Prescription or medication errors arise when the wrong medication or an incorrect dose of the right medication is administered to a patient. Medication error represents the second most common cause of claims according to a 2013 review[1] of malpractice claims in the UK, Australia and the US. Human error is the cause and may give rise to a claim in medical negligence.

Here in Australia, it is estimated that 59% of Australians use prescription medication and that, of the 200million prescriptions written every year, a large proportion have some degree of error. [2]

What kind of errors might occur?

Prescription and medication errors can occur for several reasons and at various stages of the clinical process from diagnosis and treatment, to administration and discharge. The incorrect dose, incorrect type of medication, allergies to medication and missed dose are just some of the medication errors that can occur whether in a clinic, emergency department or hospital ward. Errors can also result from computer systems that do not have up-to-date patient information regarding medications allergies.

A medication or prescription error not only results in a person taking medication that is not clinically indicated, which may of itself cause injury or harm. It can also result in the person’s underlying illness or condition not being treated promptly or at all which, again, can cause injury or harm.  For example, if a person develops epileptic seizures and their GP mistakenly prescribes an antidepressant instead of an anticonvulsant, that person may suffer cognitive damage or physical injury from the seizures continuing without treatment. The repeated seizures may have been prevented had an anticonvulsant been prescribed.

Examples of common medication errors:

• A doctor makes a mistake deciding what medication is appropriate and writes a prescription for the wrong medication.
• A doctor intends to prescribe the correct medication but makes a mistake in transcribing the name of the drug onto the prescription or when rewriting a drug chart.
• The right medication is administered to the wrong patient.
• A mathematical error is made when calculating the correct dose.
• A pharmacist, nurse or another doctor misreads the doctor’s handwriting and dispenses or administers the incorrect drug or dose as a result.
• A nurse makes a slip-up during routine tasks such as checking the name and dose of a drug before administration.
• Mislabelling of the drug or misreading of the label on the drug, particularly where drugs have similar names.

Factors which increase the likelihood of medication error:

• Lack of prescriber experience, inadequate prescribing training.
• Deficits in drug knowledge (such as giving the wrong dose for older patients) coupled with difficulty accessing drug information.
• Failure to apply a protocol (for example, modifying the dose in the presence of renal failure).
• Non-existent drug protocols or guidelines or inability to access them on the hospital computer system because of difficulty accessing terminals or because too much time is required.
• Patient characteristics such as language barriers.
• No prior knowledge of the patient and complexity of the presentation.
• Systemic problems such as high workload and time pressures causing slips in attention or lapses of memory.
• Staff being busy, tired, stressed and/or engaged in multiple tasks causing them to potentially be distracted.
• Staff working in unfamiliar hospital areas or attending a patient who is not their prime responsibility.
• Poor communication and co-ordination between heathcare teams at the time of handing over care.

When will an error amount to negligence?

Medication and prescription errors do not always amount to medical negligence. To do so, it must be shown that:

In making the error, the practitioner failed to exercise the reasonable skill, care or expertise to be expected of a practitioner of his or her position;

AND it must also be shown that

The error caused harm or injury beyond the underlying condition the patient was being treated for. In some cases, the medication error does not result in any further material harm to a patient and, as such, compensation would not be payable because there has been no loss in the eyes of the law.

Our team can assist you by providing expert advice and legal support regarding your options. Contact us today on (02) 4929 3995 or info@catherinehenrylawyers.com.au or visit  www.chpartners.com.au

*The material provided in our information sheets is for general knowledge only and is not a substitute for independent legal advice. For further information about the issues affecting you, please contact one of our experienced and professional lawyers for expert advice.

[1] 2013 – The epidemiology of malpractice claims in primary care: a systematic review by Wallace, Lowry, Smith and Fahey.

[2] 2013 – Study on Information Induced Medication Errors by Rebecca Hermon & Patricia A.H. Williams.