Are prescription errors classified as medical negligence?
29/06/20 | Medical Negligence
Most people reading this will have received some form of prescription from their GP or another medical professional in their life. It is one of the key actions that a doctor performs on a daily basis, with the goal of treating patients for a wide range of illnesses and conditions.
In the majority of cases, the role of prescriber is carried out professionally and accurately, and the patient recovers thanks to the medication provided. However, with over a billion prescription items dispensed each year by pharmacies across England, prescription errors do occur, and the implications of those errors can range from minimal damage and near misses, to far more significant harm inflicted on a patient.
With this in mind, in this article we will outline common types of prescription error and the potential causes of these, what consequences these mistakes can cause, and what your options are if you have been harmed as a result of being given the wrong prescription.
What are some of the common types of prescription error?
Research conducted by the Universities of York, Manchester and Sheffield released in 2018 revealed that approximately 237 million medication errors occur in the NHS in England every year.
While it is reassuring that over three-quarters of these cause no harm to the affected patients, it does illustrate that this is one of the most common types of negligence that someone can suffer, and therefore we feel it is important people know about some of the most common prescription errors.
However, it is important to distinguish between an error when prescribing medication, and an error when dispensing medication.
If the error occurs when the medication is being prescribed, the act of negligence falls on the shoulders of the GP or medical professional who wrote out the initial prescription. Conversely, if you take the prescription to a pharmacy and they do not give you exactly what is set out on the prescription, then it is the pharmacist that is at fault.
This is important for establishing who the claim should be brought against, if harm is caused by an incorrect prescription.
Common prescription errors can include:
- Prescribing the wrong dosage or frequency of the medication in question
- Prescribing the wrong format of drugs (e.g. prescribing a pill when the patient in question is supposed to take liquids)
- Prescribing an incorrect or inappropriate medication, or prescribing a branded product which does not perform the intended treatment
- Prescribing medication that conflicts with another medicine that the patient is already taking (e.g. Fluoxetine and Phenelzine or Warfarin and Diflunisal)
- Prescribing medication that does not take into account a patient’s physical condition (e.g. HRT medication for women who have undergone a hysterectomy as opposed to those who have not)
- Prescribing medication that the patient has a known allergy to
- Prescribing the medication in question for too long a period of time, or not monitoring and reviewing this for repeat prescriptions
- Not giving clear guidance to patients on how they administer the medicine or drug prescribed
- Not including sufficient details on the prescription
Fortunately, pharmacists are trained to be able to identify if anything on a prescription looks unusual or out of the ordinary and they will then contact the medical professional in question to query this with them. The Pharmaceutical Services Negotiating Committee (PSNC) details all the prescription checking procedures that pharmacists and dispensers should take to ensure it is valid and contains no noticeable errors.
This extra layer of checks can help lead to prescriptions quickly being adjusted without any risk of harm coming to the patient. However, as the pharmacist will not have as clear an understanding of the patient’s condition or symptoms as their doctor, it is not always possible for them to recognise if the information noted is incorrect.
Therefore, any apparent prescribing error is deemed to be the responsibility of the medical professional who filled it out and signed it. Consequently, this means they are responsible for any harm that may come to the patient as a result of this mistake.
But, as noted, a prescription error can also come as a result of negligence from the pharmacist or dispenser who receives the form from the patient. Common dispensing errors include:
- Mixing up patient prescriptions
- Incorrectly labelling medication
- Not keeping accurate records of which patient has been prescribed what medication
- Neglecting to give patients advice on how and when to administer their medication
- Keeping medication at an incorrect temperature, or not informing patients about how to store the medication at home
- Supplying fake medication, or not regulating suppliers who may provide fake/incorrect medication
- Failing to challenge a prescription that they believe is inappropriate or potentially harmful for the patient
In these circumstances, the burden of any harm caused to the patient as a result of a drug error would fall on the pharmacy that dispensed their medication.
What causes prescription errors?
The causes behind problems with prescriptions are varied, but in the majority of circumstances can be traced back to a clerical error as opposed to deliberate actions. These can include:
- The writing on a prescription being ineligible, or a typo made on a computer-generated prescription
- A lack of sufficient training for GPs or pharmacists in relation to safe prescription practices
- Problems with the GP or hospital’s computer systems
- A lack of robust checking of the condition or tests of the patient before providing them with a prescription
- Time pressures on medical professionals leading to medical administration errors
- Not conducting routine checks on the patient to identify if any changes to their prescription are required
What are the consequences of a prescription error?
As noted earlier, in more than 75% of prescribing errors, no harm comes to the patient in question. This can be due to the pharmacist, another medical professional or the patient themselves identifying the error before any medication is dispensed, or the medication prescribed not affecting the patient negatively.
This is backed up by a report published by the General Medical Council (GMC) in 2012, which highlighted that only 4% of prescription errors they surveyed were judged to be severe.
However, even if this only occurs in a handful of cases each year, it is important not to overlook the potentially serious consequences a prescription error can lead to. Practically all medications have side-effects alongside their primary function, and an excessive dosage could significantly enhance these or make the least common side effects more apparent.
On the other hand, if the dosages are too small or infrequent, or the medicine chosen is not correct, it could mean that the condition the medication is meant to treat is not managed, allowing it to cause further harm to the patient. The death of a woman last year who received the wrong prescription for a urine infection as a result of an electronic prescription error is a stark reminder of the harm that these mistakes can potentially have.
Indeed, prescription error statistics accrued by the Universities of York, Manchester and Sheffield estimated that 712 deaths each year can be directly attributed to adverse drug reactions (ADRs), while these could play a contributory role in anything up to 22,303 deaths annually.
While it is important to note that this is only a small fraction of the approximate 237 million prescription errors every year, this does not offer any comfort to those who are severely harmed as a result of prescription drug errors. That is why we work hard to guide and support our clients who have been affected by a medication error, either befalling themselves or their loved ones.
Making a claim for a prescription error
The economic impact of medication errors varies significantly based on the harm caused and the nature of the mistake – it can be as little as £60 for providing the wrong inhaler medication, to over £6 million in relation to claims involving anaesthetic dosage errors.
When we investigate claims for prescription errors, we will examine the paper trail involved in the issuing of the medication in question. This will include looking at the forms themselves for any obvious errors, and checking the records of the dispensing pharmacy to check what was actually provided to the claimant.
This is typically less open to interpretation than other forms of medical negligence claims, making it often more straightforward to establish what error or inaction led to our client’s harm, which will then support negotiations for compensation.
Putting things right after a medication error
While medication errors typically do not cause significant harm, it does not make them any less of a breach of a medical professional’s duty of care. So, when they do lead to severe complications for a patient, and possibly even death, it is crucial that those affected receive the answers, justice and compensation they are entitled.
If you have been affected by a prescription error or another form of medication mistake, our specialists have your back. While we cannot fix what has happened, we are dedicated to helping you secure the closure and resources you need to move forward from this incident.
For more information, get in touch with our team today.
All content contained within this article is meant for general information only – this should not be treated as a substitute for medical advice from your doctor or another healthcare provider. If you require legal advice specific to your situation, please contact our team directly.
Gadsby Wicks is not liable for any diagnosis made from the content of this article, nor does it endorse any service or external site linked to within the article.
Always consult your GP if you are concerned about your health and wellbeing, or speak to us if you require legal advice.