Pharmacy mistakes kill, injure thousands Soaring number of prescriptions, druggist shortage, lack of state oversight blamed
WARREN-April Ozias burst into her son's elementary school and raced to the office. There, Ozias found Corey, her fourth-grader, limp in a school wheelchair, unable to speak or walk. His eyes rolled back into his head. His face was pale.
Later that day in March 2001 at Providence Hospital in Southfield, doctors found that Corey had overdosed on medication. His prescription was incorrectly filled with twice the needed dose of Tegretol, his panic disorder medication, Oziad said.
Problems like that are on the rise, experts say. Prescription mistakes by pharmacists and doctors cause at least 7,000 U.S. deaths per year, according to a report released in 2000 by the Institute of Medicine, a Washington-based research group that advised Congress on health policies. That's more than double the annual number of U.S. deaths blamed on prescription errors in the 1980's, the report said. Some industry observers say the number of mistakes is bound to increase as the number of prescriptions dispensed in the United States surges.
Still, 49 of 50 states do not require pharmacists to report prescription errors, making it difficult to track the extent of the problem.
At the same time, drug chains are struggling to cope with a nationwide shortage of pharmacists. A 2000 study by the U.S. Department of Health and Human Services found the number of pharmacist vacancies rose from 2,700 in 1998 to 7,000 in 2000. While trade groups say the shortage has eased somewhat since, it remains a problem.
Ultimately, the responsibility lies with consumers to be more diligent in checking their medicine.
'You've got people getting (more) prescriptions and fewer people to fill them,' said Jesse Vivian, a pharmacist, attorney and Wayne State University professor.
Devastated and outraged, Ozias, 34, of Madison Heights has sued Rite Aid in Macomb Circuit Court, she said, because its store at 12 Mile and Dequindre in Warren gave her son the wrong prescription. 'You put so much trust in your pharmacist,' Ozias said. 'You hope that they are paying attention. You hope that they won't make a mistake.'
Ozias' lawsuit against Rite Aid is pending.
At least seven other families in Metro Detroit also have filed pharmaceutical malpractice lawsuits since 1999, some of which allege the mistakes have left victims severely incapacitated and others dead.
As errors mount, lawsuits 'increase exponentially,' Vivian said. 'Ten years ago, you have about 15 to 20 cases at the appellate level. Today, you see 15 cases a month.'
Prescription errors also lead to higher insurance premiums for pharmacies as juries come back with big damage awards in civil lawsuits.
In March 2002, a jury ordered pharmacists at Children's Hospital in Boston to pay $7.1 million in damages to the family of Joey Rice, a mentally challenged toddler who as a premature infant received an overdose of a high blood pressure drug.
His parents claimed the pharmacists' failure to dilute the drug caused permanent brain damage.Pressure grows
Pressure on pharmacists keeps growing, partly because the number of prescriptions they're filling annually has jumped 50 percent, from 2 billion a decade ago to more than 3 billion now.
It's because people live longer and today's medicines are effectively treating ailments that traditionally were left up to surgery, Vivian said.
As things get more complicated, one truth has emerged: 'Ultimately, the burden (to stay safe) is on the patient,' said Greg Baran, director of government affairs for the Michigan Pharmacists Association.Coverage soars
Many pharmacists are tripling their medical malpractice insurance, Vivian said, to give themselves up to $3 million in coverage against mistakes.
'it is a problem in that we don't know how many errors are out there, how serious they are or how to fix them,' said Carmen Catizone, executive director of the Park Ridge, Ill.-based National Association of Boards of Pharmacy.
The number of malpractice cases goes largely undetected by regulators because pharmacists in Michigan and every other state but North Carolina are not required to report mistakes, Catizone said.
Consumer advocates want states to require pharmacists to report prescription errors to regulators.
Michigan also doesn't keep a record of pharmaceutical malpractice suits. The only tracking statistic in Michigan is the number of complains consumers file-about 200 per year, said Lori Donlan, spokeswoman for the Michigan Department of Consumer and Industry Services.
Some of those complaints include prescription mistakes, but state officials said they don't know how many because those complaints are lumped together into a category called 'incompetence.'
Ninety-nine Michigan pharmacists were disciplined by the state agency in fiscal year Oct. 1, 2000, to Sept. 30, 2001, and most were reprimanded or received probation, records show. Fifteen had their pharmacist license suspended or revoked.
