Lawyer Resources for Medication Errors

Medication errors in inpatient medical facilities such as nursing homes are so commonplace that they are recognized as a common problem in the medical field. The facility’s medication error rate is identified by state inspectors who have to ensure that the error rate of medication errors be kept below an acceptable or standard percentage. While it is positive to note that state inspectors are keeping track, we also have to be realistic and wonder how many errors go unreported.

Dealing with these issues

It is true that minor medicine errors are inevitable. Especially when dealing with elderly patients, staff members may sometimes be confused about what medication is required. However, it is important to refrain from any severe medication errors. When looking at the definition, medication errors are mistakes that happen while administering or preparing medicine. This goes against accepted professional standards, manufacturer’s instructions, or doctor’s orders.

Examples of medication errors

To the untrained eye, it may be difficult to determine whether something qualifies as a medication error. However, once you have a better understanding of what constitutes a medication error, it is easier to be aware of them.

Splitting medications that should not be split – These include tablets, capsules, or other types of medication that specifically say, “Do not crush.”
Not having enough fluid – There are countless prescription medications that require the elderly patient to consume a certain amount of fluid when ingesting the medication. Improper hydration or not taking in fluid when taking the medication may actually cause harm to the patient.
Inadequate antacids or food – Just as some prescriptions require fluid, others require food. There are also medications that require the patient to take an antacid before ingesting the medication. It is important that the nursing staff ensure that patients follow the recommended guidelines regarding antacids, fluids, and food.
Not preparing the medication properly – There are a number of nursing home medications that require that it be shaken or mixed before the patient takes it. Without following the proper procedure, the resident is at risk of receiving too much or too little of the medication. For example, it is important to mix insulin suspensions without air bubbles before administering the medication.
Swallowing sublingual tablets – Sublingual tablets are administered by placing them underneath the tongue and allowing them to dissolve. However, some elderly patients will swallow these sublingual tablets instead. While once or twice might not be terrible, it is important that the staff recognize this is happening and address this as a reoccurring issue. Perhaps the medication needs to be altered to ensure proper ingestion.

Negligent errors

Because many nursing home facilities do not have enough staff members, it can lead to staff members feeling overworked or not paying attention to the small details. It may also cause them to feel rushed when administering medication. Some of the negligent medication errors include:

Outdated, or expired, elder medication order
Errors with lab work
Incorrect elder patient or documentation
Incorrect elder medication administration technique
Incorrect rate, duration, or time of medication administration
Using expired medication
Medication overdose or multiple doses
Medication dose omission or under dose

While a single wrong dosage is not likely to cause severe problems in most cases, if it happens consistently, it could lead to serious medical problems, possibly even death. If you suspect medication errors for your loved one, it is important to speak out to ensure that appropriate steps be taken to avoid these mistakes in the future.

Nursing Home Employees Plead ‘Not Guilty’ To Charges Related To The Intentional Chemical-Sedation Of 22 Elderly Residents

February 23, 2009 | Nursing Home Law Center Staff

Three employees of the Kern Valley Healthcare District’s skilled nursing facility have plead not guilty to multiple felony counts of elder abuse causing harm or death. The instances of nursing home abuse allegedly occurred between August 2006 and January 2007 when the employees intentionally over-medicated residents with anti-psychotic drugs at Kern Valley to keep them quiet and make them easier to handle.

The situation was brought to authorities attention by an unnamed healthcare ombudsman who witnessed a resident of Kern Valley being forcibly held down by nursing home staff and injected with drugs. In total, 22 residents of the California nursing home were believed to be intentionally drugged by the threesome. Additionally, the deaths of three residents are also believed to be related to the improper drugging.

Among the three nursing home employees charged:

Nurses Caught Administering Insulin To Non-Diabetic Nursing Home Residents

January 10, 2009 | Nursing Home Law Center Staff

New York Nursing Home inspectors were recently called to investigate Hilltop Nursing Home, following two incidents where nurses at the facility gave insulin to non-diabetic residents. The residents went into shock and were hospitalized. According to a report from the New York Department of Public Health, the two incidents were investigated following tips made on the telephone hot line. One of the insulin errors involved an LPN who admitted to being under the influence of narcotic medications not prescribed to her.

During the recent health department investigations, investigators also determined that nurses at the facility signed out narcotic medications for resident use, but there was no documentation that the medications were actually administered. Upon discovering this situation, the findings were turned over to the Bureau of Narcotics Enforcement.

Hilltop Nursing Home is a short-term sub-acute facility certified for 110 residents and has a staff of 200. It specializes in treatment of traumatic brain injury and pediatric care. Hilltop Nursing Home has been part of the government’s nursing home watch list or “Special Focus Facility” since 2006 when an 11-month-old boy stopped breathing for 20 minutes following the displacement of his breathing tube. The boy suffered brain damage from the incident. An inspection of the incident confirmed the boy received improper medical care and the staff failed to timely respond to alarms signaling a problem.

