Rx deleted after incident

[ancienbon]

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My partner dispensed humulin u 500 vial instead of kwikpen. Patient s daughter called to complain. It was a new script. I then inactived it and initiated the incident report onMonday. I printed the hardcopy and typed it for kwikpen.Was a busy day and i worked morning shift. I called a few cvs to see if they have kwikpen but none had it . I ordered it for the patient before my shift . Patient brought vial back the next day. I was off and when i came on wednesday, i realized the script dissapeared in his profile. Looked like they refunded it and deleted it. And i dont even see the incident i started in QA now.
What do i do?

 

[FlavyFlav]

I think you know your options, it's just hard to pull the trigger. This is assuming you've already talked with your partner about this and they are deliberately going against policy.

1) Go to your DM and report the entire situation and put everything on your partner as soon as possible. The obvious consequences being: You would be off the hook for any future punishment if it ever was found out, your partner would loathe you (not necessarily a bad thing or their right, but it would happen), you have proof that you do the right thing in case you happen to make any mistakes in the future.

2) Do nothing. This assumes you would go with the belief that it was your partner's mess-up and you believed they would fix it, therefore letting the matter go. This is fine unless you're a PIC. If anything does come out, you may not be able to shed all blame, however, so there is some risk involved.

3) Cover it up. The evidence has already been deleted out of the computer, why cry over spilled milk? Just know, nothing is ever deleted permanently and if the patient wanted to push it further you would both be reprimanded heavily for trying to hide the mess-up.

Personally, you might still talk to your partner and find out everything that is going on and ask what they intend to do. Your license isn't worth covering up their mistake and if you aren't satisfied with the answer then you should still go to the DM with it. If I had my QA deleted by someone else and I wasn't even told, I would be furious and I wouldn't give a single **** what they thought about me.

 

[maria1oh]

It's baffling how cvs does not link up their inventories so you can check in the computer if another cvs store within 20-30 mile radius has something in stock. It's a major waste of time cold calling all the stores.

Was the patient harmed? Did it require rx supervisor follow up? If not I would not worry too much about it. Also cvs wants you to email your supervisor each time you file an incident report. Just let them know.

 

[Rukn]

It's baffling how cvs does not link up their inventories so you can check in the computer if another cvs store within 20-30 mile radius has something in stock. It's a major waste of time cold calling all the stores.

Was the patient harmed? Did it require rx supervisor follow up? If not I would not worry too much about it. Also cvs wants you to email your supervisor each time you file an incident report. Just let them know.

Counts would be off anyway knowing CVS

 

[Lnsean]

My partner dispensed humulin u 500 vial instead of kwikpen. Patient s daughter called to complain. It was a new script. I then inactived it and initiated the incident report onMonday. I printed the hardcopy and typed it for kwikpen.Was a busy day and i worked morning shift. I called a few cvs to see if they have kwikpen but none had it . I ordered it for the patient before my shift . Patient brought vial back the next day. I was off and when i came on wednesday, i realized the script dissapeared in his profile. Looked like they refunded it and deleted it. And i dont even see the incident i started in QA now.
What do i do?

Yea that is a pretty serious mistake. Your partner is lucky the pt didnt use it. You need to go to your DM and report the entire situation. If anything does come back later on, you're not liable for it.

 

[ldiot]

Nobody is going to get fired over the mistake but people do get fired for not reporting. You don't have to play detective and/or screw her over but I'd bring it up and make sure it is reported asap.

 

[aznkukuboi]

The reporting system at CVS isn't great since it's possible to delete the script as if it never existed. Plus if the rph pulled the hard copy and tossed it, then it's as if it never happened!

The question is, however, how the heck your store stocks the concentrated insulin?
How was the product scanned? The box literally has a lot of orange lines as big flags.

 

[ancienbon]

The reporting system at CVS isn't great since it's possible to delete the script as if it never existed. Plus if the rph pulled the hard copy and tossed it, then it's as if it never happened!

The question is, however, how the heck your store stocks the concentrated insulin?
How was the product scanned? The box literally has a lot of orange lines as big flags.

Script was typed and verified for humilin u 500 vial instead of the pen.

 

[Old Timer]

Write an e-mail from your home computer to your pharmacy supervisor and lay out all of the facts.

 

[BidingMyTime]

I'm reading this as a 500 unit vial was dispensed instead of the 500 unit quick pen--I would hardly even count that as an error, the medicine is the exact same, just the pen is a convenience factor. Now if I'm not reading this right and it was a 500 unit given in place of a 100 unit, yeah, now that is a major error that needs to be reported.

 

[ancienbon]

I'm reading this as a 500 unit vial was dispensed instead of the 500 unit quick pen--I would hardly even count that as an error, the medicine is the exact same, just the pen is a convenience factor. Now if I'm not reading this right and it was a 500 unit given in place of a 100 unit, yeah, now that is a major error that needs to be reported.

You are reading it right. I was not aware until the event that it was available in pen. I was going to report it because the patient was upset .

 

[owlegrad]

Wait, it was vial vs pen? I might have deleted that **** too, lol

 

[doublehh03]

IF it vials v. pen, sure you should still report it b/c patient complained. If it gets to corporate and nobody wrote it up, someone is going to get in trouble. Just use the new RX # and an IR based on that but detailed what happened. Your sup is going to read that IR too.

 

[trailerpark]

At Walmart you can deactivate a script but there's no way to delete it out of the system.


