Wrong script was sold to wrong patient. Patient took a month dose. Both patient have same name and different Dob. Tech must have looked up dob in the computer. Now patient is super upset. Said will call coeporate. Patient received ppi instead of Bc. Patient was breasfeeding. Is the rph who verified the script liable? Incident report has been filed
Pos incident
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I don't see why the verifying pharmacist would be liable. I would think the tech who sold the Rx, the pharmacy manager, and possibly the pharmacist on duty when it was sold. Calling corporate is not what I would be worried about, it's the board of pharmacy being called.
Both PIC and/or staff could be liable. It is not who verified the script is important in this case but who was the pharmacist on duty when that patient picked up the script.
- Pharmacist is responsible on what happens in the pharmacy.
- Counseling obligation might come into play too.
- PIC is often dragged into this no matter what.
- Pharmacist is responsible on what happens in the pharmacy.
- Counseling obligation might come into play too.
- PIC is often dragged into this no matter what.
I agree, except I think techs don't have any real liability. It all would fall to the PIC and pharmacist on duty.
Nothing you can do at this point except follow company policy. All actions from you will be a response to whatever the patient decides to do. As others have said, corporate is the least of your concerns as long as you did what your employer asks of you.
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This sounds like a pretty run off the mill screw up I've seen a hundred times. It's sucks that it happened to the patient, but every pharmacist makes a few mistakes here and there. I doubt much will come of it.
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Action plan to train the technicians on verifying identity on pickups.
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The only way possible the pharmacist could be liable is if the pharmacist placed Patient's "A" prescription in patient's "B" bag or vice-versa. Or the other possibility is if it were a new prescription and the pharmacist didn't counsel.
Now I am assuming this had to be a new prescription b/c you would assume if the lady had been on b/c before she should have known something was wrong if her "B/C" came in a amber bottle. It appears that the tech made the error- I can expect the board would perhaps want some type of implementation program to prevent this error and a possible fine on the store, but not on the pharmacist- again unless it was a new prescription and No counseling provided.
Now I am assuming this had to be a new prescription b/c you would assume if the lady had been on b/c before she should have known something was wrong if her "B/C" came in a amber bottle. It appears that the tech made the error- I can expect the board would perhaps want some type of implementation program to prevent this error and a possible fine on the store, but not on the pharmacist- again unless it was a new prescription and No counseling provided.
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You seem to think pharmacists are not liable for an error made by a technician. Obviously different BOP's are going to react differently, but I would be willing to bet that every state requires the pharmacist on duty to be responsible for everything every tech does while they are on duty. Many states go as far as setting tech to pharmacist ratios, and this is why - so the pharmacist can reasonably be expected to supervise what every tech is doing at all times.
OP, for what it is worth I used to have this issue at CVS. I would train my techs to follow the prompts on the register and as soon as I stopped looking over their shoulder they would go back to overriding or otherwise getting around the prompts. I doubt you will get in serious trouble and I suggest taking it as a learning experience - in the future if you see pickup techs going to a computer terminal ask yourself why are they doing that - are they going to scan the script to get the DOB so they can skip asking the patient? If you catch it, send the tech home and tell them it will be termination next time. You can also retrain your techs about the need to follow proper pick up procedure. I bet if you are honest with yourself, you knew that the techs weren't following proper procedure (do you ever hear them ask for DOB?) and were just letting it slide. Sadly that behavior now has you in some hot water. Just take it as a learning experience and move on. 🙂
Oh and hope that the patient doesn't get pregnant. You don't want to be liable for child support for the next 18 years. Also I hope you have insurance, they will help you if it does end up as a legal battle.
Keep us informed, it is always nice to get updates for how these things turn out.
Cvs has the safest post system .we always tell techs not to ever look up dob in the computer. Yes it was something that i could not have prevented. It was the 2 second fill. Well it is hard at busy store to supervise every tech. At time we have 6 techs working with only one rph.
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Just curious what state do you work in b/c a 6 to 1 Tech to pharmacist ration seems a bit high- albeit that's good if you can get away with it.
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I respectively disagree- if the pharmacist verified each prescription correctly and the OP mentioned this was a refill- explain to me again how the pharmacist could have been liable for an apparent error made at the register by the tech? Tell me specifically what any BOP will charge the pharmacist with sir? Are you implying that the pharmacist on duty on EVERY prescription has to run to the register and make sure the tech didn't bypass any of the company's protocol? You are living in a fantasy world if you think a pharmacist needs to run to the register on every refill and make sure the technician is following procedure.
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You have to be trolling me, right?
Yes, your BOP does expect you to be Responsible for everything that happens during your shift. Why do you think the pharmacist has to be present for the pharmacy to be open?
No I don’t suggest running to the register for every transaction but I do suggest keeping an eye on the pick up person and making sure they are following protocol. We both know this wasn’t the first person that tech ever skipped date of birth check for. Even if it was, the pharmacist is still responsible for everything the techs do. Do you really not think the pharmacist on duty is legally responsible for the pharmacy?
