Medication is a critical part of the healthcare experience, whether those drugs are administered in the hospital/clinic or picked up at the pharmacy. But most pharmaceutical drugs are tightly controlled because they can cause serious harm if given to the wrong patients, in the wrong dose or in combination with certain other medications.
Although exact statistics are sometimes impossible to obtain, it is estimated that each year in the United States, about 1.5 million patients are harmed by medication errors. Harm can range from adverse reactions to permanent injury to death. When a healthcare professional makes a medication error that leads to patient harm, it is often considered to be medical malpractice.
Common categories of medication errors
There are many ways that things can go wrong in the administration of medicine. Here are some common types of errors:
Dosing errors: The physician (or someone preparing the medication) delivers the wrong dose of medication to the patient. This may be because of illegible handwriting, a careless reading of the patient’s chart or simply being distracted while dosing the medication. An incorrect dosage is most likely to be harmful if it is too high rather than too low.
Dangerous drug interactions: Some drugs should not be taken in combination with others because they can interact dangerously in the patient’s body. Physicians are supposed to thoroughly check a patient’s medical history and their list of other medications to ensure that a newly prescribed drug won’t interact with those the patient is already taking.
Drug allergies: Again, these are often the result of a physician’s failure to carefully read (or collect) a patient’s medical history. Patients can be severely harmed if given a drug containing ingredients they are allergic to.
Pharmacy errors: There is a “chain of custody” for prescriptions, often running from doctors to nurses to pharmacists. Medication or dosing errors can happen anywhere along the chain. Pharmacists may issue the wrong dose or the wrong medication (particularly if there are similar-sounding medication names). In some cases, a patient picking up at the pharmacy may be given a different patient’s medication by mistake.
Hospital culture can increase risks of mistakes
The practice of medicine in many American hospitals and clinics is strictly hierarchical, and that can be dangerous if people lower in the hierarchy are discouraged from asking questions. There are doctors who will not tolerate anything they see as dissent or questioning of their judgment. In environments like this, a nurse may notice a medication error in time to fix it but doesn’t do so because she fears that the doctor will be angry that his instructions weren’t followed.
This type of authoritarian culture increases the risk of all types of medical mistakes, not just those related to medication.
Be Your Own Advocate
Most of us would like to trust the doctor and assume that the drugs we are receiving are appropriate for us. Unfortunately, doing so can have dangerous consequences. You have the right to ask as many questions as you need to about what drugs you are being given, what the dosages are and what the risks may be. Being willing to speak up could just prevent a serious medication error.