deficiencies in the health care system.  Only by recognizing these deficiencies can we hope to improve the system.  It is important, however, to recognize that most doctors, nurses and associated providers are good people, doing their best, and providing us with the care we need when we are sick or helping to keep us from getting sick in the first place.

As everyone surely knows by now, we are in the midst of a health care crisis.  The COVID-19 virus is on the loose throughout the world and many people will die from it.  People who come into close contact with a coronavirus patient are at risk of contracting the disease.  Although coronaviruses are common, this one is new to us and we have little to no immunity to it.  The people on the front lines of treating this disease place themselves in harm’s way and deserve our thanks and support.

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If you have been following the news about COVID-19, you know that a Chinese doctor in Wuhan, who first spread the news about the new virus, was among its early victims and died.  Other doctors and health care providers, including nurses, hospital and clinic workers have been exposed and have fallen ill.  Although some have died, most have survived.

It is not very often that we think of doctors and nurses being in danger while doing their jobs.  When times are good, we see them in the office or in the hospital and everything seems fine.  However, like the members of our armed forces, they are ready to do their jobs, even when the stakes go up.  They are willing to expose themselves to dangerous illnesses in order to keep us healthy.

In times like this, it is especially important to say, “Thank you” and to let the medical profession know how much we appreciate what they do.

Posted in Doctors, health, medical ethics, Nurses |

Not All Doctors Are Created Equal.

March 09, 2020

I was going to give this post a title about getting what you pay for in medicine as in many other walks of life.  Then I thought better of it.  The pricing of medical care is so crazy and opaque, you often end up paying more for poorer care.  Better to focus on quality of care than cost.

First, a warning about recommendations.  It never ceases to amaze me how some of the worst doctors I encounter get good reviews on line or have patients or even other doctors who recommend them.  Just because your neighbor or bridge partner received successful treatment from a particular doctor does not mean that doctor is well-qualified.  Just because a surgeon plays golf at the club with your treating physician doesn’t mean he is a good doctor.  As the old saying goes, “Even a blind squirrel finds an acorn every once in a while.”

So how do you find out if the doctor you are planning on seeing or planning on having operate on you is well-qualified.  The first place to start is your state’s medical board.  Where did your doctor go to school?  Did your doctor complete a residency in which he or she received additional training in a medical specialty?  Does your doctor have training in the medical specialty for which he or she will be treating you?  Has your doctor been disciplined?  All of this information should be available on your state medical board’s web site.  Here is a link to the Arizona Medical Board’s web site.

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Assuming you are satisfied by what you find out from the medical board, your next step should be the American Board of Medical Specialties.  Here is a link.  The ABMS administers the board certification programs for the various medical specialties.  There are 24 medical boards that have been approved for membership in the ABMS.

When a doctor in one of those specialties wishes to become board certified, he or she must submit an application.  The application must demonstrate that the applicant has successfully completed whatever educational requirements the particular member board has established.  Each board has its own requirements which relate to what its doctors do.  At a minimum, the application is going to require successful completion of studies at an accredited medical school, completion of a residency and letters of recommendation.  The applicant must have been in practice for the requisite number of years and have completed a requisite number of operative procedures or show some other comparable experience.  There will be both a written and an oral test.

Certification is not a one time thing.  The board certified doctor must apply for recertification every so often.  He or she will have to demonstrate that they have kept up with developments.

It is not easy to become board certified and board certification is no guarantee of a good outcome or that the board certified physician won’t make a mistake.  Doctors are human beings and human beings make mistakes.  What board certification does is help you identify a doctor who is at least highly qualified to treat you.  Highly qualified doctors are less likely to make a mistake than those who are less well-qualified.

After getting this far, you should still talk with the doctor about his or her experience doing whatever it is you want done.  Some very highly qualified doctors have a terrible bedside manner.  Communication with your doctor will be important, so you should consider getting a doctor with whom you feel comfortable and who is willing to talk to you and can do so in an understandable manner.

There is lots of malpractice and poor care out there.  Your best protection is to do your homework before getting treated.