Anyway it doesn’t really matter what you or I think, it only matters what the board of pharmacy thinks. I would be shocked if any board decided that the pharmacist was not responsible for what the technician did.
that's not true...the PIC or pharmacist on duty would be responsible for scripts that left the pharmacy that day.
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If you verified it under the wrong patient definitely. They would likely hold pharmacist on duty liable even if the RX was dispensed correctly but sold to the wrong person since techs have 0 liability and pharmacists have 100% liability. In the board's eyes the techs are an extension of you and you are liable for 100% of what they do as you are the "supervisor" even though it's not really a fair stance to have. They may hold PIC accountable as well if they feel there was a failure to properly train staff.
The pitfalls of this POS error seem more to do with the CVS systems/procedure than anything else.
Pregnancies are expensive.
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If you work for a big chain, they have risk management and assessment teams who will take care of it.... the pts and their lawyers know that the chains have much deeper pockets than any rph, so most likely nothing will happen to you... If you have secondary insurance like HPSO, that helps. But , most likely all the fire will be directed at the chain, not you
As several pointed out, pharmacist=100% liability, tech=0..BOP likely to impose a fine for pharmacist on duty and PIC... typically chains will pay the fine...
Sorry to hear this happened to you, but unfortunately stuff like this happens when you are an rph ...
So there will be, in theory, no repercussions from this? Does the chain blackmark you for this event?
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It was the second fill for a B/B pill? If it was and she didn't know the difference between a bottle of tablets and pack of pills?
And, counsel the person who sold it. Also, take a minute to speak to everyone on staff and remind them if they do it again, you'll remove their fingers with a hammer, one at a time
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Maybe she thought they opened up the pack and put the tablets in the bottle. Lol.
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you make a good point. In some states pharmacists/cashiers/techs are not required to ask for counseling for refills at checkout so it would make no sense if the pharmacist on duty was held accountable if he/she wasn't the one filling/verifying it.
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I live and work in a non-mandatory counselling state. I've never ever seen board disciplinary action on a tech other than if they were to steal controlled substances or have some felony conviction. I can't think of a state that would exonerate the pharmacist and hold the tech liable.
It was the second fill for the ppi she picked up. So counselling was not required. How will corporate handle such a case if patient sues?
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Not sure. But please have personal malpractice insurance. If it's something major beyond settling out of court they may throw the pharmacist under the bus.
If they are going to screw you over might as well complain about the tech not properly verifying and demand action. You could potentially right them up internally. Legally basically everything lies on the pharmacist on duty though. That's how the board and malpractice court will see it. Techs are basically not legally liable for anything they do.
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Probably in a state like IL that has never had a tech/pharmacist ratio. I agree, 6/1 is pretty high, nothing good about it (although some have argued here that more technician help is always better than less.) I think there at a certain point, the pharmacist will be a bottleneck....which sadly is probably why there are pharmacists who've posted here that they don't actually look inside bottles when verifying, they just check and bag and keep on going.
You are right, there is no reasonable way the pharmacist could have caught this.....but the BOP won't care. The pharmacist is still legally responsible for anything that goes on under his/her shift. The BOP's answer is that pharmacists should only take jobs where they can monitor everything the technician(s) are doing. Impossible in the real world, but the BOP doesn't care.
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Objectively false in Texas.
Look up the disciplinary records.
You'll find loads of incidents where pharmacists were punished because techs didn't bother to verify patient identity.
What @ancienbon doesn't realize is that as soon as the patient calls corporate and it even sounds like there's gonna be trouble, they'll throw him under the bus.
If any liability insurance, personal or corporate, is activated, the insurance company notifies the state board.
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If I had to make a prediction, the chain's risk management team will settle behind closed doors with the customer and her legal representatives. If the pharmacist followed all corporate policies like filling incident report etc, there will be no disciplinary action taken against the pharmacists. Chains do not want bad publicity and will do everything to keep things quiet.
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Depending upon state law and whether counseling is mandatory on ALL prescriptions (new Rx, renewals, refills, ALL), the pharmacist does have to run up to the counseling booth, sometimes the register and ensuring those medications are:
- for the correct patient
- indicated
- right dose
- clinically appropriate
and uncap each vial in the process. So it varies by state. Come on colleagues... before you start yelling at each other remember the reason every time you decide to work in another state you have to take the MPJE.
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Next time you see a tech bypassing the prompts at the register or when filling, get a witness and the policy and have them acknowledge it and sign it. Sometimes one head has to roll for people to get it that you mean business. A tad of fear goes a long way. It’s reason behind the success of world religions.
If you’re at Walmart you could send them to the training room to redo some CBLs.
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This.
There's also no reason the two first names should be spelled the same way in your system, @ancienbon.
Either add an asterisk, an extra character, or my favorite and most subtle, add their middle initial after the first name.
That's like year 1 retail stuff.
I am lost.. The two patients have same name and different dob... it seems that you dont work for cvs.. at pos we enter the first 3 caracters of first and last name,the system populates the list of patients.. now there is a new update where we can enter the dob and it will take you directly to the patient.
