Accidently Filling Script under wrong pharmacists initials.

[Sparda29]

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How big of a deal is this?

For example:
We are at SDN Pharmacy. The two pharmacists at the pharmacy are Old Timer and MountainPharmD. Sparda is the intern who is taking prescriptions in at drop off. Since Sparda only works Saturdays, and MountainPharmD always works Saturdays, Sparda is used to typing in MountainPharmD's initials.

However, this one Saturday, Old Timer is covering for MountainPharmD. Since Sparda was rushing, he typed in MountainPharmD's initials onto the script when Old Timer was on duty, and the initials were not fixed.

How big of a deal is this? If anything adverse happens with this script, even though MountainPharmD's initials are on it, he wouldn't be liable since just by checking the HR records, he wasn't at the pharmacy that day. Right?

 

[crazybob]

wouldn't the manager or the owner check which pharmacist worked that day after looking at the schedules? Then both of the pharmacists could discuss whether they were there that day, right?

 

[CUninja]

How big of a deal is this?

For example:
We are at SDN Pharmacy. The two pharmacists at the pharmacy are Old Timer and MountainPharmD. Sparda is the intern who is taking prescriptions in at drop off. Since Sparda only works Saturdays, and MountainPharmD always works Saturdays, Sparda is used to typing in MountainPharmD's initials.

However, this one Saturday, Old Timer is covering for MountainPharmD. Since Sparda was rushing, he typed in MountainPharmD's initials onto the script when Old Timer was on duty, and the initials were not fixed.

How big of a deal is this? If anything adverse happens with this script, even though MountainPharmD's initials are on it, he wouldn't be liable since just by checking the HR records, he wasn't at the pharmacy that day. Right?

Is there a password involved, or is it picking the wrong person's name off of a drop down menu? What were you overriding?

I guess my concern would be that if the wrong pharmacist's name is on the script and it was billed to Medicare, would that not constitute Medicare fraud? I could be wrong about that, though.

 

[rxlea]

Old Timer and MountainPharmD behind the same counter?

 

[StevePerry]

Old Timer and MountainPharmD behind the same counter?

That situation would obviously quickly deteriorate into the climax of First Blood...

 

[Farmercyst]

How big of a deal is this?

For example:
We are at SDN Pharmacy. The two pharmacists at the pharmacy are Old Timer and MountainPharmD. Sparda is the intern who is taking prescriptions in at drop off. Since Sparda only works Saturdays, and MountainPharmD always works Saturdays, Sparda is used to typing in MountainPharmD's initials.

However, this one Saturday, Old Timer is covering for MountainPharmD. Since Sparda was rushing, he typed in MountainPharmD's initials onto the script when Old Timer was on duty, and the initials were not fixed.

How big of a deal is this? If anything adverse happens with this script, even though MountainPharmD's initials are on it, he wouldn't be liable since just by checking the HR records, he wasn't at the pharmacy that day. Right?

Seems to me you shouldn't be using either. I've never had to type in my RPh's initials. Those are usually reserved for overriding DURs, allergies, and other such things. As a 1st/2nd year intern those were verboten. When I passed 2nd year I was given clearance to override using my own initials. The final check was still done by the pharmacist. Never at anypoint did I need to override anything using someone else's initials, password, code, etc.

 

[PharmDstudent]

I don't think it matters. There's always a "pharmacist on record", which is whoever is on duty.

If you're using a combination of initials, like SpardaSmith + Old Timer or MountainDewd (SS/OT or SS/MD), then it's no biggie. If you used OT or MD only, then that's not good, because you're using someone's initials to process prescriptions.

 

[J ROD]

It is not a big mess up but problems could arise if the Rx is filled wrong.

Where I work, I enter that I am the PharmD on duty and my initials are on the label. How are you changing the initials?

 

[PharmDstudent]

It is not a big mess up but problems could arise if the Rx is filled wrong.

Where I work, I enter that I am the PharmD on duty and my initials are on the label. How are you changing the initials?

How could problems arise? The blame goes to whoever is verifying the script.

If he's on rotations, then he may have to use the RPh's initials (if he isn't registered or they don't have a student account registered).

 

[Sparda29]

Basically, Costco uses Condor Rx90, which is a 20 year older version of Rx2000 that CVS used before they upgraded to CVS RxConnect.

When you type in a prescription at Costco, you need to finish it with something like this:

For example, if Old Timer was the pharmacist and SpardaSmith was the intern it would be: OT/SS

However, in this case, Sparda forgets that MountainPharmD is not on duty and he mistakenly types in: MP/SS

 

[charfdorn]

Basically, Costco uses Condor Rx90, which is a 20 year older version of Rx2000 that CVS used before they upgraded to CVS RxConnect.

When you type in a prescription at Costco, you need to finish it with something like this:

For example, if Old Timer was the pharmacist and SpardaSmith was the intern it would be: OT/SS

However, in this case, Sparda forgets that MountainPharmD is not on duty and he mistakenly types in: MP/SS

And at some point OldTimer checks it and corrects the error?

 

[Phlame217]

rx2000 does it the same way with Pharmacist/Tech and honestly it was never a big deal because though it may print wrong on the label, the internal verification stage where the pharmacist checks and does his initials will always be apparent.

 

[Pharmavixen]

No biggie. What really counts is who actually checked the scripts and signed their name. The wrong initials in the computer have no legal ramifications.

 

[J ROD]

How could problems arise? The blame goes to whoever is verifying the script.

