5 month old grandson given wrong medication

[terriersaregreat]

Sorry HB can't agree, a pharmacist's job is to prescribe the correct medication otherwise they are negligent. This poor baby and family suffered as a direct result of negligence. Yes it's good to apologise but lessons have to be learnt or someone else will suffer.

 

The question is how can you compensate for such danger and worry? Surely the answer should be with the person or family affected.

[**Tilly**]

Tilly, check your house insurance - it may have legal advice/services included, if so you could ring them and see if they will either point you in the right direction or take this on for you.

 

Hi Ell

 

Checked house insurance nothing on there just the norm...was a good thought though thank you:-)

 

Thanks for all of your replies guys got a lot of reading to do i think.

 

In the meantime i have printed off the complaints form to the GPC they have to give formal acknowledgement of the complaint within 5 working days of receiving the complaint stating whether the complaint will be investigated or explaining why it will not be investigated.

[beachbird]

OMG so sorry to hear this tilly im just so pleased hes doing ok hes such a weeny baby as well, i dont want to even think what IF, that mistake could have cost that baby his life, find out all you can first tilly, so good to hear hes doing ok now though phewwwwww xxx

[**Tilly**]

OMG so sorry to hear this tilly im just so pleased hes doing ok hes such a weeny baby as well, i dont want to even think what IF, that mistake could have cost that baby his life,

find out all you can first tilly,

Oh i am BB believe me..been around the block a few times so too speak lol so know not to jump in feet first..the more i delve the more i get so angry:-x

 

 

 

so good to hear hes doing ok now though phewwwwww xxx

Thanks Beachbird

[determindator]

Hi Tilly, firstly I hope your grandson is in full recovery from this terrible negligence of the pharmacist. To confirm then, ring/visit surgery to inform of a formal complaint. Explain/show the forms you have printed off. They will guide the way as it will be their NHS Trust who will take this forward. They will have their equivalent of PALS. This is a risk which has been flagged up within the NHS and they 'will' act quickly. Bullet point the sequence of events. This makes it easy and concise for them to read your report. There will be a meeting for you all to attend. Will leave it at that for the moment for you to tell us how you progress. Here for you as always X

[**Tilly**]

Hi Tilly, firstly I hope your grandson is in full recovery from this terrible negligence of the pharmacist. To confirm then, ring/visit surgery to inform of a formal complaint. Explain/show the forms you have printed off. They will guide the way as it will be their NHS Trust who will take this forward. They will have their equivalent of PALS. This is a risk which has been flagged up within the NHS and they 'will' act quickly. Bullet point the sequence of events. This makes it easy and concise for them to read your report. There will be a meeting for you all to attend. Will leave it at that for the moment for you to tell us how you progress. Here for you as always X

 

Hiya Termi

Funny you should mention about ringing the surgery rang them this afternoon and spoke to asst practice manager and asked what

their complaints policy/procedure was, explained that i was putting a complaint in told her what the forms where i was sending...although the

pharmacy is independant of the surgery they like to follow any complaints she asked me for a copy before i mentioned it but will

be ringing on Monday when the practice manager is in.

 

All dates of events have been written down by my daughter in-law so tomorrow i will be going around my son's and sit with them and go through the

forms will keep you all updated.

 

Once again guys thanks for your support xx

[zippygbr]

there are a number of places where the error may have occured 1. the prescription was written / printed wrongly - this is suprisingly easy with some versions of the electronic patient record systems in use and as for the hand writing of some practitioners ... 2. the correctly written prescription was dispensed wrongly AND the post dispensing check was omitted or a further error was made at that stage.the incident would probably be best be dealt with by assuming that either of these occurences happened and the GP practice and the pharmacy who dispensd the medication need to investigate it. fully.as usual with such things the over-reaction brigade have struck and the vultures are beginning t ocircule ooking for the 'free money' ...

[determindator]

there are a number of places where the error may have occured 1. the prescription was written / printed wrongly - this is suprisingly easy with some versions of the electronic patient record systems in use and as for the hand writing of some practitioners ... 2. the correctly written prescription was dispensed wrongly AND the post dispensing check was omitted or a further error was made at that stage.the incident would probably be best be dealt with by assuming that either of these occurences happened and the GP practice and the pharmacy who dispensd the medication need to investigate it. fully.as usual with such things the over-reaction brigade have struck and the vultures are beginning t ocircule ooking for the 'free money' ...

 

 

Explain yourself please.

[Nystagmite]

No-one has mentioned money here. I read this as "I want to ensure this never happens again / I want an explanation as to why it happened".

 

Do the parents receive the repeat part, which is the white bit of the prescription? What does it say for the dose / medication name?