Posted in Arizona Medical Board, Board Certification, Doctors, Fee for Service, medical errors, medical ethics, Medical Malpractice, medical mistakes, Medical Negligence |

Lots of Malpractice Out There

March 02, 2020

There is often a debate about just how much medical malpractice there is.  Advocates for the medical industry and their insurance companies would have you believe that there is very little malpractice and that lawsuits claiming malpractice are almost always frivolous.  Patient advocates on the other hand, point to estimates of malpractice causing hundreds of thousands of deaths each year.  Each side accuses the other of not having proof to support their claims.

Much medical care takes place in hospitals.  Malpractice in hospitals makes up a large part of the medical malpractice in the United States.  This year marks the tenth anniversary of a report by the Office of the Inspector General of the Department of Health and Human Services of a study that sought to answer the question of how much malpractice there is in hospitals and how it affects Medicare payments.  You can be sure that however much was found to occur in hospitals, there was lots more that occurred in doctor’s offices, in surgicenters, in laboratories, in urgent care facilities and in clinics.

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Medicare is a huge participant in the health care delivery system in this country.  Congress wanted to know how many medical errors there were in the system and how much it was costing us.  It tasked the Inspector General’s office with finding out.

The Inspector General’s team randomly selected 780 Medicare beneficiaries who were discharged from the hospital in October of 2008 and obtained their medical records for the hospitalization.  In the first step, a team of nurses indentified patient charts in which it appeared there had been an adverse event.  A team of doctors then reviewed the flagged charts.  Over half of the charts showed some questionable event and were sent to the doctors for review.

If the team of doctors found an adverse event that caused harm to a patient, they coded it for the degree of harm caused.  The degree of harm ranged from minor harm, to harm which lengthened the hospital stay, harm which was permanent, harm which required live-saving treatment and harm which caused death.  In addition, if the doctors found an adverse event which caused harm, they determined if the event was preventable.  They used five categories:  clearly preventable, likely preventable, clearly not preventable, likely not preventable, and unable
to determine.  The results were disturbing to say the least.

Almost 14% of the patients experienced an adverse event during their hospital stay that was significant.  Given the total number of Medicare beneficiaries who were discharged in October of 2008, that translated to 134,000 patients across the country.  Just over 13% of the patients who experienced an adverse event had one that fell into the four most serious categories of patient harm.  1.5% of the patients whose charts were reviewed never left the hospital alive.  An additional 13% of Medicare patients had adverse events which caused only temporary harm.  All told, if you were a Medicare beneficiary, you had over a 1 in 4 chance of having an adverse event occur during your hospitalization.

So what?  People, especially Medicare beneficiaries, have medical problems and can be expected to have things happen in the hospital.  All true.  However, the team of doctors found that almost half (44%) of the adverse events were preventable.  “Preventable events were linked most commonly to medical errors, substandard care, and lack of patient monitoring and assessment.”  If patients were highly susceptible to the adverse events due to their health status, the events were classified as not preventable.

It was estimated that 16% of the Medicare beneficiaries incurred additional medical bills as a result of the adverse events.  The Inspector General determined that this amounted to an extra 3.5% in the bill for the stay.  Applying that to Medicare beneficiaries across the country in Fiscal Year 2009, that amounted to an extra $4.4 billion in costs to you and me due to adverse hospital events.  At least $2 billion of that was due to preventable events.  The cost to the taxpayer for preventable events was actually greater as the study did not include the cost of follow up visits after discharge.

The implications of these findings are concerning.  For example, almost 80,000 Medicare patients died in Fiscal Year 2009 due to preventable medical errors occurring in hospitals alone.  While there is no reason to believe the health care system is significantly better today than it was in 2009, there are far more patients today than there were then.  When you consider the number of hospital patients who are not Medicare patients and include the patients who die due to care received outside a hospital setting and the growth in population, the total number of deaths annually due to preventable medical errors has to exceed 250,000 deaths a year now.  This is staggering.  You can rest assured that very few of the families of these poor people were told that their loved one died due to a preventable event.  The curtain of medical secrecy remains tightly closed.

It is hard to argue with these figures.  They are based on a large number of randomly selected patients.  The medical records were subject to rigorous reviews by doctors themselves who discussed each of the cases and reached a consensus.  This is Grade A evidence.

