What Are the Common Causes of Medication Errors?

Medical errors are a significant root cause of patient injuries and deaths in the U.S. According to some studies, medical errors may contribute to several hundred thousand preventable deaths every year. Awareness of the causes and frequency of these mistakes helps patients, doctors, and even insurers prevent them or mitigate their effects.

But even with the most rigorous systems and standards in place, medication errors will still happen. Gaps in knowledge, skill, communication, and information can lead to adverse medical events. In this article, we’ll explore these and other causes of medical errors.

Examples of Medical Errors

According to the AMA Code of Ethics, a medical error includes any unintended act that endangers patient safety. Examples include:

Diagnostic Errors

Misdiagnosis or underdiagnosis accounts for 40,000 to 80,000 hospital deaths per year. Misdiagnoses are a leading cause of medical errors. This error is most common in primary care settings where a doctor fails to:

• Order tests
• Refer to specialists
• Follow up with patients
• Interpret test results correctly

Doctors might commit a medication error by prescribing the wrong medication based on inadequate information.

Unnecessary Tests

Overdiagnosis is also an issue. Patients may receive unnecessary surgeries or treatments that diminish their immune systems, mobility, and overall quality of life. Patients might even receive the wrong drug for their condition, causing death or new complications.

What Causes Medication Errors?

Patients may receive too much medication or a drug that causes allergies. Also, medication storage errors cause patients to receive the wrong medication. Other prescription errors arise from a lack of pharmacist involvement; in one case, a young girl died after a pharmacy technician compounded her intravenous bag incorrectly.

Common medication errors include:

• Incorrect dosage
• Wrong drug
• Adverse reactions

These errors can kill or injure patients.

Surgical Errors

Around 4,000 surgical errors occur each year. They include treating the wrong body part, accidental hemorrhage, and anesthesia miscalculations. Anesthesia errors commonly cause catastrophic medication complications, such as nerve and brain damage or death, even when patients receive the right drug combination. New robotic surgical techniques increase hemorrhage and laceration risks. These incidents are common hospital errors.

Delayed Treatment

Delayed treatment is the third most common medical mistake, according to health statistics. It frequently involves physicians performing an inadequate examination and assigning a benign diagnosis to more serious conditions. Delayed treatment prevents patients from receiving the right medication for their disease or injury. Patients face higher mortality rates and more healthcare costs due to readmission and additional care.

Failure to Follow Up

While this is often associated with misdiagnosis, healthcare workers can provide inadequate follow-up even with a correct diagnosis. That includes higher medical expenses due to needing more invasive care. Patients then receive inadequate care and face delayed treatment consequences. Follow-up communication also detects prescribing errors where patients experience adverse reactions from the wrong dose or medication. This error also includes failure to inform. For example, cardiovascular patients often need to reduce physical activity. If they do not do so, they face death or hospitalization.

Medical Errors Statistics

Medical error rate statistics illustrate the sheer scope of the medication error problem:

• Patients report over 100,000 medication errors to the U.S. FDA every year.
• Over 40% of Americans have seen or experienced a medical error.
• Doctors in the U.S. commit more than 7 million medical errors each year, although not all of them result in adverse consequences or inadequate care.
• The most likely causes of medical errors involving medication are prescribing errors where the patient receives the wrong dose or drug.
• The least likely cause of a medical error is a mix-up where one patient receives another patient's medication.

Regardless of the reasons, medication errors are a common cause of adverse medical events.

The Cost of Medical Errors in Healthcare

Medical errors account for $4 billion in costs each year. These expenses include additional care to fix the inadequate care. Medication errors can damage organs, trigger allergic reactions, or cause fatal overdoses. Also, many errors lead to new injuries and health problems arising from surgical, diagnostic, and medication errors, increasing healthcare costs.

Why Do Medical Errors Occur?

Medical errors happen for many reasons. Understanding the root causes of medical errors can prevent future mistakes and determine liability for past mistakes. Medical errors are most often due to:

Poor Communication

Uncoordinated care is one of the root causes of medical errors even as technology seeks to solve the problem. Sometimes, the mistake is as simple as a primary care provider failing to read a specialist’s report on a patient. Other times, inadequate technology, including network breakdowns, make it impossible for healthcare providers to stay in contact or properly route information. The result is often conflicting care, including prescribing medications that interact poorly.

Communication problems can also arise between a doctor and a patient during intake and examination. An inadequate discussion about the patient's allergies can cause prescribing and dispensing errors.

Poor communication during the examination can produce medication-associated errors. The doctor might miss symptoms. As a result, the doctor might make a mistake in prescribing medication to the patient. Communication problems can even happen when a doctor prescribes the right medication. A doctor's failure to discuss side effects can blindside a patient taking the right drug.

Human Factors

Human factors that contribute to medication errors include:

• Knowledge-based errors due to inadequate training about patient safety
• Lack of skill can lead to medication dispensing errors
• Understaffing can prevent follow-up with a patient

Healthcare workers are not solely to blame for mistakes. Healthcare providers need a standardized system to monitor them to eliminate these causes of medical errors.

Patient-Related Issues

An emergency department or hospital administrator can cause a medication error by mixing up patient records. Doctors can also fail to provide patients with education about safe medication practices.

Lack of Knowledge

Medical knowledge is always advancing. Knowledge-based errors can occur when new studies change medication administration or identify other medication complications that were previously unknown. Doctors are responsible for remaining aware of healthcare research, current drug names, and accepted medical standards.

Technical Failures

Technical errors can occur when the equipment and instruments used to administer or monitor a patient's medication break down.

Racial Bias

Racial biases can lead doctors to jump to conclusions about the patient. When doctors ignore patient symptoms, it causes medical errors and misdiagnoses.

