Following a medication-error related death and other medication-related problems that resulted in patient injuries, Minnesota Department of Heath investigators concluded that Fair Oaks Lodge in Wadena, MN was guilty of neglect and other federally mandated nursing home standards.
The ‘major medication errors’ occurred within 16 days of one another. According to the State’s investigative report:
- A medication aide mistakenly gave an Alzheimer’s patient drugs for her central nervous system, the heart and anti-psychotic medication all of which resulted in an immediate drop of her blood pressure. Despite being rushed to the emergency room, the elderly woman died three days later.
- A patient was hospitalized after receiving two does of Tylenol within two hours and an improper medication related to hypertension
- A third nursing home patient was hospitalized after a nurse administered medications a medication aide had intended for another patient.
Despite the serious medication-related problems at Fair Oaks, state investigators still found a medication error rate of 18% 2 1/2 months later. Read more about these medication errors in a nursing home here.
In the nursing home setting, some of the more common medication errors include:
Administering The Incorrect Prescription
Medication errors can result when there is a mis-communication or misunderstanding of drug orders. These errors may be due to: poor handwriting, confusion between drugs with similar names, misuse of zeroes and decimal points, confusion of metric and other dosing units, and inappropriate abbreviations. Doctors must take reasonable care in correctly and accurately writing prescriptions and staff must similarly confirm medication types and dosages when in doubt.
Medication errors can also occur when doctors take an incomplete medical history from a patient. For example, the doctor might not know about the patient’s allergies, any other medications the patient is taking, previous diagnoses, and lab results. Nursing homes should help treating physicians by ensuring that they provide the physician with accurate medical charts.
Failure to Consider Adverse Side Effects of Drugs
Many prescription (and over-the-counter) medications have serious side effects that should be considered before taking them. Some serious and common side effects include: allergic reactions, heart problems, liver and kidney failure, weight gain/loss, and psychological effects. The doctor prescribing your medication should consider the pros and cons of prescribing the medication as opposed to leaving the condition untreated or prescribing a different medication. Similarly, the staff in a nursing home, should monitor patients to help detect adverse reactions as quickly as feasible.
Incorrect Medication Dosage
Prescription medications have more serious dangers associated with them than over the counter (OTC) drugs. Therefore, it is important that nursing home staff issue the correct drug (the one the doctor prescribed) at the correct dose. At many nursing homes and medical facilities, medications are administered via a ‘medication cart’ where many similar-looking pills are stored. Consequently, staff in nursing homes must check and re-check before administering medication to assure the patient receives the proper dosage.
Medical complications may arise when patients are administered too much or too little of a drug. Many prescription medications require must be taken at a specific time, staff must be aware of these administration parameters and dispense the medication accordingly.
Adverse Drug Interactions
Many older adults, take multiple prescription medications, which are commonly prescribed my multiple doctors. However, problems can occur because the doctors prescribing these medications might not know about the other drugs you are taking. This can lead to serious complications stemming from drug interactions. Drug-drug interactions are not the only type of potentially dangerous drug interactions; there can also be drug interactions with foods, beverages, and dietary supplements.
There are three main types of drug interactions:
- Drugs with food and beverages
- Drugs with dietary supplements
- Drugs with other drugs
Drug interactions can reduce the effectiveness of drugs, cause unexpected side effects, or increase the action of a particular drug. Drug interactions with food and beverages might result in delayed, decreased, or enhanced absorption of a medication. Dietary supplements can also cause a variety of drug interactions, and with fifty percent of American adults using dietary supplements (vitamins, minerals, amino acids, herbs or botanicals) on a regular basis, the risk of negative drug interactions is high.
Nursing Home Liability for Medication Errors
Medication error cases can frequently be some of the more complex cases due to the fact that a variety of parties may be responsible for the error(s). In some cases, liability may be imposed on the physician, nursing home and pharmacy involved in the incident. Consequently, in order to fully investigate each parties culpability, it is important to speak with a lawyer experienced in handling cases involving medication errors as soon as feasible after the event.
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