The study shows, as those of us who do medical malpractice work already knew, hospitals are dangerous places in which you can be gravely injured or killed.  Keep your eyes open.   Have someone with you to keep an eye out when you cannot and to advocate for you.  Ask questions.  Make sure you are the patient for whom this medicine or treatment is intended.  Be alert and you will have the best chance of coming out of the hospital without a serious injury.

 

Posted in disclosure of medical mistakes, Doctors, Health Care Costs, Hospital Negligence, Hospitals, Malpractice costs, medical charts, Medical Costs, medical errors, Medical Malpractice, medical mistakes, Medical Negligence, Medicare, never events, Nurses, Secrecy |

Vaginal Birth After Caesarian Section

February 24, 2020

Many women who have had Caesarian sections would like to give birth more naturally.  Typically, they did not voluntarily choose to have a Caesarian section during their prior pregnancy or pregnancies.  More often than not, some complication of the delivery process required the Caesarian section.  They are hoping for better luck this time around but a vaginal birth after Caesarian section (“VBAC”) poses risks to both the baby and the mother.

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First the good news.  60 to 80% of mothers who elect a trial of labor after a previous Caesarian section are successful in delivering their babies vaginally.  A vaginal delivery avoids the surgical risks which accompany every procedure. It gets mom back to her normal life more quickly and it increases the likelihood that future babies can be delivered vaginally.

On the other hand, VBAC does present some risks to the baby and the mother.  Perhaps the most significant risk is uterine rupture.  The wall of the uterus is weakened where it was cut open during the earlier Caesarian section.  The wall is surrounded by powerful muscles, which, during childbirth, contract to push the baby through the birth canal and into the world.  Sometimes the power of those muscles overwhelms the strength of the uterine wall and it ruptures.  When that happens, the mother begins to hemorrhage and the baby loses its oxygen supply.

Doctors who are caring for patients undergoing a trial of labor after a Caesarian need to be alert for signs of uterine rupture.  A delay in recognizing and treating a uterine rupture can cost the life of both the baby and the mother.

You would think that obstetricians who have been trained about the risks of VBAC, the signs and symptoms of uterine rupture and what to do in the event of a rupture would be able to promptly recognize a rupture and deal with it.  While most of the time you would be right, sometimes you would be wrong.  Sometimes, obstetricians are oblivious.  Sometimes it is the nurses who are oblivious or are just not as well-trained as they should be and who fail to appreciate the significance of what is happening right before their eyes.  Either way, it is bad news for the mother and her baby.

The good news for mothers laboring after a Caesarian is that, even with a uterine rupture, the baby can be saved and delivered both alive and healthy.  Babies are incredibly resilient.  Mom can be successfully treated as well.  The bad news is that there is only a short period of time in which to recognize the uterine rupture and deliver the baby.  If that period of time is exceeded, the baby will either be born dead or will be born with deficits caused by the lack of oxygen following the uterine rupture.

If you have lost a baby due to uterine rupture while laboring following a Caesarian section, you should consult with a qualified medical malpractice lawyer.  It may be that everything that could have been done was done.  On the other hand, it may be that someone or many someones were asleep at the switch and that your baby did not need to die.  A good medical malpractice lawyer should be able to discover which it was.

Posted in Birth Injuries, Cesarean Section, Doctors, Hospital Negligence, Hospitals, medical errors, Medical Malpractice, medical malpractice lawyers, medical mistakes, Medical Negligence, Nurses |

Being Nice Can Be Good For Your Health.

February 17, 2020

Turns out that being nice and polite is not just the right thing to do as your mother told you, it can also affect the health care you receive.

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OR

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Which are you?

Like all the rest of us, doctors are human.  They react to patients the same way we all react to the people we meet.  We enjoy being around positive people, who make us feel good.  We do not enjoy being around Negative Nellies who are always complaining. Nothing is ever right.  Just being around them is draining.  We look forward to seeing the positive people; we dread seeing the Negative Nellies.  It is the same with doctors and their patients.