Poor Sanitation

Poor sanitation causes infections and contaminated medication. Sanitation is one of the most common causes of medication errors.

Reduced Staffing

Medication errors occur when understaffing in the healthcare system forces workers to work while fatigued. These medical errors can be solved by increasing staffing.

Inadequate Information Flow

Medical information must flow between patients, administrators, and doctors. When records get mixed up, poor communication and medical errors can occur. Many medication errors occur simply because medication gets provided to the wrong patient.

Doctors need to provide patient education. They also need to communicate with pharmacies about refills at the right time. Information flow will become one of the most common causes of adverse events as the industry becomes more reliant on computers.

Top Ten Patient Safety Concerns

The ECRI compiled a study of the top ten patient concerns for 2021. Many of these concerns relate to the pandemic; however, they apply to most healthcare settings even when there are no pandemics. The pandemic merely highlighted the process. The top patient safety concerns include:

Racial and ethnic disparities in healthcare: As discussed, a patient is more likely to face the impacts of medical error if they are not white.

Emergency preparedness in aging services: Natural disasters make managing the most vulnerable difficult. Evacuation, shelter-in-place orders, and modified visitation affect staffing numbers and patients’ physical safety. Falls during evacuation often cause further patient injury in nursing homes where supplies and equipment are already limited.

Pandemic preparedness: Pandemics create inpatient surges that pressure short-staffed hospitals. This situation increases the chance of preventable medical errors, including diagnosis mistakes and the possibility of healthcare-related infection.

Supply chain interruptions: When hospitals lack critical medical equipment, they improvise. Patients may catch infections from equipment that is not medical grade or face adverse effects from off-label uses. According to the ECRI, 60 to 70 percent of respirators failed to reach the standards requiring 95 percent filtration efficiency. For hospital gowns, 52 percent of them do not meet the lowest protection standards.

Drug shortages: Related to supply chain issues, drug shortages threaten patient health. Without certain drugs, patients face delayed or canceled appointments or fewer options. Sixty-seven percent of drug shortage events lead to missed or delayed medication doses.

Telehealth workflow management: By 2030, healthcare workers will provide at least half of their services virtually. The communication issues with Telehealth have more to do with technology; poor WiFi accessibility in clinics and hospitals and inadequate translation services often interfere with effective virtual appointments. Also, there are concerns about how to protect patients' privacy and provide proper follow-up care. This could become one of the root causes of medical errors as more patients use virtual services.

Improvised use of medical devices: When medical staff must improvise with medical devices, they risk spreading infections or injuring patients. As stated above, this is a supply-side issue that exists even outside of the COVID pandemic.

Methotrexate therapy: Methotrexate treats cancer and autoimmune disorders. At its root, it also presents dosage problems. Of the medical errors traced to Methotrexate, 41 percent of them are the wrong dose. Overdoses can be deadly; patients suffer vomiting, mouth sores, severe skin lesions, renal and liver failure, and pulmonary symptoms.

Peripheral vascular harm: Peripheral intravenous catheters (PIVCs) are the most commonly used medical device in hospitals. Unfortunately, misuse leads to burns, leaks, redness, swelling, drainage problems, erythema, ecchymosis, and other issues. Patients also develop infections due to improper insertion.

Aerosol-generating procedures: This issue is amplified with COVID. The droplets produced in this process spread infectious diseases and place healthcare workers and other patients at risk.

How Patients Can Protect Themselves

Avoiding illness and injury from medical errors requires vigilance. While we all want to trust our medical care providers, they are human and make errors. Here are three tips for advocating for yourself in a healthcare setting:

Ask questions: If your doctor will not perform a test or offers a diagnosis that seems alarmist, start asking questions. Inquire about symptoms and treatment. Make sure your doctor presents all options and explains the risks and side effects. Research your condition online for reliable background information. While a Google search does not give you the same authority as a medical degree, it will offer a foundation to ask questions and stay involved in your care.

Pursue second opinions: Dire diagnoses should demand a second option. Otherwise, you risk facing unnecessary treatment that may injure you in the future. If a doctor seems soft on making a diagnosis, that is also a sign to seek another opinion. You want as much confirmation as possible. Otherwise, you may suffer from delayed impacts.

Bring someone to appointments: See if a friend, family member, or partner can attend appointments with you. Besides moral support, they also act as an advocate. They may consider questions that do not occur to you or remember details that you were too overwhelmed to comprehend. Also, you have a witness if a doctor dismisses symptoms, refuses tests, or fails to look at test results or reports. That makes it easier to seek another healthcare provider or if you need to pursue a malpractice claim, provide evidence.

Remain involved: The best thing you can do for yourself during medical upheaval is to remain involved. If something does not seem quite right, investigate it or take the matter to a clinic or hospital advocate. You are entitled to effective medical treatment and should not suffer in silence. How do human factors influence healthcare errors? Medication errors sometimes occur when no one questions something that is clearly wrong.

What to Do If You’ve Become a Victim of a Medical Error

After a medical error, you face both health and financial issues. You need corrective treatment, but the mistake disabled you.

After common medical errors, you should consider pursuing a medical malpractice claim. You will need to document what happened and gather evidence of the negligence, if possible. Consider contacting an attorney to handle your case while you focus on your health.

Contact an Experienced Medical Malpractice Attorney at Jacob Fuchsberg Law Firm Today!

An experienced medical malpractice attorney from Jacob Fuchsberg Law Firm works to protect patients who have been injured by common medical errors. An attorney can help you recover fair compensation for the impacts of malpractice on your finances and quality of life. Just as importantly, a malpractice claim can help you get justice against those responsible for medical errors.

Proving medical malpractice often requires experience in dealing with malpractice insurers and knowledge about how medication errors occur. To learn about your right to injury compensation after a medical error, contact us online or by calling 212.869.3500 for a free consultation.