The Most Common Types of Medication Errors

When you go to the doctor and he/she prescribes you medication for your ailment, you expect that medication to help ease your medical issues. But what if the medication does the opposite? Instead of getting better, you get worse and worse. The next thing you know, you’re going to the emergency room for an injury that could have been prevented if you were given the right prescription.

Approximately 1.3 million people are injured annually because of medication errors. Since 2000, the U.S. Food and Drug Administration has received more than 95,000 reports of medication errors. The Centers for Disease Control and Prevention estimate that on a yearly basis, 700,000 emergency department visits and 120,000 hospitalizations are because of adverse drug events. This number is expected to grow thanks to the new medication being developed, new uses for older medication, and an increase in prescription drug use for disease prevention.

Fortunately, medication errors can be prevented. But how? The best way to stay safe is to be prepared and that’s by recognizing what the most common types of medication errors there are:

• Poor communication between healthcare providers. For instance, your doctor recommends that you take a certain medication. However, the nurse informs your pharmacist of the wrong drug when calling in your prescription.
• Poor communication between your provider and you. Perhaps you misunderstood how often you’re supposed to take the drug. Or maybe your physician fails to tell you that you only need the prescription for a certain period of time.
• A mixup with the medication name or abbreviation. Many medication names sound very similar and it’s easy to get them mixed up.

The best way to prevent a medical error such as this one is to stay on top of your health care. Be your own advocate. Question your doctor’s prescription and make sure you understand what the medication is its side effects, and if there are any adverse reactions to any other medication you’re taking.

If you are injured because of a medication error in New Jersey, you do have the right to file a claim against your healthcare provider. Let us help you. Contact the Law Offices of Anthony Carbone today for a free consultation.

Why These Numbers Represent Real People, Not Statistics

The scale of medication errors in the United States is difficult to fully absorb. 1.3 million people injured per year is not a background hum of acceptable risk in a complex healthcare system. It reflects preventable failures at specific, identifiable points in the process of prescribing, communicating, dispensing, and administering medication. Behind each of those 700,000 annual emergency department visits is a patient who came to the healthcare system for help and left worse than they arrived, often through no fault of their own.

The FDA reporting figures are almost certainly an undercount. Hospitals and providers are not always required to report medication errors, and many incidents that result in patient harm go undocumented or are attributed to the underlying illness rather than an error in treatment. The true scope of medication error harm in the United States is likely considerably larger than the reported numbers reflect.

What the numbers do tell us is that these events are not rare or random. They occur along predictable fault lines in the healthcare process, which is exactly what makes them legally significant when a patient is harmed.

A Closer Look at the Communication Failures That Drive Errors

The three categories identified above — provider-to-provider miscommunication, provider-to-patient miscommunication, and medication name confusion — each play out in distinct ways that are worth understanding in more detail.

Provider-to-provider communication failures happen at transitions of care. When a patient moves from a primary care physician to a specialist, from an emergency department to an inpatient floor, from a hospital setting to a rehabilitation facility, or from any one care environment to another, the medication record travels with them in documentation. If that documentation is incomplete, inaccurate, or misread, the next treating clinician may make decisions based on a flawed picture of what the patient is actually taking. Hospital admissions are a particularly high-risk moment. A patient who arrives at the emergency room is often unable to provide a complete medication list, and the nurses and physicians managing the admission must reconstruct it from whatever records are available, which may not reflect recent changes.

Electronic health records were supposed to reduce these errors by creating a unified, accessible record that follows the patient. In practice, interoperability between different hospital systems, specialty practices, and pharmacies remains inconsistent in many parts of the country. A patient who sees multiple providers who use different EHR platforms may have medication information that does not transfer cleanly between them, recreating many of the same risks that paper records created.

Provider-to-patient communication failures have a different character. They often stem not from technical system failures but from the assumptions healthcare providers make about what patients know or understand. A physician who prescribes a medication and tells the patient to take it “as needed” without specifying the maximum dose, minimum interval between doses, or the symptoms it is intended to address has left significant room for the patient to inadvertently use the medication incorrectly. Instructions given verbally during a rushed appointment, without written reinforcement or pharmacist counseling, are frequently misremembered or misapplied.

Language and health literacy compound these risks. Patients who are not fluent in English, or who have limited experience navigating prescription medication systems, are at heightened risk when instructions are provided only in English or assume a baseline level of familiarity with how dosing works. The legal duty to communicate clearly and in a way the patient can understand does not disappear because the appointment was running long or the provider assumed the patient would figure it out.

The Dosing Error Problem

Beyond the three categories described in the original content, dosing errors deserve particular attention because they produce some of the most serious patient harm. A dosing error occurs when a patient receives too much or too little of a medication, when doses are administered too frequently or not frequently enough, or when the route of administration is incorrect.

In hospitals, dosing errors frequently involve medications with a narrow therapeutic index, meaning drugs where the difference between a therapeutic dose and a toxic dose is small. Anticoagulants like warfarin and heparin, insulin, certain antibiotics, cardiac medications, and chemotherapy agents all fall into this category. An error in calculating or programming the dose of any of these medications can produce life-threatening consequences. Overdoses can trigger hemorrhage, cardiac events, respiratory depression, or organ failure. Under-dosing can leave an underlying condition untreated in ways that allow it to worsen.

Weight-based dosing errors are particularly common in pediatric settings, where medication doses are calculated based on a child’s weight rather than a standard adult dose. If a child’s weight is entered incorrectly into the system, or if the dose is calculated using an incorrect formula, the resulting dose can be dramatically wrong. Children are less able to metabolize certain compounds than adults, and their smaller body mass means that even moderate miscalculations can produce toxic concentrations.

