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Pharmacist Malpractice Video Case Study: Wrong Drug Involving a High-Alert Medication Results In $1M Settlement

Pharmacists face a variety of malpractice risk exposures in their profession, including wrong drug errors and wrong dose/strength claims—which represent first and second most common allegations asserted against pharmacists, as outlined in the Pharmacist Professional Liability Exposure Claim Report: 3rd Edition.

This video case study describes a wrong drug dispensing error involving a high-alert medication, which are drugs that bear an increased risk of causing patient harm when they are used erroneously. The high-alert drug in this case (methotrexate) is typically used to treat inflammatory arthritis, psoriasis, and certain types of cancer.

The case study involves an insured pharmacy under contract to an assisted living facility. The patient was a 78-year-old female living at the facility, who was prescribed a new prescription (metolazone) to reduce lower extremity edema. The following video case study is what occurred when the pharmacy dispensed the wrong medication (methotrexate), which was then administered to the patient for 10 days prior to her hospitalization and eventual death, and the civil lawsuit and policy limit settlement that followed.

In the video, you’ll learn:
  • The patient’s relevant medical history
  • The pharmacy individuals named in the lawsuit – the pharmacist technician, student intern, and licensed pharmacist preceptor on duty.
  • A range of failures identified by an investigation following the incident
  • The final cost of the malpractice lawsuit (policy limit settlement)
  • Risk management recommendations specific to the handling of methotrexate, as well as general strategies

Additional Resources
This publication is intended to inform Affinity Insurance Services, Inc., customers of potential liability in their practice. This information is provided for general informational purposes only and is not intended to provide individualized guidance. All descriptions, summaries or highlights of coverage are for general informational purposes only and do not amend, alter or modify the actual terms or conditions of any insurance policy. Coverage is governed only by the terms and conditions of the relevant policy. Any references to non-Aon, AIS, NSO, HPSO websites are provided solely for convenience, and Aon, AIS, NSO and HPSO disclaims any responsibility with respect to such websites. This information is not intended to offer legal advice or to establish appropriate or acceptable standards of professional conduct. Readers should consult with a lawyer if they have specific concerns. Neither Affinity Insurance Services, Inc., HPSO, nor CNA assumes any liability for how this information is applied in practice or for the accuracy of this information.

Healthcare Providers Service Organization is a registered trade name of Affinity Insurance Services, Inc., a licensed producer in all states (TX 13695); (AR 100106022); in CA, MN, AIS Affinity Insurance Agency, Inc. (CA 0795465); in OK, AIS Affinity Insurance Services, Inc.; in CA, Aon Affinity Insurance Services, Inc., (CA 0G94493), Aon Direct Insurance Administrators and Berkely Insurance Agency and in NY, AIS Affinity Insurance Agency.