Never Event #2: Infection In Central Venous Catheters

October 12, 2008 | Nursing Home Law Center Staff

The second most frequently encountered ‘never event’ is an infection from a central venous catheter. Infections due to improperly maintained and inplanted central venous catheters accounted for 29,536 cases in hospitals in 2007. A central venous catheter is a tube usually inserted in an arm or chest and threaded through a vein until it reaches a large vein close to the heart. Central venous catheters are used to administer medication, supply nutrition or blood products.

There are three main types of central venous catheters:

PICC Line: A ‘peripherally inserted central catheter.’ PICC’s are the most common type of central venous catheter accounting for more than 50% of the vascular catherizations because it may be inserted relatively easily. PICC’s are inserted into a vein in the arm as opposed to the neck or chest.

Who Should Manage Administration Of Medication?

October 9, 2008 | Nursing Home Law Center Staff

The discussion on administration of medication at assisted living facilities at Inside Assisted Living, caught my attention. Inside Assisted Living is an extremely useful blog dedicated to helping residents and their families transition into assisted living facilities. A reader of the blog asked:

‘Ryan, my parents are now in an Assisted Living Community. I’ve been told that they must turn over administration of their meds to the Nurse. Problem is, that there is constantly problems with the meds given by the nurse, ie. meds from another patient, not given at proper time, cannot identify the pill, not all prescriptions given. They tell me that this is a Federally mandated law that my parents cannot self administer, is this true?’

Ryan, the blog administrator gives some excellent advice when addressing this frequently encountered situation dealing with medication errors. If the resident of an assisted living facility is capable of administering medication, they should generally be able to do so. I must agree, with Ryan that once a facility takes on an important responsibility, such as the administering medication they must do so in a safe manner.

Half Of Nursing Home Residents Wrongly Drugged

September 9, 2008 | Nursing Home Law Center Staff

Ever go into a nursing home in the middle of the day? While the rest if the world busy about their business, many nursing home residents are sound asleep or staring blankly at the ceiling. Even may of the residents who appear to be awake have a dulled look in their eyes.

A new British Study suggests that many of the nursing home residents who appear to be in trances may be improperly medicated. In a study of 22 nursing homes, 51% of residents were give inappropriate drugs including anti-psychotics, antidepressants and painkillers. Frequently, anti-psychotic drugs are used to treat dementia and Alzheimer’s patients even though the drugs were not intended for those residents.

The use of medications is not only inappropriate it may be downright dangerous. Recently, evidence has come forward linking popular anti-psychotic medications such as: Clozaril, Risperdal, Abilify, Seroquil and Zyprexa to an increased risk of stroke.

Failure To Provide Medication Is A Common Error In Nursing Homes

August 26, 2008 | Nursing Home Law Center Staff

Failure to provide medication is a common problem facing nursing home residents. Many situations involving failure to provide medication result from problems with the transition of a resident’s medical charts from a hospital or facility where they were prior to their admission to the nursing home. Nonetheless, nursing homes have a responsibility to provide quality care to their residents. This includes conducting an assessment upon admission to assure all medical needs are met.

Yesterday’s blog entry on the untimeliness of administration of medication reminded me of a case my office is working on. In our case, a Chicago-area nursing home failed to provide insulin to our diabetic client for several months. As a result of this nursing home neglect, our client went into Diabetic Ketoacidosis. Diabetic Ketoacidosis, is a life-threatening condition that develops when diabetics do not get enough sugar into their cells. The lack of sugar results in the development of fatty acids which cause chemical imbalance. iStock_000004270903XSmall

Diabetic Ketoacidosis can be detected by monitoring the level of sugar in the blood and urinalysis. Diabetic Ketoacidosis may also be accompanied by:

Bar Coding To Reduce Mistakes With Administration Of Medication

August 4, 2008 | Nursing Home Law Center Staff

A Kansas hospital is using a bar coding system- the same technology that allows grocery clerks to quickly scan bags of groceries– to help with verification when administering medication at the bedside.

Many hospitals, nursing homes and long-term care facilities are quickly seeking new ways to cut down on the number of mistakes involving medication errors. Following the lead of many health insurers, new Medicare rules will deny payment for avoidable errors made by hospitals and nursing homes.

Experts estimate that 40 percent of medication errors are made with the physician’s written order. But another 40 percent are made at the point at which medication is administered. “We know medication errors occur in hospitals… we want to cut down on that.” Jim Garrelts, a pharmacy director.