Improperly Filled Prescriptions

The Journal of the American Pharmaceutical Association published an article entitled, “National Observational Study of Prescription Dispensing Accuracy and Safety…” in 2003, concluding that “dispensing errors are a problem on a national level, at a rate of four errors per day in a pharmacy filling two hundred fifty prescriptions daily.” “…an estimated fifty one point five million errors occur during the filling of three billion prescriptions each year. This figure includes three point three million errors of potential clinical importance.” Clearly the industry itself is on notice that the public should now be tuned in to the enormous potential problems with misfilled prescriptions. The problems with misfilled prescriptions begin with the utilization of unqualified personnel in retail pharmacy operations. For the most part, prescriptions are often filled by personnel who have no more than a high school education and a limited period of instruction. The prescription is then laid out on the pharmacist’s counter along with the filled bottle and the prescription and filling accuracy are quickly matched by the pharmacist’s, approved and then placed in a bag for customer pick up. The North Carolina Board of Pharmacy established a one hundred fifty prescriptions per pharmacist per day threshold for citing both the pharmacist and the permit holder in a disciplinary proceeding. The Board adopted this threshold level using information presented at the National Association of Boards of Pharmacy (NABP) Health Law Officers Conference in Savannah, Georgia in November of 1996. Experts on this program gave the range of not more than ten to twenty prescriptions per hour as established levels of safe dispensing. A vice president for one national chain store stated that its standard was five minutes per prescription for technical function only which did not include patient counseling and prospective utilization review. Their standard then would be something less than twelve prescriptions per hour. Applications of this data to work schedules lead the North Carolina Board of Pharmacy to its one hundred fifty prescription threshold.

Pharmacists throughout the country often exceed this threshold. The large number of prescriptions per pharmacist per shift is the reason for the exorbitant number of misfilled prescriptions per year in the United States. The reason that pharmacists are required to fill such a large number of prescriptions, often far-exceeding the one hundred fifty per shift threshold established by the North Carolina Board of Pharmacy, is very simply the profit motive of the retail pharmacy industry. Many pharmacists are leaving these large retail chains that require such huge numbers of prescriptions filled by pharmacists and going to smaller pharmacies across the country where they can feel more secure in filling prescriptions and properly include patient counseling and prospective drug utilization review. While most misfilled prescriptions do not result in significant injury, misfilled prescriptions obviously can cause serious injury and death. The retail pharmacy industry is literally playing the lottery every day simply counting on the fact the prospect that misfilled prescriptions will remain undiscovered, will not cause significant harm, or the bad results of the misfilled prescriptions will not come to life. The only way for this serious problem to be addressed is either more stringent regulation or for juries to hold the retail pharmacies responsible at the trial level and impose punitive damages intended to make an example of those pharmacies that overload their pharmacists so that it is no longer profitable for pharmacies to do so.

If you or your loved one has had a misfilled prescription, please contact our office.