Every doctor has patients whom they dread. According to studies, it can be about 15% of their patients.  It can ruin their whole day to have to deal with one of those patients.  They have symptom after symptom.  Nothing the doctor does is ever good enough.  Fix one thing and they complain about another.  Doctors hate to see these patients.  No matter how hard they try, doctors are only human and cannot set these feelings aside completely.  In spite of their best efforts it can affect the care they give.

Many of these patients are not content to merely complain about all the things that are wrong with them.  They have researched their condition on the internet and know what the doctor should do, even if she or he does not.  They tell the doctor what tests to order and what medications to prescribe.  They tell the doctor she needs to refer them to this or that specialist.  The doctor often just gives in rather than get into an argument that she is not likely to win or which will result in negative comments by the patient on social media.  As a result, these patients often receive unnecessary treatment, which can be both costly and dangerous and which burdens our health care system.

Studies have shown that difficult patients are more likely to be misdiagnosed.  One study in Europe illustrated this tendency with great power.  Resident physicians were given neutral vignettes about patient history, signs, symptoms and test results.  Some of the vignettes were accompanied by information about the patients behaving badly.  Each resident received the negative information about different patients.  The results were striking. When the presentation was relatively simple, the difficult patients were misdiagnosed about 6% more often.  When the presentation was complicated, the misdiagnosis rate rose to 42%.  And this was without the residents ever having to actually see the difficult patients.  Just the negative attitude generated by the submission was enough to affect the performance of the doctor.  One of the theories advanced by the researchers is that the doctors must devote some attention and energy to addressing the bad behavior and this detracts from their ability to focus on the medical problem before them.

I am not suggesting, however, that you be a passive patient who just sits there and accepts whatever the doctor says.  That is not the path to good care.  Any time you feel that you or your symptoms are not being taken seriously, you need to speak up. This is a fine line you have to walk but it is one you have to walk.

Select your doctor with care and then pay attention.  Let someone know if you see something amiss but do so respectfully and you will have the best chance for successful care.

 

Posted in Doctors, General Health, healthy living, medical errors, medical ethics, Misdiagnosis |

Why More Pharmacy Malpractice?

February 10, 2020

Last week I blogged about how to protect yourself from pharmacy malpractice and remarked that instances of pharmacy malpractice were increasing.  The current situation was discussed at length in a New York Times investigation.

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The days of the corner Mom and Pop pharmacy are gone.  Today, the vast majority of Americans get their prescriptions filled at chain pharmacies.  Between them, CVS and Walgreens fill almost half of the prescriptions in the United States.  Walmart, Kroger and Rite Aid are the next three largest players.  Together, they fill the vast majority of prescriptions that are filled at brick and mortar stores.  The efficiency and accuracy of those pharmacies are important to all of us.  Given their nature, they are prone to mistakes and are making more and more of them all the time.

State pharmacy boards have been getting complaints from pharmacy employees of these chain companies that working conditions are such that they are making mistakes.  The employees complain that the chains are reducing the staff at the pharmacies at the same time that they are increasing the workload.  In addition to filling prescriptions, the pharmacist and his or her assistants must deal with drive through customers, give shots, answer the phone, and counsel customers about the prescriptions they are receiving.  While these jobs are pretty straightforward, the chains are also requiring their pharmacy employees to call doctors for refills and to urge customers to let them seek refills automatically.  Everything is aimed at producing the highest possible revenue from pharmacy operations.

According to the complaining pharmacists, all of the duties they are required to perform add up to an unsustainable workload.  They cannot do everything their employer wants and still maintain quality control.  Mistakes are being made and patients are suffering as a result.  As I mentioned last week, I have represented families of patients who died because of pharmacy mistakes.  They happen.  While there will always be mistakes, because pharmacists are only human, we should do everything we can to make the environment in which they work as conducive to accuracy as possible.

It is hard to get a handle on the exact magnitude of the problem.  The chain pharmacies won’t reveal their error rates or talk about how many of their customers are injured by mistakes in prescriptions.  When people are injured, many will not make a claim.  Those that do make a claim and resolve that claim with the chain are required to sign a confidentiality agreement that prevents them from discussing what happened.  The last comprehensive study of medication errors took place 10 years ago.  It was performed by the Institute of Medicine.  It estimated that medication errors injure at least 1.5 million Americans each year.  Importantly, that figure includes all medication errors and not just those made by the chain pharmacies.

