pharmacy law case review

[rxforlife2004]

Advertisement - Members don't see this ad

I'd like to see your inputs about this case:

5PM on 4/20/2009 a pharmacist received an order for a narcotic medication A 100 mg BID for chronic pain ( Pt is in ICU with renal failure, COPD). Pharmacist reviewed the order, checked the dosage and found out the maxium documented dose for this drug is only 120mg daily. Pharm.D called MD and talked to MD about this. On the phone, MD said, "it's okay...pt had 75mg BID at home already and still in a lot of pain, and i would like to increase it". Pharm.D documented the conversation.

Two days later....pt crashed in ICU and passed away (dead!). Hospital clinical team reviewed and they concluded that pt is dead due to drug A OVERDOSE. Now my question is....if this takes to court, who would be responsible for pt's death? Will be pharmacists license suspended? or how would you think this case would be?

 

[Aznfarmerboi]

I'd like to see your inputs about this case:

5PM on 4/20/2009 a pharmacist received an order for a narcotic medication A 100 mg BID for chronic pain ( Pt is in ICU with renal failure, COPD). Pharmacist reviewed the order, checked the dosage and found out the maxium documented dose for this drug is only 120mg daily. Pharm.D called MD and talked to MD about this. On the phone, MD said, "it's okay...pt had 75mg BID at home already and still in a lot of pain, and i would like to increase it". Pharm.D documented the conversation.

Two days later....pt crashed in ICU and passed away (dead!). Hospital clinical team reviewed and they concluded that pt is dead due to drug A OVERDOSE. Now my question is....if this takes to court, who would be responsible for pt's death? Will be pharmacists license suspended? or how would you think this case would be?

The pharmacist should be okay because he documented the conversation. I am curious though, what narcotic has a MDD?

 

[WhiteSnows]

Doctor is in trouble since he was warned by a pharmacist already.

 

[MountainPharmD]

That is why you document everthing. First and last name, day, time and exact wording of the converstaion. We live in a CYA world.

A better question is: If you were the pharmacist in question what would you have done? Would you have filled it after the conversation with the MD or would you have protested?

 

[WhiteSnows]

That is why you document everthing. First and last name, day, time and exact wording of the converstaion. We live in a CYA world.

A better question is: If you were the pharmacist in question what would you have done? Would you have filled it after the conversation with the MD or would you have protested?

After this case, I have enough evident to protest the MD in the future when something like this happens. Since our education and job provide us oppportunity to check dosage for safety. MD may have too much work, and sometimes they would be careless.

In my opinion, a pharmacist in the story has a spiritual responsibility for the death of the patient because he knew it was wrong to give that patient an over dosage. However, some states require pharmacists to dispense medication according to MD's will.

 

[PumpkinSmasher]

In my opinion, a pharmacist in the story has a spiritual responsibility for the death of the patient because he knew it was wrong to give that patient an over dosage.

Thank you for the good laugh.

 

[WhiteSnows]

Thank you for the good laugh.

You're welcome.

 

[prevacid]

all the time i get major D/I and doses that dont make sense, i verify with the md and document the convo and thats it

 

[sanrevelle]

call me stupid, but does the court always believe a piece of paper someone documented? it's possible that someone can lie on the document, right? how do you prove your document states the truth?

 

[PharmDstudent]

call me stupid, but does the court always believe a piece of paper someone documented? it's possible that someone can lie on the document, right? how do you prove your document states the truth?

2 signatures. 😉

 

[Old Timer]

call me stupid, but does the court always believe a piece of paper someone documented? it's possible that someone can lie on the document, right? how do you prove your document states the truth?

Because the note is contemporaneous. Unless the plaintiff could prove through scientific means it was not written after the fact it is proof the conversation transpired as the pharmacist indicated.

Legal Issues: This varies from state to state. Some state courts have held that the Pharmacists has no duty to warn the patient as the physician is "learned intermediary" and the pharmacist is not. The pharmacist will be sued, the courts will decide to dismiss based on the laws and rulings of the particular jurisdiction. The next legal issue is whether the dose of the drug as prescribed is over some known limit. Does the package insert or the medical literature support doses that high in some circumstances? Do they say never to give doses that high? If the dose as prescribed is generally known to be fatal, the pharmacist may have problems with the law and with the licensing authorities.

Unless the OP will identify the drug, all of the is nothing but speculation.