Medication-related errors are now the fourth leading cause of medical malpractice claims in the U.S. When looking at overall usage of prescription medications, this may not be surprising as over 48% of the population use at least one prescription drug. The Center for Disease Control and Prevention say that over 23% of the population use three or more prescription medications regularly.
A recent report by Coverys, a leading provider of liability insurance for medical professionals, analyzed the types of prescription medications which are most likely to lead to a claim of malpractice based on the specific medical setting in which they are prescribed.
Overall Claims According to Medication Type
- Opioids accounting for roughly 24% of prescription-related claims
- Anticoagulants (blood thinners) rank second at 16%
- Antibiotics are associated with 12% of claims
- Anti-anxiety: 6%
- Antidepressants: 6%
Opioids & Anticoagulants Leading the Way
The U.S. has been in the midst of a widely recognized opioid “crisis” for the last decade. Recently, the federal government has labeled the problem a "national emergency". The volume of prescription opioids sold has more than tripled in the last 15 years and unfortunately, many users have transitioned to illegal drugs such as heroin when they are no longer able to obtain prescription access to these products.
Meanwhile, approximately six million Americans use anticoagulants to prevent blood clotting, which are effective for long-term treatment in the prevention of problems such as stroke. Looking further into medication-related claims of malpractice, the Institute for Safe Medication Practices (ISMP), has reported on the patterns showing which drugs are the most likely to result in patient harm according to the clinical setting or location where the patients receive them.
Acute Care Settings (inpatient)
Settings that provide acute care are those where the patient is under constant medical care, such as a hospital. The medications that are most likely to cause patient harm include:
- Epinephrine: In a hospital setting often used in emergency situations such as in treatment of allergic reactions. The drug is commonly administered via injection to the layer of tissue below the skin (subcutaneous)
- Epoprostenol: Often referred to by the brand name Flolan, is a vasodilator that relaxes the muscles to open blood vessels
- Magnesium sulfate: Typically injected in situations involving asthma or stroke
Ambulatory Settings (outpatient)
- Carbamazepine: For seizures and nerve-based pain
- Chloral hydrate liquid: A hypnotic to promote calmness
- Heparin: An anticoagulant (blood thinner)
- Metformin: Diabetic treatment
Long-Term Care (nursing home)
- Digoxin: Cardiac-related problems
- Epinephrine: Injected for allergic reactions
- Iron Dextran: Injected for anemia
- Morphine: Opioid pain reliever
Approximately 42% of errors involving medications occur in an office or clinical setting. Roughly 31% of errors are associated with a failure to monitor the patient's medication regimen. Some of the mistakes are from failures to monitor dosages and harmful interactions between prescription drugs and often interactions with over-the-counter products. In 38% of medication-related malpractice claims the patient has died as a result.