The state pharmacy boards seem to be having little success in overseeing the chain pharmacies and getting them to increase the number of pharmacy employees.  The chains are just too large and the nature of the problem is too amorphous.  Also, according to the New York Times, at least some pharmacy boards have industry representatives sitting on the boards, which further complicates imposing discipline against them.

There does not appear to be a fix for the problem of overworked pharmacists on the horizon.  The only thing you can do is protect yourself using the suggestions in last week’s blog post.  If, in spite of your precautions, you or a loved one gets hurt by a medication error, give me a call.  Maybe I can help.

Posted in disclosure of medical mistakes, medical errors, Medication Errors, Pharmacies, Pharmacy Malpractice, Secrecy |

Malpractice at the Pharmacy

February 03, 2020

We don’t normally think of danger or risk when we go to have a prescription filled at our local pharmacy.  Maybe that should change.  For a number of reasons, the risk of a misfilled prescription is increasing.

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There are lots of ways a pharmacy can make a mistake and almost all of them can kill or seriously injure you.  I have represented the families of people who died as a result of a pharmacy mistake.  In one of the cases, the pharmacy gave the patient narcotics that were many times the dosage prescribed by the doctor.  She took what she was given and died of an accidental overdose.  Here is list of just some of the ways in which the pharmacy can make a mistake and what you can do about it.

Wrong Patient:  When we pick up our prescriptions, they are almost always in a paper or plastic envelope with our name on the outside.  Unfortunately, we don’t use the envelope.  We use the pills in the bottle that is inside the envelope.  Sometimes, the pharmacy employees place someone else’s bottle in our envelope.  Always make sure the bottle inside is yours and that its label matches the information on the outside of the envelope.

Wrong Medication:  Sometimes the medication inside the envelope is ours and matches the outside but it is not what our doctor prescribed for us.  Before taking any medications make sure the label on the pill bottle is the medicine your doctor wants you to take in the amounts ordered by your doctor.

Wrong Medication II:  In this variation, the medication described on the outside of the pill bottle is what the doctor ordered but that is not the medication actually inside the bottle.  Usually, the information on the outside of the envelope tells us what the the pills in the bottle should look like.  If you are unfamiliar with a new medication, always compare the appearance of what is in the bottle with the description on the outside of the envelope.  If there is no description on the outside of the envelope, you can find one on line.  If this is a medication you have been taking for a while, make sure the pills are the same as the ones you have been taking.  I am taking some medications that are almost identical in size, color and shape.  The only way to tell them apart is by the writing on them.  Just because the prescription looks like what you have been taking doesn’t mean that it is the same.   If you want to be safe, check.

Wrong Dosage:   The medication inside the pill bottle is the medication the doctor ordered but the strength is wrong.   The strength may or may not be accurately described on the outside of the bottle.  If the strength is too low, it may not do you any good.  If it is too strong, it may kill you.

Changed Strength:  In this variation of pharmacy malpractice, the medication is the one the doctor ordered and is one you have been taking for a while.  This time, however, instead of giving you 50 mg pills to take two at a time, the pharmacy gives you 100 mg pills to take one at a time but forgets to tell you that each pill is now twice as strong.  They may also forget to change the dosage pattern on the outside of the bottle as well.  Pharmacies are always supposed to tell you when they make this change but sometimes they forget and you end up taking a lot more of your medication than you are supposed to.  Needless to say, this can be very bad.

What I am suggesting is not hard to do but it is not something we usually think about.  We just assume the folks at the pharmacy are doing their jobs correctly.  After all, they haven’t made any mistakes before.  Hint: It only takes one mistake to kill you or seriously injure you.  Don’t be a sheep.  Take a few moments to check your prescriptions.  You may just save your own life.

So why are pharmacy errors increasing?  More on that next week.

Posted in Medication Errors, Pharmacies, Pharmacy Malpractice |