Doctors and nurses have around 10,000 prescription drugs at their disposal, medications that can drastically improve the lives of patients or cause irreparable harm when administered improperly. As a nation, we rely on pharmaceuticals more than almost any other country. Nearly one in three adults in the United States are currently taking five or more drugs, the Agency for Healthcare Research and Quality reports.
Epidemic Of Drug Errors Continues
The widespread prescription of pharmaceutical medications has undoubtedly led to major advances in patient health, but licit drug use is not without its dangers. Dangerous medication interactions are increasingly common in the private home, leading to debilitating disorders and even death. The situation becomes even more complicated, and no less perilous, when we enter the halls of medical facilities.
Most patients are not allowed to bring their own medications to the hospital. Instead, the task of selecting and administering the appropriate drugs is given over to the facility’s staff. This requirement shouldn’t surprise us. Doctors and nurses want to control what goes into our bodies – and they should. Your surgeons and anesthesiologist need to know exactly what you’ve taken to reduce drug complications and monitor your health.
Alongside their pre-existing prescriptions, most patients will be administered a slate of new medications. Antibiotics to reduce the risk of a hospital-contracted infection. A benzodiazepine anxiety drug to cut the nerves before surgery. Opioid painkillers to help manage the discomfort of an invasive procedure, along with stool softeners to treat the constipation that often accompanies opiate use. Warfarin or other blood thinners to decrease the likelihood of a life-threatening blood clot. No matter their particular medical conditions, most patients will find themselves swimming in a new chemical cocktail on the ward.
More Than Half Of Drug Mistakes Are Preventable
Medical errors in hospitals, nursing homes and other medical facilities remain shockingly common. According to a 2007 report from the Institute of Medicine (now known as the National Academy of Medicine), the average hospitalized patient experiences at least one medication error every day. These risks threaten patient health at every step in the medication process, from prescription and dispensation to administration and monitoring. Prescription and administration errors, however, are most frequent, at least in the hospital setting.
Even more shocking? An estimated half of these “adverse drug events” are preventable. That’s right. Millions of damaging medication errors, some with devastating consequences, could be avoided, but aren’t. Moreover, some tens of thousands of patients every year are injured by “ameliorable” adverse drug events, ones that, while not completely preventable, could have been mitigated in some way.
The 4 Most Dangerous Drugs In A Hospital
Medication errors are a huge problem, one that harms patients and families every day. Despite this far-reaching problem, a select group of four drug types are responsible for over 50% of all the emergency room visits linked to adverse drug events:
- antidiabetics – insulin
- anticoagulants – blood thinners like warfarin
- antiplatelets – aspirin
- opioids – morphine and oxycodone
Many drugs used both in outpatient and inpatient settings are surprisingly difficult to administer. The Agency for Healthcare Research and Quality points to heparin, a blood thinner delivered intravenously.
Heparin, along with warfarin, comes with a high risk of harm, in part because the drug’s dosage must be calibrated exactly to account for a patient’s weight and pre-existing medical conditions. Dosing is just one part of the equation, however. After heparin is administered, the patient must be monitored closely. Blood tests are conducted to ensure that the patient’s blood clotting ability remains within a healthy window. Too much heparin and internal bleeding could result. Too little heparin and the drug doesn’t work, allowing blood clots to form.
Causes Of Medication Errors
A medication error could occur at any point during this process. A doctor, for example, could prescribe the incorrect dosage of heparin, leading to disaster. Or a nurse could administer the wrong amount of the drug, even though the prescribing physician had hit on the right quantity.
After administration, a moment’s carelessness during the monitoring phase could allow the patient’s level of heparin to slide outside of the safe range. Even earlier, the doctor could prescribe the wrong blood thinner entirely, failing to account for a patient allergy or potential drug interaction. Or the nurse, despite being provided with the correct prescription, could choose to administer the wrong medication, perhaps one that looks or sounds like the right drug.
These mistakes would all be classified as medication errors. In many cases, they could also be classified as examples of medical negligence, a legal concept that rests at the heart of every medical malpractice lawsuit.
Proving Medical Negligence
Doctors, nurses and hospitals have a basic duty to provide their patients with adequate care. We’re not asking for superheroes who can cure any disease without even touching a stethoscope. We’re talking about adequate care, what we would expect a reasonable, similarly-educated medical professional to provide. No obvious mistakes. No disastrous communication breakdowns in the operating theater. No unproven treatment methods or experimental techniques.
What Is A Standard Of Care?
Every medical situation comes with a standard of care. It’s how logical, sufficiently-knowledgable practitioners would act in the same situation. For obvious reasons, standards of care change. The standard of care for administering heparin won’t be the same as for administering an opioid painkiller, since the drugs are different and have very different effects on patient health. In either case, however, there is a standard, one developed over decades of medical research and clinical experience. Medical professionals are bound, both ethically and legally, to adhere strictly to the applicable standard of care.
Violating The Standard
Medical negligence is what happens when a practitioner fails to uphold their standard of care, allowing harm to befall a patient. Notably, a negligent act (or failure to act) need not be intentional. People who file medical malpractice lawsuits don’t have to prove that a doctor or nurse wanted to hurt them or their loved one. A large number of malpractice suits revolve around what are essentially mistakes, since we hold doctors and other medical professionals to a high level of practice. Errors just aren’t acceptable when lives are on the line.
Our civil legal system understands this, allowing patients who have been hurt to secure financial compensation after becoming the victims of medical errors and lapses in judgement, in addition to reckless or intentional misconduct. Intentions aren’t inconsequential, however. For example, medical professionals who are deemed to have acted with particular disregard for patient health can be hit with punitive damages, increasing an injured patient’s award exponentially. In Pennsylvania, punitive damages are regulated by the State. When a patient secures punitive damages, 25% of that award goes to the MCare Fund, a special trust that helps pay for the claims of other injured patients.
Not every medication error is appropriate for a medical malpractice lawsuit. In addition to defining a standard of care, and explaining how a doctor, nurse or pharmacist deviated from that standard, patients must prove that the medical professional’s negligence directly caused their injuries. Simply prescribing the wrong medication isn’t enough, when that mistake doesn’t have any consequences.
What patients must show is that their injuries would not have occurred but for the medical professional’s mistake. In some cases, proving causation can be difficult. Most hospital patients, for example, already suffer from medical conditions, some extremely serious. Many doctors attempt to argue, in their own defense, that a patient’s injuries actually occurred as a result of these pre-existing conditions, rather than a medication error.
In other cases, physicians will try to shift blame, noting that, while their own actions may have been in error, some one else, like a nurse or pharmaceutical company, should shoulder the blame.
Experienced Medical Malpractice Attorneys
These are complex questions of medicine and law. As a result, medical malpractice lawsuits are often considered the most difficult negligence claims to win. Experienced representation is almost always required. The testimony of independent medical experts is also a must.
Pennsylvania’s Statute Of Limitations
Prompt action is another top priority. In Pennsylvania, injured patients have only two years from the date they discover (or should have discovered) that malpractice may have caused their injuries to file a civil lawsuit. Failing to meet this crucial deadline, known as the statute of limitations, could forfeit a patient’s rights entirely. Most cases filed after the statute of limitations has run out will be dismissed without compensation.