Investigating a medication error as the basis for a medical malpractice claim requires a clear understanding of the way that medications are prescribed and dispensed. Medication error lawsuits typically involve serious injury or wrongful death as a result of an overdose, missed dose, misfilled prescription, administration of the wrong drug, or drug interaction. A patient’s death or serious injury associated with a medication error (e.g., errors involving the wrong drug, wrong dose, wrong patient, wrong time, wrong rate, wrong preparation, or wrong route of administration) is considered a “never event” by the Center for Medicare and Medicaid Services. Never events are, as the name implies, things that should never happen in a hospital. Medication errors account for about 2% of all never events, and remain the leading source of errors in Ohio hospitals.
There are a variety of standards of care that apply to medication administration, depending on where the medication is being dispensed from and who is dispensing it. Generally speaking, under Ohio law, only licensed physicians and certified nurse practitioners can prescribe medications. Only a registered nurse can administer a medication in the hospital or long-term care setting. And, only a licensed pharmacist can dispense drugs on an outpatient basis.
When investigating a medication error that results in harm, a medical negligence attorney would want to obtain all relevant medical records. In an outpatient setting this might include the doctor’s entire office chart. When a pharmacy is involved in a prescription error, pharmacy records would, of course, be obtained. In a hospital setting, the relevant records would include the Medication Administration Record (MAR), physician orders, lab results and discharge instructions. Other important information might include the following:
- A complete list of the patient’s medications.
- The patient’s medical history including all past surgeries and chronic medical conditions.
- Medication allergies.
- Information about the drug’s uses, contraindications, side effects and dosing.
- Subsequent treatment records, including any toxicology report.
- Autopsy or cause of death when a fatality occurs.
A thorough investigation requires inquiry into whether the medication was indicated in the first place. You would also want to know whether the medication is a dangerous drug that is subject to a class action lawsuit. Was the drug dosed consistent with dosing recommendations? Did the drug carry side effects or interactions with drugs that were not discussed with the patient. Was the drug and its dosage explained in clearly written discharge instructions? And, ultimately, was the drug prescribed and administered in an appropriate dose? These are general considerations. Additional points of inquiry might arise on a case-by-case basis.
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