Medication malpractice, a form of medical malpractice, is a common but preventable problem in medical care. It happens when mistakes occur at any stage of the medication process—whether it's prescribing, dispensing, or administering medication. These errors can cause easily correctable short term problems or they can lead to serious complications and even injuries or death.
In this article, we’ll break down medication malpractice, what causes it, and how to prevent it. We'll also cover the legal consequences for medical professionals and share real-life case studies. By the end, you’ll have a better understanding of how medication errors happen and how to avoid them.
Read our definitive guide to the statute of limitations on medical malpractice here.
What Is Medication Malpractice?
Medication malpractice, commonly known as pharmaceutical malpractice, occurs when healthcare professionals make mistakes prescribing, dispensing, or giving medications. These medical errors can lead to significant harm, including overdose, dangerous drug interactions, unexpected side effects, an incorrect diagnosis, or even the failure to treat the problem requiring the medication.
Here are some common causes of medication malpractice:
- Wrong Diagnosis: This happens when a doctor prescribes the wrong medication because of a misdiagnosis.
- Incorrect Medication: Giving the wrong medication for a patient's condition or choosing the wrong type of drug.
- Drug Interactions: Failing to consider harmful drug interactions, which can lead to serious side effects.
- Dosing Errors: Prescribing too much or too little of a drug based on a patient's weight, age, or medical history.
- Overmedication: Continuing to prescribe medications without considering their long-term effects or exploring better alternatives.
Medication errors are a major concern. The World Health Organization (WHO) says that medication errors cost about $42 billion USD each year. This highlights the urgent need to address and prevent these errors.
Please see our recent blog explaining the increase in medical malpractice nuclear verdicts over the past 10+ years to read more about large monetary awards.
Why Medication Malpractice Is a Serious Problem
Medication errors aren’t just small mistakes—they’re a serious public health crisis. Here’s why pharmaceutical malpractice matters:
- Prevalence: Medication errors happen way too often. In the United States, the Institute of Medicine estimates that these errors lead to over 1.5 million preventable drug-related injuries each year.
- Consequences: Medication errors harm patients in many ways. They can cause extended hospital stays, unnecessary treatments, or even longer term health problems. Patients often experience emotional distress and anxiety, which can lead to a loss of trust in their healthcare providers.
Financially, these errors hit both patients and the healthcare system hard. In severe cases, medication errors can cause permanent disability or even death.
- Ripple Effect: Medication errors don’t only hurt patients—they also harm healthcare providers. These mistakes can ruin careers, drive up insurance costs, and undermine public trust in the healthcare system.
Hidden Factors Behind Medication Malpractice
Medication malpractice doesn’t just happen, several factors contribute to medication errors, from human mistakes to systemic issues and technological failures.
Here are some examples of medication errors:
Human Error
- Prescription Errors: Doctors sometimes make mistakes when prescribing medications. They might select an inappropriate drug, give the wrong dosage, or fail to consider drug interactions and patient allergies.
- Dispensing Errors: Pharmacists might hand out the wrong medication, mislabel drugs, or give unclear dosage instructions. These mistakes are more likely when pharmacies are understaffed or overwhelmed.
- Administration Errors: Nurses and doctors are responsible for giving the right medication at the right dose. When they make mistakes, it can lead to catastrophic results.
Systemic & Environmental Issues
- Communication Failures: Poor communication between doctors, pharmacists, and nurses is a top cause of medication errors. When doctors don’t clearly communicate dosage or drug instructions, it increases the risk of mistakes.
- Workplace Conditions: Overworked, stressed, and tired medical care staff are more likely to make errors. High-pressure environments are especially prone to medication mistakes, which leads to events such as emergency room errors and surgical errors in the operating room.
- Lack of Standardization: Hospitals or clinics without clear medication procedures increase the chances of errors. This is especially dangerous with high-risk drugs like chemotherapy.
Technological Failures
- EHR Issues: Electronic Health Records (EHR) can sometimes have outdated or incorrect data. If a patient’s allergies aren’t updated, doctors may prescribe medications that can trigger dangerous reactions.
- Medication Dispensing Errors & Prevention: Machines that dispense medications or scan barcodes can malfunction, causing mistakes like giving the wrong drug or dosage.
