When drugs are in short supply in Colorado, it can lead to patients receiving incorrect dosages of prescribed medications. One example of this is when a healthcare organization discovered that the hospitals it controlled were running short of potassium acetate in 2 mEq/mL dosages. To make up for the shortfall, the group began ordering potassium acetate in larger dosages. When the new medication was entered into the organization’s database, it was not marked as having a different dosage, leading to hospital workers administering the wrong amount of medication to patients.
In an effort to find out what led to this mistake, the group completed an in-depth investigation. There were several issues that led to patients receiving the wrong amount of medication, and they included excessive trust among staff members, failure to communicate properly with hospital pharmacists and the lack of error correction practices. Trusting one’s colleagues can be a good thing, but hospital workers assumed that mistakes would occur at unrealistically low frequencies. This led to only cursory checks of medications and dosage amounts.
Another issue that the investigation discovered was that buyers would often fail to alert the pharmacy manager that an alternative drug was being bought. This meant that pharmacists had no reason to be on the lookout for the new shipments of potassium acetate. Additionally, there was no system in place to ensure that the drugs were entered into the organization’s computer systems correctly.
Even if someone is receiving the medication they were prescribed, an incorrect dosage can still cause an enormous amount of harm. Some levels of medication are toxic, and others will not work properly if a patient’s dosage is too low. A lawyer may be able to help an individual to seek compensation for injuries related to incorrect dosages.
Source: Pain Medicine News, “A Dangerous Interplay: Rx Shortages and Med Errors“, May 27, 2013