In my legal practice as a Houston, Texas medical malpractice attorney, I have represented countless clients who experienced problems as a result of medication issues. These problems come in a number of shapes and sizes.
Pharmacy and dosage errors
One kind of medication problem is dosage or pharmacy errors. I recently settled a case against MD Anderson Cancer Center, in Houston, Texas, where the doctor ordered one dosage of a medication and the hospital pharmacy filled and dispensed a dosage 1,000 times stronger. Our expert in that case said that the medication overdose caused the patient to develop a brain hemorrhage and die.
Drug warnings and contraindications
Another medication problem is when a doctor, physician assistant, or nurse practitioner prescribes medications that are contraindicated or warned against for a patient.
A drug contraindication means that the manufacturer and the U.S. Food & Drug Administration have found that, based on research, the medication should never, under any circumstances, be given to patients with specific conditions or who are taking other drugs. For example, the manufacturer’s label for the anti-vomiting medication Zofran has a contraindication on it for patients with a certain heart disorder known as a prolonged QT interval. I represented the family of a patient who died during a routine upper endoscopy. We sued the anesthesiologist and certified registered nurse anesthetist for giving the patient Zofran before the procedure, despite the fact that her cardiac clearance showed a prolonged QT interval.
A drug warning differs a bit from a contraindication. For a drug warning, research shows that there is an increased risk in prescribing a medication for a patient with certain medical conditions or who are taking certain drugs, but there is not an absolute prohibition in place.
For both drug contraindications and warnings, the pharmacy must have a system in place to prevent filling and dispensing the drug automatically. For contraindications, the system should block processing the prescription altogether. For warnings, the standard of care requires the pharmacist to consult with the prescribing healthcare provider before releasing the medication to the patient. The purpose is to make sure that the prescriber took the additional risk into account and has exercised independent medical judgment when ordering the medication.
Unnecessary drugs
A medical trend that I have noticed over the last several years is how many patients have been prescribed, and are taking, many unnecessary medications for long periods of time.
I believe that this happens most frequently when patients see a number of health care providers who prescribe different medications for them. For example, a person may take medications prescribed by a family practice doctor, cardiologist, and rheumatologist. Quite often, in reviewing records in medical malpractice cases, I have noticed that medications are ordered for health conditions and continued month after month for years—with no real evidence that prescribing physicians ever thought about whether they continued to be needed.
Of course, the more medications that a person takes, the greater the risk of drug-drug interactions. In addition, it becomes more challenging for patients to keep their healthcare providers in the loop regarding drugs ordered by other individuals.
A December 2017 Forbes article focused on another problem regarding prescription medications. Many doctors over-hype the benefits of new drugs without fully disclosing all the facts. Surprisingly, some peer reviewed medical journals, including the respected New England Journal of Medicine, contribute to the over-hyping through the careful, deliberate use of selected statistics.
Forbes posed the question of how excited would you be about a new drug that reduced your risk of heart attack, stroke, of cardiovascular death by 1.5%. What if, instead, you were told that it could reduce those outcomes by 20%?
Statistically, those numbers are the same, but the 1.5% figure has a much greater decision-making impact on patients. The drug in question reduced the absolute risk of those conditions by 1.5%. The same drug lowered the relative risk by about 20%, meaning a reduction of risk from 7.4% to 5.9%.
What you can do
When it comes to medications, there are a number of things that you can do to improve your safety as a patient. Provide this list to your doctor, nurse practitioner, or physician assistant on each visit, to make sure your medical record is updated. This important information will help them avoid ordered new drugs that can dangerously interfere with your current medications.
First, keep a list of all medications, including who prescribed them and when, as well as dosages.
Second, always fill your medications at the same pharmacy. That way, the pharmacy’s computer system will have information about all of your drugs and will generate contraindication or warning messages, as needed, before new prescriptions are filled and dispensed to you.
Third, always accept or ask for counseling when picking up a new medication at the pharmacy. It only takes a few minutes. Ask the pharmacist if the drug poses a particular risk to medical conditions that you have, or any of the medications that you are currently taking.
Fourth, talk about your prescription medications with your healthcare providers. If you have been taking a drug for a long time, ask if it is still needed. Is it possible to taper off or discontinue a medication? When your doctor recommends a new drug, ask about the “absolute risk reduction”—in other words what does the drug do and what does the medical literature show about how it may actually help you.
We are here to help
If you or a loved one has been seriously injured as a result of a drug or medication issue, or any type of medical malpractice, call Painter Law Firm, in Houston, Texas, at 281-580-8800, for a free consultation about your potential case.
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Robert Painter is a medical malpractice and wrongful death attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who files medical negligence lawsuits against hospitals, clinics, doctors, surgeons, and other healthcare providers on behalf of patients and family members.
