I presented a hospitalist expert for deposition today in a pending case. The patient went into the hospital for a total knee replacement. Prior to that, he had been up and around, active and working. Within a few days after his surgery, he developed a hospital-acquired bedsore. His doctors felt he would benefit from a brief admission to the inpatient rehabilitation unit at the hospital.
During his stay at the inpatient rehab unit, his attending physician, a physical medicine and rehabilitation doctor, two wound consultants, and a variety of nurses dropped the ball and his condition dramatically deteriorated. They proceeded to discharge him to home, but he went to a different hospital a day later. He ended up requiring around 100 days of treatment at hospitals and skilled nursing facilities because of the poor care that he had received.
Before the deposition began, the hospitalist expert and I discussed how disappointing the care was in this case. It really looked like the doctors and nurses were just going through the motions rather than treating a patient who had real needs. The conversation moved on to some other cases.
I told her about another medical malpractice lawsuit that I am handling where three doctors and some emergency room nurses mismanaged a young man’s care in numerous ways. I remarked about how the ER doctor ordered a powerful medication that was contraindicated (never to be prescribed) for the patient’s condition, as well as some other drugs that had drug-drug interaction warnings based on other medications that he had been prescribed.
In the end, the contraindicated drug that he was prescribed caused him to have a massive stroke. I remarked that it could have all been avoided if the patient used the same pharmacy for all of his prescriptions. That way, the pharmacy’s computer could warn about any contraindications or drug-drug dangers, allowing the pharmacy a chance to contact the provider and counsel the patient before dispensing the drug. If the patient uses multiple pharmacies, though, any given pharmacy will not have all prescription information available.
I was surprised when the doctor commented how many hospitalists and other doctors go through the effort of telling their patients where they can purchase prescriptions for individual medications at the cheapest price. Walmart, for example, will fill prescriptions for many drugs for $4.00, while other pharmacies can charge many times more. Why not get the best deal for the same thing?
From a safety perspective, I recommend that patients use the same pharmacy to fill all prescriptions. Some consumers will understandably want to shop around when purchasing their medications.
What you can do
I think it is always a good idea to have a list of all medications that you take, so you can discuss it with your doctor and pharmacist.
You can improve your safety as a patient by talking with your doctor, nurse practitioner, or physician assistant about any new prescription. Ask about any contraindications or drug-drug interactions that come to mind.
Since 2014, Texas pharmacies must provide new and existing patients counseling with each new prescription drug order. Under the rules, a “new” prescription drug order is one that has not been dispensed by the pharmacy to the patient in the same dosage and strength within the last year.
When you go to fill the prescription at the pharmacy, always take advantage of the opportunity to receive counseling from your pharmacist. At many pharmacies, a pharmacy tech will check you out, hand you a prescription, and ask if you have any questions for the pharmacist. You should always say “yes.”
When speaking with pharmacist, share why you were given the drug and what overall conditions you have. Ask if the prescription medication has any contraindications or serious drug-drug warnings that you should know about.
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If you or someone you love has been seriously injured because of a medication or pharmacy error, our experienced medical negligence attorneys can help. Click here to send us a confidential email via our “Contact Us” form or call us at 281-580-8800.
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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. In 2017, H Texas magazine named him one of Houston’s top lawyers. Also in 2017, the Better Business Bureau recognized Painter Law Firm PLLC with its Award of Distinction.
