Medication Errors in Nursing Homes

Medication mismanagement issues, broadly referred to as “medication errors,” are a leading cause of injury or death in nursing homes. The term “medication error” is often misunderstood, in that many assume that it refers solely to incidents that occur through accident or mistake. However, medication errors can also involve acts or failures to act that occur intentionally, knowingly or purposefully. The FDA defines a medication error as:

“Any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer.  Such events may be related to professional practice, health care products, procedures, and systems, including prescribing; order communication; product labeling, packaging, and nomenclature; compounding; dispensing; distribution; administration; education; monitoring; and use."

Because most long-term care facilities are directly involved with the entire medication process—from handling and storage, to dispense and administration of meds—the potential for medication errors are particularly high amongst the residents of nursing homes. Some of the most common medication errors include:

• Medication Substitutions: Using a generic version when the resident requires a name-brand drug, or administering a different type of medication altogether. Often time, drugs are substituted intentionally, because the facility may be trying to save money, has run out of a certain medication, or a staff member steals a resident’s medication and replaces it with another. However, substitutions can also occur accidentally and/or as a result of negligence.
• Under-Medicating: Giving a resident less medication than what is prescribed, either by decreasing dosage, reducing frequency, or shortening the time-period set for on the prescription. Under-medicating frequently occurs due to facility under-staffing, but can also occur for reasons similar to drug substitutions (save expenses, not enough meds on hand, staff-member theft, accident or negligence).
• Over-Medicating: Dispensing or administering too much medication, whether intentionally, knowingly, accidentally or negligently. In the most egregious of cases, a nursing home will over-medicate a resident for purposes of sedating or chemically restraining, when the use of restraints is inappropriate and/or unnecessary to protect the resident from harming themselves or another.
• Medication Instruction Failures: Failing to administer medication as instructed on the prescription with regard to the intake of fluids, food, or antacids. (i.e. ‘drink plenty of water,’ ‘take with food, ‘do not take with food,’ ‘take an antacid prior to taking this medication.’).
• Incorrect Administration Technique: Giving a resident medication in an improper manner.

  Common examples include:

  • Failing to ensure that eye drop medication actually gets into the resident’s eye(s);
  • Improper placement of transdermal patches;
  • Not waiting long enough between successive doses;
  • Shaking a medication when it should be “rolled” (to prevent air bubbles);
  • Failing to shake medication (or shake sufficiently) prior to administering;
  • Improper administration of subcutaneous medication;
  • Not monitoring the resident to ensure that they ingest all medications administered;
  • Allowing the resident to repeatedly misuse sublingual medication (i.e. swallowing medication that needs chewed or placed under the tongue);
  • Failing to identify, prevent (or report) issues with regard to administration techniques, when the staff member was required to, or, they knew or should have known that doing so was necessary to ensure the resident’s well-being.
• Expired Medications: Intentionally OR Accidentally administering medication beyond its expiration date, the result of which causes harm to a resident due to ineffectiveness and/or under-medicating.
• Out-of-Date Medication Orders: Continuing to administer medications when the treatment order/plan is expired, out-of-date, requires doctor approval, and/or should be renewed.

Medication errors are a serious problem, and can cause significant injury, and in some cases even death. It is important to know that although federal regulations only require that facilities keep medication errors under a 5% rate, this does NOT mean that a nursing home can avoid civil liability for harm caused to a resident due to a medication error simply because their ‘error’ rate falls below the so-called ‘deficiency level.’

If you suspect a medication error has occurred, or is currently occurring, our team of Nursing Home Negligence Attorneys encourage you to discuss your concerns with an experienced legal professional. Contact Chicago Injury Lawyers Zneimer & Zneimer P.C., at 773-516-4100 or online 24/7, and allow us to review your personal injury case free of charge, and explain your legal rights to financial compensation.