A medication error can lead to serious injury or wrongful death.  A recent study shows that medication errors related to drug and supplement interactions are on the rise, especially among the elderly.  As medical lawyers, we have seen numerous cases involving a misfilled prescription or an overdose, but there has been a spike in cases involving injury caused by a drug interaction that should have been prevented by a doctor, nurse or pharmacist.  The Journal of the American Medical Association (JAMA) reported that the incidence of a drug interaction doubled among the elderly during the 5-year study period being reported on.

A major culprit in this rise is the increased use of prescription medication to treat chronic illness.  For example, researchers reported that the use of five or more prescription medicines by one patient increased from 31% of the U.S. adult population to 36%.  Likewise, the concurrent use of over-the-counter (OTC) medications such as dietary supplements, which can cause significant drug interactions with prescription drugs, increased as well.  We have also long known that pharmaceutical companies are promoting medications and influencing physicians’ prescribing patterns like never before.

JAMA Article on Drug Interaction

The JAMA article concluded as follows: “In this study, the use of prescription medications and dietary supplements, and concurrent use of interacting medications, has increased since 2005, with 15% of older adults potentially at risk for a major drug-drug interaction. Improving safety with the use of multiple medications has the potential to reduce preventable adverse drug events associated with medications commonly used among older adults.”  Frequently implicated OTC medications included antiplatelet medicine (e.g., aspirin) and dietary supplements such as Omega 3 fish oil.

Under Ohio law, a doctor owes a duty to monitor his/her patient’s medications in order to assure that the proper medicine is given in an appropriate dose.  This duty includes the duty to instruct the patient on the risks of the medicine, including known side effects and interactions.  When a physician fails to properly advise or monitor, and serious injury or a fatality results, a claim for medical malpractice may arise.  This duty extends to the pharmacy as well, since many drug interactions are reported as part of the package insert and should be known to the pharmacist.  A major medication error is almost always preventable.  However, the JAMA article reports that physicians frequently fail to ask about patients’ use of OTC supplements and medications.

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