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As patients, we entrust our health to a variety of medical professionals. We often think of the role doctors play in our well-being, but pharmacists - the gatekeepers of the medicine that doctors prescribe - also play a crucial part.
Like other medical errors, pharmacy mistakes can have serious consequences. According to a 2009 ABC News report, medical mistakes are the eighth-most-common cause of death in the U.S., and pharmacies account for a large portion of those errors.
We occasionally hear stories about the aftermath of these errors, like the Houston woman who last fall sued the pharmacy she says filled her daughter's medication at 10 times the prescribed dose, causing her death. But most people have no idea how frequently these errors occur. I know I didn't until it happened to me. In December, my four-year-old Labrador retriever was prescribed a medication to help with a condition related to her cancer. The pharmacist at a West Chester, Pa., Rite Aid mistakenly filled the medication at three times the prescribed dose, putting my dog's life in danger. Fortunately, she recovered from the overdose after two nights at the emergency veterinarian.
It turns out that dispensing the wrong dose of a prescribed medication is one of the most common pharmacy errors, along with dispensing the wrong drug and providing incorrect instructions. And while we know these errors occur all too frequently - a pharmacy auditor I consulted called them "fairly common" - we don't know exactly how frequently because many cases are never reported and even fewer are publicized. With Americans these days taking more prescription medications than ever before, we should expect these errors to increase.
Even worse, victims of these mistakes often have little recourse. Many states do not require pharmacies to report errors, and few do so voluntarily. While patients can report mistakes to state pharmacy boards, punishments are often light or nonexistent. In the absence of a legal judgment against it, a pharmacy is not required to reimburse a victim for damages incurred because of an error. Even when a pharmacy does agree to pay for its mistake, it often requires the victim to agree to non-negotiable settlement terms. In my case, Rite Aid offered a settlement that included a clause forbidding me from ever talking about the incident. When the company rejected my request to remove the clause and refused to pay the veterinary bill without my agreement to it, I effectively paid $866 for the right to tell my story here.
Many victims have no choice but to agree to these settlements. Most Americans have little or no financial cushion and can't afford to pay unexpected bills. Agreeing to a settlement is a quick way to get the bills paid, though settlements may not come close to covering costs of long-term damages. Filing a lawsuit can be prohibitively expensive, takes time, and further postpones needed restitution. And winning a lawsuit is never a sure thing. Thus, many victims are left with a tough choice: agree to the settlement terms and be reimbursed, or get stuck with the damages.
More needs to be done to prevent these incidents and empower victims. We need to determine the source of these errors, whether that's overworked pharmacists, inadequate safeguards, or illegible prescriptions. We need policies in place that require pharmacies to report all errors. We need an oversight body that will consistently dole out appropriately harsh penalties. And we need to work to reduce barriers for victims to take legal action when necessary.
Until more support is available, it will be up to patients to take an active role in protecting themselves and their families. Patients should write down all prescription information, including the drug name, dosage, and doctor's instructions, and make sure the filled prescription matches. If you can't read your doctor's handwriting or the prescription is called in or electronically submitted, don't be afraid to ask your doctor for this information. In addition to reading the pharmacy-provided information about the drug's appearance, it's a good idea to check online for images of your drug. Try the Drugs.com Pill Identifier. And if you do become a victim of a pharmacy error, take the time to file a formal complaint with the pharmacy and the State Board of Pharmacy.
Pharmacies clearly are good at keeping these incidents quiet, but they need to get better at preventing them in the first place. The public must demand higher standards when it comes to our health and the health of our families.
Pharmacy has gone from being a professional service (though often misguided) to being a production line.
Individually pharmacists have much to be blamed for, especially endangering clients by not performing due diligence on the information that's pushed on them by big pharma - which directly and indirectly is nearly all the info they get unless they are truth seekers.
But working pharmacists hate the production line box they've been pushed into by business management strategies - cutting staff, hugely increasing work load, not allowing time to trouble shoot problems, etc. If you've ever seen the old TV skit about Lucy (Lucille Ball) in the candy factory -- that's what it's like. The pharmacy staff are faced with increasingly impossible demands and decreasing resources to meet them.
Safety concerns are dealt with by "managing" them away. Essentially that means making the working staff sign lots of documents that wind up assigning blame to the front line workers and providing legal cover for management and administration.
Same old same old in most jobs in the US now, I think. Definitely psychopathy at work.