If he's on rotations, then he may have to use the RPh's initials (if he isn't registered or they don't have a student account registered).

The only retail I have done is at RA and there I enter as the pharmacist on duty and it automatically populates to the script so that no entering by a tech is required.

For interns, we have techs that sign in under their initials and then they fill under their login. But, techs/intern dont enter pharmacist initials.

Now, they could fill under my initials but the Rph initials would still be mine.

 

[PharmDstudent]

The only retail I have done is at RA and there I enter as the pharmacist on duty and it automatically populates to the script so that no entering by a tech is required.

For interns, we have techs that sign in under their initials and then they fill under their login. But, techs/intern dont enter pharmacist initials.

Now, they could fill under my initials but the Rph initials would still be mine.

RA supposedly has a computer system that makes everyone else's computer system bite the dust. 😉

 

[aboveliquidice]

Kaiser gives everyone in the pharmacy a mini stamp with their initials... It works out pretty nice.

Not sure why everyone thinks it's cool to fill / verify under someone else's initials... Hell no it is not okay.

 

[PharmDstudent]

Kaiser gives everyone in the pharmacy a mini stamp with their initials... It works out pretty nice.

Not sure why everyone thinks it's cool to fill / verify under someone else's initials... Hell no it is not okay.

It's irrelevant whose initials are recorded while filling (other than verifying that the person is a licensed tech/intern/pharmacist), because the pharmacist who does the final check is ultimately responsible. If the techs were responsible, then what's the point in having a pharmacist do the final check?

 

[J ROD]

RA supposedly has a computer system that makes everyone else's computer system bite the dust. 😉

Besides the paychecks and their pens (they have really great pens!! lol), their computer system is good.

It is easy to use.

Everything else is the problem there.....🙁

 

[PharmDstudent]

Besides the paychecks and their pens (they have really great pens!! lol), their computer system is good.

It is easy to use.

Everything else is the problem there.....🙁

 

[aboveliquidice]

It's irrelevant whose initials are recorded while filling (other than verifying that the person is a licensed tech/intern/pharmacist), because the pharmacist who does the final check is ultimately responsible. If the techs were responsible, then what's the point in having a pharmacist do the final check?

Techs are held accountable for making errors as well... The board hands out disciplinary actions to techs all the time.

 

[PharmDstudent]

Techs are held accountable for making errors as well... The board hands out disciplinary actions to techs all the time.

Do you have any to post? I've never come across that, and I read the newsletter from my board of pharmacy when I get it in the mail.

For example, the pharmacist in Ohio who was criminally charged for a chemo misfill was held liable, not the tech who used the wrong strength of saline to mix it.

 

[owlegrad]

Do you have any to post? I've never come across that, and I read the newsletter from my board of pharmacy when I get it in the mail.

For example, the pharmacist in Ohio who was criminally charged for a chemo misfill was held liable, not the tech who used the wrong strength of saline to mix it.

When I attended a FL BOP meeting the last activity was tech discipline matters. Kinda a new thing in Florida, techs now have to be registered by the board. My guess is it varies by state.

The Emily Rose case has been discussed at length, but yes the ruling was dis-equitable. Very sad case for everyone involved. The reason that tech was not disciplined by the Ohio BOP was because at that time techs did not have to be registered with them in order to work. If the same thing happened now that tech would very likely not be able to work in Ohio afterward. The board can only discipline someone who is registered with them.

On a side note you seem to be grouping criminal charges in with Board disciplinary matters when of course they are very different. The Ohio Board did not choose to criminally prosecute Eric Cropp.

 

[aboveliquidice]

Do you have any to post? I've never come across that, and I read the newsletter from my board of pharmacy when I get it in the mail.

For example, the pharmacist in Ohio who was criminally charged for a chemo misfill was held liable, not the tech who used the wrong strength of saline to mix it.

None specific - I was recalling the lecture given to us by the Oregon BOP... Oregon just finished making the switch to licensed-only techs.

 

[PharmDstudent]

On a side note you seem to be grouping criminal charges in with Board disciplinary matters when of course they are very different. The Ohio Board did not choose to criminally prosecute Eric Cropp.

No. It's a well-known example. That's all.

 

[PharmDstudent]

None specific - I was recalling the lecture given to us by the Oregon BOP... Oregon just finished making the switch to licensed-only techs.

That's strange. We have licensed techs too, and they aren't legally responsible for errors if the pharmacist does a final check.

 

[owlegrad]

No. It's a well-known example. That's all.

A well known example that doesn't apply. That's all.

 

[PharmDstudent]

A well known example that doesn't apply. That's all.

The principle is the same.

 

[aboveliquidice]

The principle is the same.

To be fair, things are done different in Louisiana 😀

 

[PharmDstudent]

To be fair, things are done different in Louisiana 😀

You're right! 😛

But the thing is, we've had a similar discussion on SDN where Old Timer talked about how only pharmacists make mistakes, because pharmacists are held responsible. If anyone has the energy, they are more than welcome to dig up the old thread. I haven't been feeling good, so I'm not up for digging it up, but I believe it's there.

 

[owlegrad]

The principle is the same.

Your point seemed to me to be that because that tech was not held criminally liable in the Emily Rose case, BOP's will not hold registered techs responsible for their actions. I don't think that is quite the same principle because in that case the tech was not registered. The Ohio BOP could not hold that tech responsible for her actions, it was outside their ability. Also criminal liability is completely different than board sanctions. So it's not the same.

Sorry if I am just being dense here, but I just do not see how it is the same principle.