Often, pending malpractice cases never are formally brought to the agency's attention, Donlan said.
One such case happened two years ago, when Michigan reporters called Consumers and Industry Services about a pharmacist from Ann Arbor who dispensed Viagra instead of an antibiotic to a 6-year-old girl. The family had filed a lawsuit against the drugstore that dispensed the drug.
'But we knew nothing about it,' Donlan said. 'The family never reported it to us.'
The mistake was settled out of court.
Some victims overlook prescription errors, Catizone said, because the mistake is caught before any real damage is done.
That's what happened with Iva Russell, 83 of Madison Heights.
In July 2001, she got two times the prescribed dose of a strong painkiller, OxyContin, from a Warren drugstore.
She took the medicine for about a week while staying at her daughter Carol's home in Troy. Soon the double dosage made Iva comatose. She couldn't speak and stared blanked at people.
Doctors determined she had incorrectly been given 20 mg of her medicine instead of 10 mg. Despite the error, Russell recovered.
Russell's family has not filed a lawsuit and was unaware of the reporting procedures to the state. Her adult children are grateful she survived.
'People are human,' said Ivan's son, Adam Russell, 41, of Lake Orion. 'They make mistakes.'Double dosage
Corey Ozias' problems began when the family doctor increased his prescription for Tegretol to 100 mg tablets. When his mother, April, picked up his prescription from Rite Aid, the bottle was correctly labeled: '100 mg' tablets.
Corey took his pills as directed, not knowing they were 200 mg tablets, his mother said. After three days of the double dose, he passed out at Simonds Elementary School in Madison Heights.
'I felt so dizzy,' said Corey, now a sixth-grader. 'I thought I was going to die.'
Now, April Ozias feels more comfortable with her son's prescriptions because she has developed a good relationship with a new pharmacist and is studying to be a surgical technician. She prides herself on knowing everything about her son's pills, even it if means questioning doctors and pharmacists. Despite her diligence, Ozias still doesn't know who made the mistake with her son.
That's because in Michigan, pharmacists by law must be on duty whenever drugs are dispensed, said Baran, of the Michigan Pharmacists Association. But that doesn't mean they fill the prescriptions themselves.
High school students often pull pills off the shelf, count them and make labels, said Vivian, of Wayne State University. By law, pharmacists only are required to double-check what's dispensed.
And at many Rite Aids, a RapidScript robotic filler reads prescriptions with bar codes and a robotic arm grabs the pills off the shelf, counts them and puts the bottle on a conveyer belt, company spokeswoman Jody Cook said. The pharmacist double-checks the machine's work by matching the pills inside the bottle with a computer picture of what the pill should look like.People die
When mistakes happen, people like Frances Gentry die.
Gentry, 74, of Warren died from a drug overdose in December 2001, according to an autopsy report.
Her doctor had prescribed a high dose of liquid painkiller, Roxanol, as she was to begin radiation treatment for cancer.
The medicine from a Warren drugstore came without instructions and had no dropper to dispense the medicine, said James Gentry, her son.
Fifteen minutes after taking some of the medicine, Gentry couldn't speak and was moaning and groaning, James Gentry said. Two days later, on Dec. 13, 2001, she died.
The Gentry family is suing Rite Aid in Macomb Circuit Court, claiming the pharmacy killed their mother by failing to provide 'proper instructions.'
Since the medicine came without a dropper to dispense the medication, a family member bought a syringe. The syringe didn't fit in the bottle, and Gentry needed pain relief. So a family member poured a small amount in a cup and gave it to her. What they thought was only a few drops ended up as an overdose.
Rite Aid spokeswoman Cook said the drugstore denies wrongdoing in the Gentry and Ozias cases, both of which involved the same Dequindre pharmacy. The pharmacists who were on duty have not been disciplined.
In the meantime, the Gentrys mourn their loss.
'I can't bring back my mom,' James Gentry said. 'But if something can be changed to help pharmacies be more safe and secure for others, than I have won.'
David Oliver is the nation's leading experts on helping and supporting a loved one with bipolar disorder. You can get learn about many of David's little known, yet effective strategies to cope and deal with your loved one's bipolar by clicking here right now. View all articles by David Oliver