Are pharmacists responsible for ALL medical doctor's mistakes?

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jjoeirv

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Are pharmacists responsible for ALL of the medical doctor's mistakes? Possible mistakes on the doctor's part may include:

(1) the medical doctor recommending the wrong dosage, type, or frequency of medication
(2) sloppy handwriting by the doctor that makes the pharmacist give the wrong drug
(3) doctor recommends a drug that will have harmful interactions with other drugs the patient takes, or a drug the patient would be allergic to

If pharmacists are responsible for all of the medical doctor's mistakes, then why should pharmacists be responsible? The medical doctors have more years of training, so doesn't it make more sense for the doctors to be responsible for any mistakes they make in terms of the medication they recommend?

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I think that for the majority of your questions, the answer is "yes" the pharmacist is at least partially responsible, however, it would highly depend on the situation and "it will all come out at the trial". Got malpractice insurance?

Jd
 
Yes and no.

We had this pathetic doctor who always screwed up dosing. We checked doses and every time he would go forward. We even reported his incompetence to BOMEX and they did squat.

Lo and behold, the day came where that doctor made an ultimate mistake, Lovenox injection. Pt. bled profusely, went to hospital, got clotting factor to compensate, and ended up with the following acronyms: MI, CVA, DVT, and PE.

Pt. sues everyone.

Smart pharmacist gets off the hook.

Why?

1. SHE DID HER JOB. She documented the dosing question and error with the doctor. She had documented past incidents with the doctor. She checked her dose and considering her pt.'s options, he used his professional judgment. In her professional judgment, not dispensing the med would probably cause more problems than dispensing the med.

2. She has a $3 million from Pharmacists' Mutual (which costs only $150 per annum for pharmacists and $40 for students).

3. Pharmacists' Mutual hired a lawyer who quashed her negligence lawsuit before it went to trial.

Moral of the story: The most important lessons in law to avoid a lawsuit are:
1. CYA by Document, document, document....
2. Be a nice guy (I've seen major lawsuits averted because the pharmacist was concerned, caring, and had a concience. I've also seen the opposite...)
3. Carry a good malpractice policy. I highly recommend Pharmacists' Mutual.
4. Know your drugs.

BTW, I would look up DVT prophylaxis doses for enoxaparin in hospital and in community. It's a common mistake.
 
Most of the claims against pharmacists seem to be from misfilling a prescription....pharmacist dispenses wrong drug, dosage, misreads/mislabels directions, etc. The duty of a pharmacist to accurately dispense a medication according to a physician's instructions would have been breached. Is it reasonable for a patient who hands you a piece of paper to believe that he/she will receive just what the doctor ordered? Yes! Then why shouldn't you be sued if you "screw up"? That was a mistake that could have been easily avoided by a phone call to the doctor's office.

Litigation that claims a pharmacist is, in part, responsible for a physician's mistake (ie, physician has prescribed wrong drug, dosage, etc...not your "misfill"), is, ironically, kind of a good thing. When such lawsuits are successful, it says the responsibility of a pharmacist goes beyond the simple act of correctly dispensing a medication as written on a script. It says that pharmacists have the knowledge, the know-how, to make judgements on the efficacy and safety of a medication as it is prescribed. The courts, by ruling in favor of plaintiff patients (or the family), will have expanded the legally expected duties of pharmacists, by saying that pharmacists can reasonably foresee potential problems by virtue of their training and expertise. Therfore, you'll have to know "your stuff" because that is what is expected of you.

Ultimately, you have a duty to your patient, just as that patient's physician has, to use your knowledge for the benefit of the patient. To echo what Lord999 said: if your concerns were not adequately addressed by the doctor, document your communications (document everything), and fill it if you feel that not filling it is worse for the patient than filling it as per doctor so-and-so's order. You also have the right to not fill it at all. As one of my pharmacy practice profs said, the magic words come litigation time are "In my professional judgement...".

By the way (I know I've said it before in previous threads), sharing the "risk" with doctor and patient makes the system work. Whether you like it or not, the "stick" of potential pharmacy board adverse actions, and potential malpractice needs to be around for the safety of the patient. As Lord999 said, you should get yourself a good malpractice insurance policy.
 
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