Any time that a patient is hospitalized, transferred to a new facility, or sees a new physician in an office setting, a healthcare provider—typically a registered nurse (RN)—obtains a medication history from the patient. This is the first step in a process that is called medication reconciliation.
At some doctor’s offices, clerks hand patients a stack of paperwork to fill out, burying the medication history form among them. Patients can understandably get fatigued after filling out their Social Security number and birthdate on five different forms and may not put much thought into the medication history form. Thus, a nurse should always go over the medication history with the patient to make sure that the information is complete.
At other physician offices, and most hospitals and facilities, medication reconciliation begins with a nurse asking patients what medications they are taking.
From my experience as a Houston, Texas medical malpractice attorney, and formerly as a hospital administrator, I know that nurses, pharmacists, hospitals, and physicians vary on how well they complete medication reconciliation. In addition, some patients are not very thorough and do not recognize the importance of providing a complete medication list.
To boil it down, a comprehensive medication list is necessary to prevent a doctor, physician’s assistant (PA), nurse practitioner, or certified registered nurse anesthetist (CRNA) from prescribing a new medication that would be inappropriate.
Manufacturers and the U.S. Food & Drug Administration (FDA) provide contraindication and warning instructions that certain prescription drugs should not be ordered for patients taking other drugs. In addition, healthcare providers must be aware of all medications that a patient is taking to be able to appreciate how those drugs might change the patient’s clinical signs and symptoms. If prescribers do not know what drugs a patient is taking, then the contraindications and warnings may be useless.
I have handled medical malpractice lawsuits involving a variety of situations where the nursing staff did a poor job of collecting medication information from patients.
One case comes to mind, where a Sugar Land, Texas rehabilitation facility botched the medication list when an elderly patient was transferred from a hospital. Because of the mistake, the patient was overmedicated and ended up dying from a condition called polypharmacy, meaning the interaction of multiple drugs. The drugs should not have been prescribed together and basically put her to sleep until her body shut down completely. Meanwhile, the doctor was nowhere to be found and the nurses did not seem to notice that something was wrong.
What you can do
The healthcare industry realizes that the medication list and reconciliation is a big deal. Some hospitals have gotten pharmacists involved in taking an accurate medication history, because they typically do a better job than many doctors and nurses.
You can improve your safety as a patient and help whomever is tasked with collecting your medication history by keeping your own medication list in a diary or journal. It should include each prescription medication that you take, including the name of the drug, dosage, the date it was prescribed and by whom. Your list should also include any over-the-counter medications, as well as herbal and alternative medicines.
Keeping your own list provides a wealth of information to doctors, pharmacists, and nurses, and helps make sure that nothing falls through the cracks regarding your medication history. A thorough medication history should include both current drugs, as well as drugs that you have taken recently. Therefore, I recommend maintaining your list in a chronological format that goes back at least six months.
Any time you have a physician appointment or go to the hospital for an emergency room visit or admission, bring your medication list with you or provide a copy to your nurse or doctor.
We are here to help
If you or a loved one has been seriously injured or suffered a wrongful death from a medication error, overdose, or other medical malpractice, then Painter Law Firm is here to help. Click here to send us a confidential email via our “Contact Us” form or call us at 281-580-8800.
All consultations are free and, because we only represent clients on a contingency fee, you will owe us nothing unless we win your case. We handle cases in the Houston area and all over Texas. We are currently working on medical malpractice lawsuits in Houston, The Woodlands, Sugar Land, Conroe, Dallas, Austin, San Antonio, Corpus Christi, Bryan/College Station, and Waco.
__________
Robert Painter is a medical malpractice attorney at Painter Law Firm PLLC, in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits against hospitals, physicians, surgeons, anesthesiologists, and other healthcare providers. A member of the board of directors of the Houston Bar Association, he was honored, in 2017, by H Texas as one of Houston’s top lawyers. In May 2018, the Better Business Bureau recognized Painter Law Firm PLLC with its Award of Distinction.
