As a patient, you want your physician to prescribe the right medicine for your condition. Additionally, you need the correct dosage for your medication or you might suffer serious health problems or even death. One reason dosage errors happen is because pharmacies did not have the correct weight for the patient.
In many cases, your body weight is not a factor in the medicine you take, but there are exceptions, especially for children since they are still growing. If your doctor needs to weigh you or your child to determine the dosage, it is important that your pharmacy has the correct information or you may receive the wrong dosage. Pharmacy Times gives some examples of how these errors may happen.
Swapping weight measurements
Say your doctor determines your weight in pounds. As long as the pharmacy calculates your dosage based on this measurement, you should not have a problem. Unfortunately, a pharmacy may calculate your dosage incorrectly because they interpret your weight in kilograms, not pounds.
The problem is that a kilogram is about 2.2 pounds, so reading a weight in pounds as if it were kilograms makes a patient seem more than twice as heavy as they are, which can lead to a dose more than twice as high as it should be. The reverse mistake, reading kilograms as pounds, can lead to a dose less than half as strong as needed. This error can endanger your health by itself and also due to other errors that may compound the effects of the wrong dosage.
Incorrect weight and other errors
It is possible that a weighing error does not originate in the pharmacy but at the doctor’s. A physician’s office or a hospital may not weigh you or your child correctly to begin with, which will affect how the pharmacy calculates your dosage.
Other sorts of errors can result in the wrong dosage. A pharmacy may have missing information from the doctor that results in the wrong calculation. Unclear writing from your physician can also result in confusion over dosage. Since medicine errors can have grave consequences for you and your family, do not hesitate to ask questions about your medicine when receiving treatment.
Why does body weight matter for some medications?
Many medications are dosed by body weight, measured in milligrams per kilogram. This is standard for most children’s medicines, and it also applies to some adult drugs, including certain blood thinners, chemotherapy drugs, anesthesia, and antibiotics. With these medications, the weight used in the calculation directly sets the dose, so a wrong weight means a wrong dose. Patient safety experts recommend that hospitals and pharmacies record weights in kilograms only, precisely to prevent the pound and kilogram mix-ups described above.
Why are children at greater risk?
Children’s doses are almost always based on weight, and their smaller bodies leave less room for error. A calculation mistake that would be minor for an adult can be dangerous for a child. Liquid medicines add another risk: confusion between milliliters and teaspoons, or measuring with a kitchen spoon instead of the device that comes with the medicine, can change the dose significantly.
What other mistakes lead to the wrong dose?
Weight errors are one of several common causes. Medication errors also happen through:
- Decimal point mistakes. A misplaced decimal can turn 1.0 milligram into 10, a tenfold error.
- Unit mix-ups. Confusing milligrams with micrograms, which differ by a factor of one thousand.
- Look-alike and sound-alike drugs. Medications with similar names can be confused when prescribed or filled.
- Missed adjustments. Some doses must be lowered for older patients or people with kidney or liver problems.
- Distraction and workload. Busy pharmacies and hospital units raise the risk of mistakes, as we explain in our article on distractions and medication errors.
Who is responsible when a patient receives the wrong dose?
Depending on where the mistake happened, responsibility may fall on the prescribing doctor, the hospital or its nursing staff, or the pharmacy and pharmacist who filled the prescription. Pharmacists are trained to double-check doses and to question ones that look wrong (see our overview of potential pharmacy errors). When a provider fails to take reasonable care, such as not verifying a weight, miscalculating a dose, or missing an obvious overdose, and a patient is harmed as a result, that may be the basis of a pharmacy error or medical malpractice claim. Medication mistakes also occur in nursing homes, where residents often take many medications at once. For more, see protecting the rights of medication error victims in Oklahoma.
What are the warning signs of a wrong dose?
Watch for new or worsening symptoms after starting a medication, such as unusual drowsiness, confusion, trouble breathing, vomiting, a racing or slowed heartbeat, seizures, or a rash or swelling. A medicine that suddenly seems to stop working can also signal a dosing problem. In an emergency, call 911. For questions about a possible overdose, Poison Help is available at 1-800-222-1222.
What should I do if I think a dosage error happened?
Get medical care first. Keep the medication, the bottle or packaging, the label, and the pharmacy receipt, and do not throw anything away. Write down what happened and when, and request copies of the related medical and pharmacy records. Then speak with an attorney, who can review whether the error was preventable.
Frequently Asked Questions
Can a pharmacy be held responsible for giving the wrong dose?
Often, yes. Pharmacies and pharmacists can be held responsible when a filling or calculation error causes harm. In some cases the prescribing doctor or hospital shares responsibility, which is why the records matter.
My child was given the wrong dose but seems fine. Should I still do something?
Yes. Call your child’s doctor or Poison Help right away, because some effects are delayed. Keep the medication and packaging. Whether there is a legal claim usually depends on whether harm resulted, and documenting what happened now protects your options.
What does it cost to talk with Glass & Tabor?
The initial consultation is free. It gives you a chance to tell us what happened and ask your questions, and it helps both of us decide whether the firm is the right fit for your situation.
If you or your child was harmed by a wrong medication dose, contact Glass & Tabor in Norman, Oklahoma for a free consultation, or learn whether you may have a case.