Educational Gaps
- Inadequate Training: Medical care professionals might not get enough training on new drugs or complex medications. This knowledge gap can easily lead to mistakes, especially with unfamiliar treatments.
8 Medications Commonly Involved in Medication Malpractice & Errors
Some medications are more prone to causing medication malpractice and medication errors. These drugs often have complex effects and can lead to risky interactions or challenging side effects.
High-risk drugs like blood thinners, insulin, and painkillers frequently cause issues when providing the wrong doses or subsequently failing to monitor patients carefully. Medications with narrow safety margins or similar names also lead to mix-ups. Let’s take a closer look at eight drugs that often cause these problems.
1. Antidepressants (SSRIs, SNRIs)
- Common Drugs: Prozac (Fluoxetine), Zoloft (Sertraline), Lexapro (Escitalopram)
- Medication Errors: Doctors sometimes prescribe antidepressants for issues such as anxiety or insomnia. Misdiagnosis or overprescribing can cause dangerous conditions like serotonin syndrome, which occurs when medications or drug interactions raise serotonin levels too high.
- Side Effects: Nausea, weight gain, insomnia, sexual dysfunction, and, in rare cases, suicidal thoughts—especially in younger patients.
2. Antipsychotics (Second-Generation)
- Common Drugs: Risperdal (Risperidone), Seroquel (Quetiapine), Abilify (Aripiprazole)
- Medication Errors: Doctors often prescribe antipsychotics for non-psychotic conditions like anxiety or mood disorders, leading to misdiagnosis. Sometimes, doctors mistakenly diagnose depression as bipolar disorder or schizophrenia.
- Side Effects: Weight gain, increased risk of diabetes, drowsiness, tremors, and tardive dyskinesia (involuntary muscle movements).
3. Benzodiazepines
- Common Drugs: Xanax (Alprazolam), Ativan (Lorazepam), Valium (Diazepam)
- Medication Errors: Doctors can overprescribe benzodiazepines for short-term anxiety, which can lead to dependence or mask other underlying problems. Misuse or mixing these drugs with other substances can also lead to overdose.
- Side Effects: Drowsiness, confusion, memory problems, and withdrawal symptoms. These drugs are highly addictive and pose serious risks when mixed with alcohol or opioids.
4. Opioids
- Common Drugs: OxyContin (Oxycodone), Percocet (Oxycodone/Acetaminophen), Morphine
- Medication Errors: Doctors can prescribe opioids without properly diagnosing the root cause of chronic pain. Using and/or overprescribing opioids to treat pain caused by mental health issues like depression or anxiety can cause addiction and other un-necessary complications.
- Side Effects: Constipation, nausea, respiratory depression, cognitive impairment, and drowsiness. Long-term use can lead to dependence, and overdoses can be deadly.
5. Stimulants (ADHD Medications)
- Common Drugs: Adderall (Amphetamine/Dextroamphetamine), Ritalin (Methylphenidate), Vyvanse (Lisdexamfetamine)
- Medication Errors: ADHD is sometimes misdiagnosed as a mood disorder or anxiety, leading to improper treatment. Doctors sometimes prescribe stimulants without fully evaluating the patient.
- Side Effects: Increased heart rate, anxiety, insomnia, appetite suppression, and the potential for addiction.
6. Antibiotics
- Common Drugs: Amoxicillin, Ciprofloxacin, Azithromycin
- Medication Errors: Doctors often prescribe antibiotics for viral infections like the flu or the common cold, even though antibiotics don’t work against these infections. Overuse of antibiotics can also lead to resistance, which makes it harder to treat infections in the future.
- Side Effects: Nausea, diarrhea, allergic reactions, yeast infections, and rashes. Overuse contributes to antibiotic resistance, which is a growing public health concern.
7. Mood Stabilizers
- Common Drugs: Lithium, Depakote (Valproic acid), Tegretol (Carbamazepine)
- Medication Errors: Doctors sometimes misdiagnose bipolar disorder as depression or anxiety, leading to improper treatment. Incorrect dosing can cause toxic drug levels in the bloodstream, which can result in severe complications.
- Side Effects: Tremors, weight gain, liver toxicity, kidney damage and hair loss.
