How Medication Errors Affect Nursing Home Residents

According to a 2024 research study published by the National Library of Medicine, almost 400,000 patients in the United States suffer complications from medical errors each year. The report, which also estimates 200,000 annual deaths, focuses on preventable situations that include the prescription, dosing, and administration of medications. The National Institutes of Health (NIH) ranks medical errors as the third leading cause of death in the U.S., including nursing home residents whose deaths were associated with medication errors.

From a clinical perspective, medication errors are among the most frequent catalysts of patient harm situations, a topic explored in Medical Malpractice: Common Errors by Doctors and Hospitals. From a legal perspective, medication errors fall under the purview of negligence, particularly when they happen at inpatient and long-term care facilities like nursing homes. According to NIH estimates, up to 70% of medication errors are detected by nurses and pharmacists; however, 25% of patient harm situations created by these blunders happen at hospitals and nursing homes.

Understanding the "Five Rights" of Medication Administration

At the clinical level, pharmaceutical products must go through a careful management process that always adheres to the "five rights." This means giving the right medications to the right patients at the right times, observing the right doses and routes. Medication errors happen when one or more of the "rights" turn into a "wrong."

If a medication error causes patient harm, the complaint must explain how and where things went wrong. For instance, if a severely asthmatic elderly patient suffers respiratory arrest and seizures from too much propranolol, the causation might not be limited to a nursing staff member administering the wrong dose to the right patient at the right time. What about the diagnosis and prescription?

In the example above, severe bronchial asthma would be a contraindication to prescribing a beta blocker like propranolol, thus suggesting a medical malpractice angle originating at the physician level.

Understanding the "Four Pillars" of Negligence

When your elderly loved ones are admitted to a nursing home, the facility and its staff are legally obligated to act in a reasonably prudent manner that upholds the professional standard of medical care. If a propranolol overdose harms your loved one because one or more of the five rights went wrong, the nursing home can be held accountable in civil court. To accomplish this and maximize the likelihood of a positive outcome, a nursing home abuse lawyer must elaborate on the elements of duty, breach, causation, and damages. These are the "four pillars" of medical malpractice, and they are summarized below:

1. Duty

The nursing home has a legal obligation to ensure patients receive an adequate standard of care.

2. Breach

This happens when the nursing home fails to meet the standard of care.

3. Causation

If medical records and available evidence show a medication error caused harm, the court will interpret it as causation.

4. Damage

This element refers to how the patient was harmed by the error; for example, suffering respiratory arrest from a contraindication.

How Medication Errors Happen

The legal analysis of tragic medication errors is always limited to the nursing home. Civil courts pay attention to the continuum of medical care because medication errors can happen at any point. The five rights are not limited to the nursing home; they must also be observed during the prescription, documentation, and transcription stages. The continuum extends to the pharmacy for dispensing, the nursing home for administration and monitoring, and back to the physician for follow-up.

Some medication error lawsuits are characterized by complexity. They aren't always as easy to prepare and litigate because not all will be as "clear-cut" as a physician ignoring contraindication. Other issues may arise from inaccurate transcriptions, inadequate monitoring for allergic reactions, incomplete medication orders, poor communications, and inaccurate patient information.