It is because the tech did not follow procedure... it was a stupid mistake...
And you think at a store that fills close to 3000 scripts a week,we have to go to the computer and figure out all patient with the same name... hum.. i dont know how is that possible
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Here we go...
There are places where names like
Xiong, Ming
Yang, Yang
Tran, Bo
Chen, Li
Tan, Vang
are VERY common. And no offense to anyone, there is often times a language barrier. It’s not a stupid mistake. It’s actually a serious mistake. But try to sort through 20 Tran, Bo and some are sometimes at the same address; and you’ll see that this mistake can happen and rather often. As a pharmacist you have to watch your techs and make sure you’re vetting everything they do or say.
Fortunately this type of mistake occurs very rarely at CVS. It looks a lot of posters here don't know how hard it is to sell the wrong scripts to the wrong patients at cvs. At pos you have to input the dob... so it is a stupid mistake. So you think working at a busy store you may notice when a tech walks to a computer terminal to check a dob because the dob the patient picking up gives does not match .. think again.
I agree we need to supervise our techs but we fall short sometimes... the tech was warned multiple times to never check the dob from the computer... the patient has to give them the correct dob...
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I can't tell if you're being sarcastic or if you actually think 3,000/wk is a lot for CVS.
You think you're safe because they "have to put the DoB"
Do you really think your technician randomly guessed the date of birth of another patient with the exact same name?
Do you believe they have the wrong patient's date of birth memorized ?
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“Fortunately this type of mistake occurs very rarely at CVS. It looks like posters here don’t know how hard it is...” Please... your view is narrow. Sure, in a perfectly caucasian world that might apply.
The names of the patients I just gave you, speak an Asian language that is really a spoken language because is a language of refugees. RARELY do theyspeak any English at all and since they are not able to read, they wouldn’t recognize an extra middle initial in a name that looks like theirs. YES AT CVS.
I never said the techs have no other choice but to hop over to a terminal and look people up. What I am saying is that techs will get creative in an attempt to find the patient. These patients get frantic, techs get anxious and if you are not paying attention, they will deviate from standard operating procedure and it will happen.
When I worked overnights, I’d get a fleet of them. Zero English. I would pull out my driver’s license, show it to them and say “your ID please”
They’d try to continue to tell me in their language whatever it was they were saying. We had techs that spoke their language but past a certain time, it was just me.
So no, I never made those errors because I always took full control of the situation. Asking for ID - most immigrants with a language barrier understand the meaning of the word “ID”.
The waiting bin was organized alphabetically, yes, but we sorted and matched bags by address and family, and kept them together.
So it’s not as simple as you put it in your narrow view.
So a non 24 hour store that fill 3000 scripts a week is not high volume ?lol.. you must be trolling... now i dont even think you really work retail...
So you know a store that averages 3000 to 3499 scripts per week is a very busy store.. The average cvs fills abt fewer than 2 k scripts a week.
Attachments
Nothing wrong with those names. You can clearly tell which is their first or last name. It's the ones with the hyphenated names that throws me bonkers. Sometimes the whole thing is their last name, sometimes it's their middle + last name, sometimes it's just Lopez.
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I remember having two patients on the floor with the exact same name but their year of birth was off by switched digits. They didn't even have a common name. It was something like John Doeingtonsky 1/12/1954 and John Doeingtonsky 1/12/1945. Can't blame anyone for not taking a second look at something like that.
FYI fake name and DOB. Just using it as an example.
FYI fake name and DOB. Just using it as an example.
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Son_Goku,
Refugees tend to have the same date of birth. It’s either 01/01/year (they’re never sure); or 03/01/ year.
True story. Sadly they don’t know their date of birth. CVS has a lot of those.
And that’s why at the first sign of a language barrier I ask for ID. If all I can do for you is get the order you placed, then I will make sure it is for you.
First 3 letters of last name, month and day do you no good if you have 8 Tran, Bo with 01/01.
So ID it is.
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amazing.
I'm not sure what i expected when i opened the attachment.
If you walk into an ER and see the pain scale, do you assume the average pain level of all patients is 5?
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Pharmacist is absolutely responsible for this. However, pharmacists make mistakes just like everyone else.
Just like surgeons who amputate the wrong limb... we're only human. What happens to you will depend on what the corporate mindset is at this very moment.
Just like surgeons who amputate the wrong limb... we're only human. What happens to you will depend on what the corporate mindset is at this very moment.
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You think that’s tough? Just wait until Sting, Madonna, or Sinbad show up at your counter.
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In all seriousness, though, the Board would assign fault to the pharmacist on duty for failure to properly supervise a tech.
Hypothetically, let’s adjust the scenario to a situation in which there 2 pharmacists simultaneously on duty. Then who’s at fault? Would the Board find both pharmacists at fault?
Hypothetically, let’s adjust the scenario to a situation in which there 2 pharmacists simultaneously on duty. Then who’s at fault? Would the Board find both pharmacists at fault?
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In TX, it's whoever is "pharmacist of record", i think
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