8. Antihypertensive Drugs
- Common Drugs: Lisinopril, Amlodipine, Metoprolol
- Medication Errors: Hypertension is sometimes misdiagnosed as stress or anxiety, leading to ineffective treatment. Failing to adjust dosages to a patient’s specific needs can cause unstable blood pressure or electrolyte imbalances.
- Side Effects: Dizziness, fatigue, erectile dysfunction, cough (with ACE inhibitors), and low blood pressure.
Legal Implications of Medication Malpractice
Medication errors can lead to serious legal consequences for healthcare providers. When a medication error causes patient harm, it may qualify as medication malpractice. Injured patients may pursue legal action, although they must meet specific legal criteria to prove their case.
The legal process typically looks at the roles and responsibilities of doctors, pharmacists, and nurses to determine who is liable. If the legal system finds a healthcare provider liable, the provider could face civil judgments for monetary damages, professional discipline or even criminal charges, depending on the severity of the error.
Here’s a breakdown of the key elements in a medication malpractice claim:
Elements of a Medication Malpractice Claim
- Duty of Care: Healthcare providers have a legal responsibility to keep patients safe when prescribing, dispensing, or administering medications.
- Breach of Duty: A breach happens when a provider doesn’t meet the standard of care. In medication malpractice cases, this occurs when a provider makes a mistake in the medication process.
- Causation & Damages: The patient must show that the error directly caused harm, whether it’s physical injury or financial loss, such as medical bills or lost wages.
Who Is Responsible for Medication Malpractice?
- Doctors: Doctors are responsible for diagnosing conditions and prescribing the right medications. They must also monitor patients for adverse drug effects.
- Pharmacists: Pharmacists must ensure they dispense the correct medication and provide vital information about side effects and potential drug interactions.
- Nurses: Nurses administer medications and monitor patients for side effects. They must ensure they give the correct drug and dosage at the right time.
Consequences for Healthcare Providers
Healthcare providers hold a huge responsibility to ensure patient safety, especially regarding medication. When errors occur and harm patients, the consequences can be severe. Providers may face not only financial penalties but also damage to their career, reputation, and legal standing. Here’s what they could face:
- Civil Liability: Patients can file malpractice lawsuits seeking compensation for medical expenses, pain, suffering, and lost wages.
- Criminal Liability: If a healthcare provider acts with gross negligence or intentional harm, they may face criminal charges.
- Disciplinary Actions: Healthcare providers may face suspension or even lose their license, depending on the severity of the medication malpractice.
Real-Life Medication Malpractice Cases
Medication malpractice can cause serious harm to patients and their families. These real-life pharmaceutical malpractice cases illustrate examples of medication errors, how serious complications can be and highlight the importance of accountability, attention to detail, and following protocols.
Case 1: Nurse Fails at Medication Error Reporting
In 2022, a nurse in Michigan was charged by the state’s Attorney General for failing to report medication errors that caused harm to a vulnerable adult. The nurse had noticed that the patient received two incorrect medication doses but didn’t report the mistake as required by law.
The Attorney General emphasized, “Caring for vulnerable adults is a huge responsibility that requires extra care. Failing in that duty can lead to serious, even criminal, consequences.” The nurse received no charge for the error itself, but for failing to report it, which made the situation worse.
Case 2: Fatal Medication Mistake in a COVID Case
In 2021, a 54-year-old COVID-19 patient nearly died after receiving cisatracurium— a muscle-paralyzing drug used in lethal injections— instead of the prescribed remdesivir. The error caused severe brain injury. The patient spent over a month in the hospital and then months in rehab, relearning how to walk and talk.
A local newspaper reviewed his 4,421-page medical report and found that following proper protocols could have helped make the mistake more easily avoidable. This case highlights how medication dispensing errors can lead to life-altering consequences.
Case 3: Pharmacy Technician’s Error Leads to Child’s Death
In Ohio, a pharmacist received jail time after failing to catch a mistake made by a pharmacy technician mixing chemotherapy drugs. The error led to the death of a 2-year-old child. This tragedy sparked concerns about whether pharmacists might hesitate to report errors in fear of facing consequences.
The child’s father, now an advocate for patient safety, speaks out to pharmacy professionals, emphasizing the need for well-trained technicians and a teamwork approach to avoid errors.
He believes that when pharmacy teams work together like a sports team, with pharmacists acting as the coach, they can reduce medication errors and prevent tragedies.