Programming errors in infusion pumps, which deliver intravenous medications at controlled rates in hospital settings, are a documented source of serious patient harm. These devices require correct programming of the drug concentration, the dose, and the delivery rate. Errors in any of those parameters, particularly when the pump’s built-in safety software is overridden or bypassed, can deliver far more medication than intended over a very short period.

Pharmacy Errors and Where They Occur

The pharmacy is a critical checkpoint in the medication process, and errors at this stage can occur independently of anything that happened during the prescribing encounter. A pharmacist who misreads a handwritten prescription, selects the wrong drug from a shelf due to similar packaging or alphabetical proximity, enters an incorrect quantity, or fails to catch a dangerous drug interaction during the verification process may be directly responsible for the harm that follows.

Look-alike, sound-alike medications are a persistent source of pharmacy dispensing errors. Drug names that are visually similar when written, or phonetically similar when spoken, have been confused by pharmacists, pharmacy technicians, and nurses with enough frequency that regulatory bodies have taken specific steps to address the problem, including requiring that medications be printed in mixed-case format to help distinguish names. The FDA maintains a database of drug name pairs that have been involved in mix-up errors, and the list is extensive. Hydroxyzine and hydralazine, Lamictal and Lamisil, Celebrex and Celexa are just a few examples of medication names that have been confused in real clinical settings with real patient consequences.

Automated dispensing systems used in hospitals and pharmacies are designed to reduce human error in medication selection, but they introduce their own risks when overrides are used routinely, when barcode verification is skipped under time pressure, or when the system’s alerts are dismissed without adequate review. The existence of technology in the dispensing process does not eliminate the duty of care. It creates a different set of obligations around its proper use.

The Drug Interaction Error

Drug interaction errors occur when a prescriber, pharmacist, or other treating clinician fails to identify that two or more medications being taken by the same patient will interact with each other in a harmful way. Some drug interactions reduce the effectiveness of one or both medications. Others produce toxic effects that neither drug would cause on its own. And some interactions that are manageable at standard doses become dangerous when a patient’s kidney or liver function is impaired and their ability to clear the medications is reduced.

Polypharmacy, the use of multiple medications simultaneously, has become increasingly common as the population ages and as more patients manage multiple chronic conditions. Patients who see multiple specialists, each of whom manages their own piece of the patient’s care, may end up with a medication list that no single prescriber has reviewed in its entirety. The cardiologist prescribing a blood thinner, the rheumatologist prescribing an anti-inflammatory, and the primary care physician managing the patient’s blood pressure medication may each be unaware of what the others have prescribed, particularly if their practices use different electronic record systems.

A thorough medication reconciliation at every point of care contact is the standard that the medical and pharmacy communities have established to address this risk. When that reconciliation is skipped or performed carelessly, and a patient is harmed by an interaction that a competent review would have identified, the failure to perform that reconciliation can be the basis for a medical malpractice claim.

What Being Your Own Advocate Actually Looks Like

The advice to question your doctor’s prescription and understand the medication’s side effects and potential interactions is sound, but it requires more than good intentions. Most patients are not trained clinicians, and the power imbalance in a medical appointment can make it genuinely difficult to ask challenging questions or push back on a provider’s recommendation.

Bringing a complete, written list of every medication you take, including over-the-counter drugs, vitamins, and supplements, to every medical appointment is one of the most concrete steps you can take. Supplements and herbal preparations interact with prescription medications in ways that many prescribers do not ask about routinely. St. John’s Wort, grapefruit juice, certain vitamins taken in large quantities, and common over-the-counter pain relievers can all affect how prescription medications behave in the body.

When a new prescription is given, asking the prescriber to confirm the name of the medication and its purpose, and then comparing that information to the label on the bottle you receive from the pharmacy, creates a verification step that catches some dispensing errors before the first dose is taken. If the medication looks different from what you have taken before, or if the label instructions differ from what your doctor told you, contacting the pharmacy before taking the medication is always the right call.

When a Medication Error Is Also a Legal Matter

If you are injured because of a medication error in New Jersey, you do have the right to file a claim against your healthcare provider. The legal framework for these claims is medical malpractice, which requires establishing that the healthcare provider’s conduct fell below the standard of care expected of a reasonably competent professional in the same field under similar circumstances, and that the deviation from that standard caused the patient’s injury.

New Jersey’s statute of limitations for medical malpractice claims is two years from the date the patient knew or should have known that they were injured and that the injury was related to treatment. For medication error cases where the harm develops gradually, or where the connection between the medication and the patient’s deteriorating condition was not immediately apparent, that discovery rule can extend the filing window. But it is not unlimited, and determining exactly when it began to run requires careful analysis of the specific facts.

Malpractice cases involving medication errors can name multiple defendants. The prescribing physician may be liable for failing to recognize a contraindication or prescribe an appropriate dose. The hospital or medical practice may bear institutional liability for systemic failures in its medication management processes. The pharmacy may be liable for dispensing the wrong drug or wrong dose. Identifying all potentially responsible parties requires a review of the complete medical record, the prescription documentation, and the dispensing record.

Working with a New Jersey Personal Injury Attorney who handles medical malpractice cases means having someone who can obtain and analyze those records, retain the medical experts required to establish the standard of care and its breach, and build the case that demonstrates how the error caused specific, compensable harm. Medication error cases are often technically complex, and the defense bar will be well-resourced. The strength of the claim depends on the quality of the evidence and the expertise brought to its presentation.

Contact the Law Offices of Anthony Carbone today for a free consultation if you or someone you love has been harmed by a medication error in New Jersey.