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Part 2: The Legal Risks of
Pharmacy Errors

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Overview

A pharmacist would be hard pressed to imagine anything worse than being responsible for an error that resulted in the death or serious injury of a patient. The psychological effect alone of seriously harming a patient would be difficult for most pharmacists to live with. Couple this with the stress and anxiety of a negligence lawsuit and a regulatory investigation and action by the state board of pharmacy, and the psychological effects can be devastating and career terminating.
The profession has recognized for several years that pharmacy errors, also called dispensing errors, are a serious problem. The Institute for Safe Medication Practices, a nonprofit organization formed in 1994, is dedicated solely to medication error prevention and safe medication use. The public is also aware and concerned. In January of 1995, the NBC Network program Prime Time Live produced a segment on pharmacy errors. In 2007, the ABC Network’s 20/20 Program aired a fifteen minute segment called “Pharmacy errors: unreported epidemic?”, which highlighted a few errors that resulted in tragic outcomes.
The pharmacy profession and corporate employers have spent considerable resources in an effort to reduce the problem. Increased automation and attention to workflow logistics have most likely had a positive effect on reducing errors. Nonetheless, errors continue and always will, because humans are fallible. Every system improvement, including automation, that is introduced to reduce errors will in itself be a new source of error. This does not mean, of course, that pharmacies should simply give up. Rather it indicates that pharmacies must continuously strive for quality improvement to reduce errors to the smallest number possible.
After briefly discussing the incidence and some common causes of pharmacy errors, this article will focus on the legal and regulatory issues related to pharmacy errors. For the purposes of this article, an error is defined as any preventable event that caused or could have caused patient harm. Pharmacy errors include errors of commission, such as dispensing the wrong drug, the wrong dosage of the drug, or entering the label information into the computer incorrectly. They also include errors of omission, such as failure to appropriately counsel and failure to screen for risks such as drug-drug interactions, excessive dosages, and prescribing errors.

Details

Publication Date: 09/18/2013
Expiration Date: 09/18/2016
CE Credit: 1.0 (0.10 CEU)
Type of Activity: Knowledge-based

This program was developed by The Rx Consultant and published by Continuing Education Network, Inc. The Rx Consultant accepts no advertising or financial support from the pharmaceutical industry and is funded solely by the purchase of programs. The Rx Consultant is dedicated to providing unbiased, balanced information to health care practitioners.

Programs developed by The Rx Consultant are written by health care providers with expertise in the topic area, peer-reviewed, extensively edited, and fact-checked. This development process was created to insure that every program presents information that is current, accurate, relevant to "real world" health care providers, and written in an easy reading, "plain English" style.

Authors

Richard R. Abood, BS Pharmacy, JD

Disclosure Statement

Mr. Abood reports no financial or personal relationship with any commercial interest producing, marketing, reselling, or distributing a product or service that appears in this issue.

Target Audience

This accredited program is targeted to pharmacists and nurses.

Goals & Objectives

At the conclusion of this program, participants will be able to:

    1. Outline at least 5 approaches for reducing dispensing errors and minimizing the risk of legal liability.
    2. List 3 policies or procedures that should be implemented when pharmacy errors are discovered after the drug has been dispensed to a patient. Discuss the pros and cons of apologizing to a patient for having made a pharmacy error.

Accreditation Statements

The Rx Consultant is a publication of Continuing Education Network, Inc.

Continuing Education Network, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education as a provider of continuing pharmacy education.

Continuing Education Network is approved by the California Board of Registered Nursing, Provider Number CEP 13118. Programs approved by CA BRN are accepted by most State Boards of Nursing.

ACPE Universal Activity Number: 0428-0000-13-014-H05-P


Exam & Credit Statement Procedures

Upon successful completion of this program and the post test (70%), 1.0 hours of continuing education credit will be awarded. To receive credit and your exam score, please complete the exam questions and program evaluation.

Editorial and Review Board

Chief Editor and CE Administrator


Terry M. Baker, PharmD

Managing Editor


Tracy Farnen, PharmD

Associate Editors


James Chan, PharmD, PhD
Pharmacy Quality and Outcomes Coordinator
Kaiser Permanente
Oakland, CA

Associate Clinical Professor
School of Pharmacy
University of California San Francisco
San Francisco, CA

Richard Ron Finley, B.S. Pharm.,R.Ph.
Clinical Pharmacist (volunteer faculty)
University of California, San Francisco (UCSF) Memory and Aging Center
Lecturer (Emeritus) UCSF, Department of Clinical Pharmacy
Health Sciences Clinical Professor, UCSF School of Pharmacy
San Francisco, CA

Consultant Pharmacist
Ray Dolby Brain Health Center, Sutter Health/CPMC
San Francisco, CA

Consult Pharmacist Aging and Adult Health Services
San Francisco Health Department
San Francisco, CA

Julio R. Lopez, PharmD, FCSHP
Chief of Pharmacy Service
VA Northern California Health Care System

Adjunct Clinical Professor
College of Pharmacy
Touro University
Vallejo, CA

Assistant Clinical Professor
School of Pharmacy
University of California, San Francisco
San Francisco, CA Adjunct Professor
Thomas J. Long School of Pharmacy
University of the Pacific
Stockton, CA

Visiting Associate Professor and Lecturer
Nursing School
Samuel Merritt University
Oakland, CA

Pamela Mausner, MD

Helen Berlie, Pharm.D. CDE, BCACP
Clinical Assistant Professor, Pharmacy Practice
Wayne State University
Detroit, MI

Ambulatory Care Specialist - Diabetes
Health Centers Detroit Medical Group
Detroit, MI

Senior Editorial Advisor


Gerard Hatheway, PharmD, PhD

Editorial Advisors


Belinda M. Danielson, RPh
Christopher M. DeSoto, PharmD
Angie S. Graham, PharmD
Cynthia Chan Huang, PharmD, MBA
Fred Plageman, PharmD

Editorial Advisor and Clinical Practice Consultant for Nurse Practitioners


Emily K.
Meuleman, RN, C, MS

About the Rx Consultant

The Rx Consultant is a monthly publication dedicated to providing health care professionals with the information they need to educate patients about drugs and manage drug therapy. The reader is responsible for confirming the information presented here and interpreting it in relation to each patient's specific situation before utilizing the information.

Technical Specifications

Hardware requirements

Any hardware that supports Microsoft Windows, Apple Mac OS, iOS, or Android, and meets the software requirements.

Software requirements

Browser that supports TLS 1.1 + and PDF files.

This includes Microsoft Internet Explorer 11, Google Chrome 38, Google Android OS 5.0 Browser, Apple Safari (version 7 for desktop, 5 for mobile), Mozilla Firefox 27, newer versions of these browsers, as well as some earlier versions that may require additional configuration.

Adobe Acrobat Reader is recommended, and is required for some browsers.

Note: TLS 1.1 and 1.2 support is required for browser security. Click here for TLS browser support details.

Internet Connectivity

Required. Broadband recommended. (T1, DSL, Cable, G4 or higher.)

Contact Us

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The Rx Consultant
rxmail@rxconsultant.com
1-800-798-3353

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The Rx Consultant
editor@rxconsultant.com
1-800-798-3353

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