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[M0df]

If you know for sure that it was intentionally deleted, then you have a problem. However, as previously mentioned, CVS system and incident reporting has a ton of glitches. You can inactivate a script but then it keeps something in a profile that can be used to fax or generate another script, which can lead to more problems.

Also, is there even an option for staff or even PIC to delete an incident report that is already in progress?

 

[Lnsean]

I thought it was u500 vs regular u100....if it's just a matter of pens vs vials then I would just let it go. Nothing major here and not really a mistake per se.

 

[ChalupaBatman86]

U 500 should not even exist, it is an accident waiting to happen. Especially when it's just 2mm South on the touchscreen of their e-prescribing application.

 

[FlavyFlav]

You are reading it right. I was not aware until the event that it was available in pen. I was going to report it because the patient was upset .

Ah, this is completely different. I was under the assumption a u500 was given out in place of a u100. I don't think I would report a pen vs vial either. it may be an inconvenience, but the drug, dose, strength, route was still the same. Go with the ignore it option for this one 🙂

 

[ancienbon]

That is true. I was going to ignore it but the patient's daughter was arguing with me over the phone for a few minutes. I told her it is the same exact med.she kept insisting that we dispensed the wrong med. Was going to report it just in case she calls corporate. But now the evidence is gone, i just let it go.

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[ldiot]

Now that I think about it it's even possible that she intentionally switched it if you didn't have the pens in stock. Doesn't mean it's legal but it's still the same drug and same dose. I've seen pharmacists do similar things.

 

[Lnsean]

U 500 should not even exist, it is an accident waiting to happen. Especially when it's just 2mm South on the touchscreen of their e-prescribing application.

Yea..it's kinda scary...I had a discussion with a doctor once about switching a patient from u-100 to u-500. He was like "isn't the patient using the same units...so there's really no change" and I was like "well yes, but you have to consult/indicate the amount pulled from standard insulin syringes will be different. If they pull to the same unit marking on their old syringes...they will overdose." To this day...I don't think he really understood.

 

[Old Timer]

That is true. I was going to ignore it but the patient's daughter was arguing with me over the phone for a few minutes. I told her it is the same exact med.she kept insisting that we dispensed the wrong med. Was going to report it just in case she calls corporate. But now the evidence is gone, i just let it go.

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The evidence is not gone and you should not let it go. Cover your ass. Find the hard copy rx in the file. You know what day it was filled. If not, call the patient and find out. Send an e-mail to your supe. Covering up an error is grounds for dismissal. Protect yourself. You know about it, you report it.

 

[doublehh03]

That is true. I was going to ignore it but the patient's daughter was arguing with me over the phone for a few minutes. I told her it is the same exact med.she kept insisting that we dispensed the wrong med. Was going to report it just in case she calls corporate. But now the evidence is gone, i just let it go.

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No. Use the new RX number and file a report based on that with detailed information. A customer complained. If it gets to corporate and they investigate, someone will be in trouble for not putting in a report. Just detail what happened and in there write the RX was accidentally deleted but this is what happened.

 

[Dr Wario]

Vial vs pen is not an error, just like given a pt watson brand when they wanted mylan band is also not an error.

 

[Old Timer]

Vial vs pen is not an error, just like given a pt watson brand when they wanted mylan band is also not an error.

It is an error of they don't have syringes and it delayed their therapy. CYA, and file a report.

 

[doublehh03]

Vial vs pen is not an error, just like given a pt watson brand when they wanted mylan band is also not an error.

If they script specified pen (and especially if the patient has a history of pens) and you give vial, it is. The new CVS incident reporting system is extremely detailed. Any patient complaint that is different from what the script entails the RPH should report to be safe.

 

[Lnsean]

It is technically an error. The legit thing to do is to report it. I don't personally report these type of things...like missing refills and such.

 

[mentos]

Really, all this discussion over pen vs vial? If you guys dispensed vitamin D softgels instead of tablets, would you report that too? Triamterene/HCTZ caps were on back order for a while and we gave everyone tabs instead. No one cared.

 

[waiter]

If you filed a report for everything you'd have at least 365 reports/year

 

[zelman]

Really, all this discussion over pen vs vial? If you guys dispensed vitamin D softgels instead of tablets, would you report that too? Triamterene/HCTZ caps were on back order for a while and we gave everyone tabs instead. No one cared.

You don't need unique administration supplies for tablets v. capsules.

 

[Carboxide]

FYI OP Humulin U500 vial is completely different from a 5 mL vial of U100 for a total dose of 500 IU in the package size. (Do they even make 5 ml vials??)

 

[zelman]

FYI OP Humulin U500 vial is completely different from a 5 mL vial of U100 for a total dose of 500 IU in the package size. (Do they even make 5 ml vials??)

New game: post another real thing that is different from something you've imagined.

Poisonous amazonian tree frogs are different from fire-breathing dragons.

Who's next?

 

[owlegrad]

New game: post another real thing that is different from something you've imagined.

Poisonous amazonian tree frogs are different from fire-breathing dragons.

Who's next?

A submarine is totally different from a moon base.

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[doublehh03]

If you filed a report for everything you'd have at least 365 reports/year

If patient complained, report, esp. if you work at CVS.

 

[FarmD711]

New game: post another real thing that is different from something you've imagined.

Poisonous amazonian tree frogs are different from fire-breathing dragons.

Who's next?

I am concerned at the apparent lack of reading comprehension we pharmacists apparently (don't) have.



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