How to Prevent Medication Malpractice
Preventing medication errors isn’t just about fixing mistakes after they happen. Instead, it’s about taking proactive steps to stop them before they occur. Healthcare providers reduce the frequency of medication errors by focusing on continuous learning, better communication, and smart use of technology. By implementing medication safety protocols, adopting new tools, and leveraging education, providers can protect patients from pharmaceutical malpractice.
Here are some key strategies to help prevent medication errors:
Education & Training
- Ongoing Professional Development: Healthcare providers should stay updated on new medications, treatments, and safety protocols. Regular training keeps them informed and sharp, helping reduce mistakes.
- Simulation Training: Healthcare professionals can use simulation-based training to practice handling complex situations. It gives them the confidence and skills to avoid medication errors in real-life scenarios.
Systemic Solutions
- Improved Communication: Good communication between doctors, nurses, pharmacists, and patients is crucial. When everyone communicates clearly, the chances of errors decrease, and the right medications get to the right patients.
- Safety Protocols: Strong safety protocols are a must, especially for high-risk medications like chemotherapy drugs. Multiple checks at different stages of the process ensure no mistakes slip through the cracks.
Advancements in Technology
- Electronic Health Records (EHR): With up-to-date, digital medical records, healthcare providers can quickly access accurate patient information. This helps avoid errors that might happen because of outdated or incomplete data.
- Medication Barcoding Systems: Barcode scanning at every stage—whether prescribing, dispensing, or administering medication—makes sure the right drug reaches the right patient. This simple step drastically reduces medication dispensing errors.
How Medical Malpractice Insurance Helps With Medication Errors
Medical malpractice insurance is vital for protecting healthcare professionals from the financial risks of medication errors. It covers costs like legal defense, settlements, lost income, and medical negligence claims. With the right coverage, healthcare professionals can avoid the financial burden of lawsuits and focus on patient care. Malpractice insurance promotes adherence to safety protocols, provides ongoing education, and encourages best practices to reduce medication dispensing errors.
Here's how medical malpractice insurance can help:
What Does Medical Malpractice Insurance Cover?
- Legal Defense Costs: If a medication error leads to a malpractice lawsuit, insurance covers legal fees, allowing providers to defend themselves without financial stress.
- Settlement and Compensation: Finding the provider liable for a medication error means insurance will help cover settlements, including medical bills, lost wages, and pain and suffering.
- Lost Income: During legal proceedings, providers might need time off work. Insurance can help replace lost income while they focus on the case.
- Protection Against Medical Negligence Claims: Malpractice insurance shields providers from the financial impact of medical negligence claims related to medication malpractice.
Why Healthcare Providers Need Medical Malpractice Insurance
- Peace of Mind: Even the seemingly most trivial mistakes can have dire consequences. With malpractice insurance, providers can rest easy knowing they have financial protection if medication errors occur.
- Reputation Protection: Without insurance, providers risk jeopardizing their career and reputation because of the financial fallout from lawsuits. Insurance helps maintain both.
- Compliance and Risk Management: Many healthcare institutions require malpractice insurance. Having this coverage encourages providers to follow safety protocols and reduces the risk of pharmaceutical errors.
How Malpractice Insurance Encourages Prevention
- Access to Risk Management Resources: Insurance providers often offer training and resources to help healthcare providers avoid medication errors. These programs teach best practices in medication administration and safety protocols.
- Ongoing Education: Many malpractice insurers partner with medical organizations to provide up-to-date training, ensuring providers stay current with the latest medications and technologies.
- Rewarding Safety: Some insurers offer discounts or other incentives to providers who follow strict safety protocols. This helps create a culture of safety and prevents medication dispensing errors.
Understanding Your Risk, Protecting Your Practice
Healthcare professionals must improve communication, follow applicable safety protocols, and use advanced technology to prevent medication malpractice. Additionally, medical malpractice insurance plays a vital role in protecting them from the financial impact of these errors.
Reliable medical malpractice insurance is a key part of managing your risk. At Indigo, we support healthcare professionals with innovative, cutting edge and cost effective insurance solutions. Let us help you protect your practice and your livelihood.
The right malpractice insurance can not only protect you from excessive claims, but also provide the support you need to continue offering exceptional care to your patients.
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