We all make mistakes; however, when it comes to the care and support you receive in a nursing home, a mistake can end up costing a life.  One of the common errors that occur in nursing home environments is medication errors. Sure, there are many excuses why your medication may have been mixed up, missed, or administered incorrectly – the staff member was exhausted; the label wasn’t clear; the staff member is new to the team; the order was read wrong; there was a problem with communication – however, none of these explanations can excuse the legal implications of the situation.

Medication errors in nursing homes are a serious situation that can end up causing severe illnesses and, in some cases, even death. Furthermore, medication errors are a serious sign of nursing home neglect or abuse and this behavior should never, under any circumstance, be tolerated. It is important to report any medication errors to a Minnesota nursing home abuse lawyer right away.

Types of Medication Errors

Medication errors often occur due to the following instances:

• If a nursing home staff fails to give the needed medications;
• If a nursing home staff gives the wrong medication;
• If a nursing home staff gives the wrong dosage of a medication;
• If the nursing home staff fails to give the medication at the correct time;
• If the nursing home staff does not follow the orders instructed by the resident’s physician.

These errors are often the result of carelessness or oversight by the nursing home staff, usually due to an inadequate number of trained staff.

Whatever the reason, the result is still harmful to the patient and can be considered a form of abuse. Just because a nursing home is understaffed and a staff member is tired does not excuse the member from providing inadequate care.

Nursing Homes MUST Ensure that Residents are Free of any Significant Medication Errors. (42 CFR § 483.25 (m)) and Minnesota Rule 4658.1320.

42 CFR § 483.1320 (m) Medication Errors. The facility must ensure that—

(1) It is free of medication error rates of five percent or greater; and

(2) Residents are free of any significant medication errors.

4658.1320 MEDICATION ERRORS.  A nursing home must ensure that:

A. Its medication error rate is less than five percent as described in the Interpretive Guidelines for Code of Federal Regulations, title 42, section 483.25(m), found in Appendix P of the State Operations Manual, Guidance to Surveyors for Long-Term Care Facilities, which is incorporated by reference in part 4658.1315. For purposes of this part, a medication error means:
(1) a discrepancy between what was prescribed and what medications are actually administered to residents in the nursing home; or
(2) the administration of expired medications.
B. It is free of any significant medication error. A significant medication error is:
(1) an error which causes the resident discomfort or jeopardizes the resident’s health or safety; or
(2) medication from a category that usually requires the medication in the resident’s blood to be titrated to a specific blood level and a single medication error could alter that level and precipitate a reoccurrence of symptoms or toxicity.
C. All medications are administered as prescribed. An incident report or medication error report must be filed for any medication error that occurs. Any significant medication errors or resident reactions must be reported to the physician or the physician’s designee and the resident or the resident’s legal guardian or designated representative and an explanation must be made in the resident’s clinical record.

Questions regarding medication errors:

• How are errors reported in the facility?
• Is the same person making repeat med errors?
• Who tracks and the errors?
• What was indicated on the Medication Administration Records (MAR)?

Make sure you are aware of what antipsychotic medications your loved you is taking.

According to an article from May 26, 2008, published in the New York Times: Elderly people with dementia who are given antipsychotics, even for a very short period of time, are more likely to end up in the hospital or even die, new research shows.

Many experts feel behavioral interventions should be tried first and antipsychotics used as a last resort, “when the behavior or the psychiatric symptoms are really out of control and causing complete distress not only for the person suffering from Alzheimer’s, but for caregivers all around them,” said Maria Carrillo, director of medical and scientific affairs at the Alzheimer’s Association in Chicago. “It’s important to work these things out with the physician and, of course, do follow-up very closely together, so you can make sure these antipsychotics are having the effect you want and, if not, discontinue them immediately.”

The findings were published in the May 26 issue of theArchives of Internal Medicine.

Antipsychotic drugs are commonly used to treat some of the behavioral complications of dementia, including delirium.

Newer antipsychotic medications such as Zyprexa (olanzapine) and Risperdal (risperidone) have been available for about a decade and have largely replaced their older counterparts.

Researchers from the Institute for Clinical Evaluative Sciences in Ontario, Canada, compared 20,682 older adults with dementia living in the community with 20,559 older adults with dementia living in a nursing home between April 1, 1997, and March 31, 2004.

Each group was divided into three subgroups: those not receiving any antipsychotics, those taking newer antipsychotics, and those taking older antipsychotics such as Haldol (haloperidol).  According to information gleaned from medical records, community-dwelling adults who had recently received a prescription for a newer antipsychotic medication were 3.2 times more likely than individuals who had received no antipsychotic therapy to be hospitalized or to die during 30 days of follow-up.

Those who received older antipsychotic therapy were 3.8 times more likely to have such an event, relative to their peers who had received no antipsychotic therapy.

A similar pattern, albeit less dramatic, emerged in the nursing home group. Individuals taking older antipsychotics were 2.4 times more likely to be hospitalized or die, while those taking newer drugs were 1.9 times more likely to die or be hospitalized during the 30 days of follow-up.

The study does, however, have its limitations. “It’s a carefully done study,” Kennedy said. “One flaw is that the [participants] weren’t randomly administered antipsychotics. There was some reason they were given an antipsychotic, such as aggression or agitation. It may have been done if they were recently admitted to the nursing home as part of the adjustment process.

Indeed, the authors acknowledged that about 17 percent of patients entering nursing homes start taking an antipsychotic within 100 days.

“For any of us, moving is like being sick. It takes a while to recover,” Kennedy said. “We need other sets of interventions besides medications. What that implies is more staffing and better training for staff, and that may not be a whole lot more expensive than medicines.”

Consequences of Medication Errors

In most instances, a medication error will go unnoticed.  However, if you have experienced confusion, over-sedation, hallucinations, bleeding and other symptoms of a medication error, or if you notice your loved one acting out of place, then it could be due to a medication error. Furthermore, if you notice that the medication prescription has been altered without the knowledge of the resident or their legal representative or if you notice that you are missing dosages, it is important to speak to someone about this problem.  Discuss your concerns with a Minnesota nursing home abuse attorney.

Contact Attorney Kenneth L. LaBore, For a Free Consultation

Kenneth L. LaBore a partner at Pearson Randall Schumacher & LaBore can offer you years of experience in handling nursing home abuse and neglect cases.  No medication error should go unnoticed and if you have been affected by this type of neglect, it is important that you get the legal advice to hold the facility accountable for their preventable neglect.  Contact Kenneth L. LaBore locally at 612-767-7503 toll free at 800-774-0757 or fill out the form on this page to discuss your nursing home medication error case.

Email: KLaBore@mnnursinghomeneglect.com

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