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How safe is your prescription?

Pharmacy errors can be life-threatening.

By Karen Datko Sep 30, 2009 3:44PM

This post is from David Wood at partner blog ConsumerAffairs.com.


As an expectant mom, Kendra of Brooklyn, N.Y., wanted the best for herself and her baby. Part of that care was a prenatal vitamin.


"My doctor gave me a prescription for the prenatal vitamin Primacare One," wrote Kendra. "I dropped off my prescription at the CVS pharmacy and when I returned to pick up the prescription, I was instead given Prednisone."


The problem Kendra encountered is one of the most common prescription errors -- the kind that occurs when a pharmacist can't read the prescription properly. Instead of contacting the authorizing physician to confirm the prescription, the pharmacist plays Russian roulette with someone else's life.


Kimberly, of Hudsonville, Mich., ran into a similar problem at Walgreens.

Kim wrote that the pharmacist couldn't read the prescription and assumed it said Corgard, a blood-pressure drug. However, Kimberly's husband didn't need a blood-pressure drug. He needed Cortef, a drug to treat his brain tumor.


Walgreens also was the target of another complaint, this time from Elana, who lives in Cranston, R.I. 


Elana said her 5-year-old daughter spent a "very uncomfortable and scary" five hours in the emergency room due to lethargy and vomiting. "The Walgreens pharmacist gave the correct medicine, but it was 10 times the prescribed dosage," complained Elana.


Light rings

What if you used an eye drop to help your vision and instead ended up seeing rings around street lights? A Mount Laurel, N.J., man knows exactly how it feels.


I talked with Earl, who visited his CVS pharmacy for a prescription eye medication. He carefully read the box, which said to put a drop in the left eye every six hours.


When Earl later read the paper instructions, he saw that the medication was for "ear use only."


"I called CVS and found that they gave me the wrong medicine. Now I have only one good eye, and CVS didn't even say they were sorry," said Earl.


No apologies

Not hearing "I'm sorry" after a pharmacy mistake is typical, according to one California-based pharmacist who spoke on condition of anonymity.


"We are told to never apologize for giving a wrong prescription because it automatically implies guilt. I suppose the company wants to leave that to the attorneys," the pharmacist said.


Unfortunately, pharmacy errors happen more frequently than you might think. The Institute of Medicine took a hard look at prescription errors, including those in hospitals and long-term-care facilities. The study, released in July 2006, showed that at a minimum, 1.5 million consumers annually are killed, injured, or made sick by drug errors.


How they happen

ConsumerAffairs.com contacted pharmacists across the country in an attempt to learn how mistakes happen -- and what you can do to make sure it doesn't happen to you. Not surprisingly, many of those we contacted did not want their name or city published.


So how do mistakes happen?


There were common themes among pharmacists we interviewed.


Unreadable prescriptions. "I don't know how some doctors ever passed med school with their lousy handwriting," commented one New Jersey pharmacist. "I have to call the doctor to verify the script, then I can't reach the doc, and the whole time the customer is waiting for their medicine."


"If I see one big problem, it's with the doctor's writing," said Dan Freund, owner of a Medicap pharmacy in Farmington, Mo. "If I'm wrong about one little letter, it could change the name of the drug. It's even worse if it's a first-time customer. And I'm trying to read this chicken scratch while working in a busy environment."


Never-ending distractions. "It's nothing to have someone on the phone, someone at the drive-through, all while you're trying to fill a prescription. And then someone walks in and starts asking questions," said Susan Freund, Dan's pharmacist wife and partner at the Missouri pharmacy.


"In pharmacy training, it is drilled into each student that before the prescription is given to the customer, that script needs to be checked three times for accuracy," Susan Freund said. "But, unlike a surgeon who is working in a relatively quiet atmosphere, we're sometimes trying to verify things in the middle of a phone-ringing circus."


Working in a hectic pharmacy might come with the territory, but when it comes to reading a doctor's handwriting, one possible solution might be to get rid of the paper prescription.


Some physicians are now moving to a paperless prescription process. One example is Dr. Raul Borrego, a Missouri internist.


"Moving to paperless has slowed me down, but I have no doubt that the chance of a prescription error will lessen," he said. "Instead of just jotting down the drug and instructions, I have to input everything into a laptop computer.


"It's a very precise system. Once I choose and verify the drug, I then must choose the dosage, frequency, etc. The pharmacy will receive it in text, so they don't have to read my writing. Even my wife says I have terrible handwriting," Borrego said.


'Don't trust us'

It might sound odd for pharmacists to say we shouldn't trust them, but that's what several told us.


"I wish more people would ask questions," said one Illinois pharmacy tech. "I consider myself good at what I do, but I know I have made a mistake in the past. Customers have to realize we are as human as they are."


What you can do

There are measures you can take to help ensure your prescription isn't among the hundreds of thousands that go awry each year.

  • Stay up-to-date on your condition and medication. Ask your doctor the name of the drug and why it is being prescribed. Once at the pharmacy, ask the same thing. One simple question from you could alert the pharmacy to a possible error.

  • If your doctor writes the prescription on paper, ask him or her to write why the drug is prescribed. For instance: "Toprol 100 milligrams for blood pressure." Make sure you can read the prescription. If you can't, maybe the pharmacy can't either.

  • If the physician sends the prescription electronically, ask for a copy.

  • If the prescription is called in, ask the doctor the exact name of the drug. Make a note of it and compare it to what the pharmacist gives you.

  • Verify that your name is on the bottle and packaging. Make sure you're not getting a prescription intended for another person with the same last name.

  • Are you filling the prescription at the beginning of the month? According to research, there is an increased chance of error at busy times.

  • Use the Internet to your advantage. Before taking any medication, verify what the drug is, based on color, shape, or the imprint code. Two good resources are the Pill Identification Wizard from drugs.com, and the RxList Pill Identification Tool.

Mistakes do happen

What happens when the pharmacy makes a mistake and you know it? ConsumerAffairs.com receives many complaints about drug errors and questions about how to handle the situation.


Suvithia, of Frisco, Texas, wrote that after she received the wrong prescription, the insurance company for Walgreens offered an "apology compensation" in hopes of keeping the case out of court.


"The insurance company offered $350," Suvithia said. "My husband and I declined their offer and then we received a letter offering a $1,000 settlement."


What should you do when mistakes happen to you? The answer depends on whether you have been seriously harmed or merely inconvenienced.


If you or a family member suffer grievous harm from an incorrect prescription, or if someone dies because of a pharmacy error, do not contact the pharmacy. You should never try to negotiate a settlement yourself, and you should not communicate with the pharmacy in any way. You can only hurt your case.


Instead, collect all the evidence -- any remaining medication, hospital and doctor bills, receipts, death certificates, etc. -- and lock them up in a safe place, preferably a safe- deposit box.


Also take notes. Write down what happened and when, and get the names of doctors, nurses, pharmacists and everyone else who played a role in the accident. Do it now, while your memory is fresh. Put the notes in the safe-deposit box with the rest of the evidence.


Once you have secured the evidence, you must find the most accomplished and most experienced personal-injury lawyer in your area.


If you are not seriously harmed, but you believe the pharmacist should be held accountable for being negligent, file a complaint with your state pharmacy board.


Each state's board has an established complaint procedure. You can find a list of the state boards at the National Association of Boards of Pharmacy Web site.


Other articles of interest at ConsumerAffairs.com:

Published Nov. 8, 2007
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