[johnnymitch]

there are a number of places where the error may have occured 1. the prescription was written / printed wrongly - this is suprisingly easy with some versions of the electronic patient record systems in use and as for the hand writing of some practitioners ... 2. the correctly written prescription was dispensed wrongly AND the post dispensing check was omitted or a further error was made at that stage.the incident would probably be best be dealt with by assuming that either of these occurences happened and the GP practice and the pharmacy who dispensd the medication need to investigate it. fully.as usual with such things the over-reaction brigade have struck and the vultures are beginning t ocircule ooking for the 'free money' ...

 

 

 

As has already been pointed out to you zippybgr, no one has mentioned money in this case , just an aim to ensure that this is dealt with so that it doesn't happen again with even worse consequences ..

 

I fail to see how one can over-react to a potentially life-threatening occurence ,, especially when such a vulnerable, poorly infant was involved ..... the situation must be addressed urgently , and this was Tilly's intention ..for which she asked help, not innuendo...

 

Maybe you should operate the first part of your handle a bit more ...and zip it !

[Night Owl]

An incident that involves the wrong medication to the wrong patient at the wrong time and wrong dose, must be investigated fully to prevent it happening again.

 

The medication given to this child is not a medication usually given to a child and as such could have been fatal.

The investigation will highlight flaws in practice and prevention of future mistakes in the process of prescribing to dispensing medication safely.

Patients, however old, should be protected at all times.

[johnnymitch]

I totally agree with you Night owl ... that was what I was trying to convey ....the importance of dealing with an error of this sort ..

 

you put it so much better than I did !

[Night Owl]

[Nystagmite]

fully.as usual with such things the over-reaction brigade have struck and the vultures are beginning t ocircule ooking for the 'free money' ...

 

I would hardly call giving a child the wrong medication, which may have been lethal and asking for an investigation, an over reaction

[zippygbr]

No-one has mentioned money here. I read this as "I want to ensure this never happens again / I want an explanation as to why it happened".

 

Do the parents receive the repeat part, which is the white bit of the prescription? What does it say for the dose / medication name?

 

when we've posters making statements likes " Isn't it amazing that professional people think that saying sorry after making a major, major mistake will make it all better. But on this forum we read of people who have made mistakes claiming benefits, they are interviewed under caution with fear of a prison sentence despite being very sorry!"

 

that's the entitlement culture looking for the magic free money off the 'compo tree' ...

[Nystagmite]

I read that as a comparison between the two. Making it out that benefit fraud / overpayment is more serious than almost killing someone.

 

As someone who was given medication they shouldn't have been, (I didn't know this until someone told me) I guess I can empathise with this. No, it didn't almost put my life in danger; but it could've left me with severe digestive problems. Thankfully, I was taken off this because of the unwanted side effects.

[determindator]

when we've posters making statements likes " Isn't it amazing that professional people think that saying sorry after making a major, major mistake will make it all better. But on this forum we read of people who have made mistakes claiming benefits, they are interviewed under caution with fear of a prison sentence despite being very sorry!"

 

that's the entitlement culture looking for the magic free money off the 'compo tree' ...

 

So Ziggy, for the benefit of the doubt, I take it you are saying, the system is quick in reacting to Benefit fraud with the threat of prison, but where a life is threatened they do not react in the same stiff way from the out set.

 

That's my last response to this.

[johnnymitch]

Good idea Termi , I think our Zippy (your ziggy ?LOL) is a bit of a wind-up merchant ... and it's not a subject for that kind of response IMHO ... if we just ignore him he may go and try someone else ..

[**Tilly**]

Meanwhile back at the ranch

 

Well it gets better..few more things have come to light reading through my daughter in-laws notes

it turns out that on the said day...there was only 2 staff on should be 3.... 1counter staff.. 1dispensing assistant and the duty pharmacist.On this particular day there was no counter staff so the dispensing

assistant was put on the counter leaving the pharmacist to check her work which is normally double

checked.Also the wrong meds where stored along side the right meds.

 

The complaint forms are filled in and ready to go Monday morning

[nolegion]

Tilly, I have been following this makes-your-blood-run-cold-to-think- about-it thread with great interest, and have been trying, with I confess but limited success so far, to get a clear handle on the legal structure of a pharmacy within a GPs surgery - as in who actually employs whom, where do the revenues go, and who ultimately carries the can for pharmaceutical negligence.

 

I sincerely hope not, but I have a horrible suspicion that sooner or later people will start pointing fingers at everybody but themselves in this matter. Keep right on going.

 

As regards who gets the profit it out of it, well in some models at least, that would seem to be the partner GPs - up to £500,000 per year, according to this article of a few years ago;-

 

“SIX hundred pharmacies inGPs' surgeries are facing the axe.

 

Only those more than a milefrom a chemist will continue dispensing prescriptions to patients undercost-cutting plans.

 

Health ministers claim shutting six in 10 of the 1,100 pharmacies - mostly in rural areas - will savemillions and allow GPs to spend more time on other duties.

 

A White Paper also claimed pounds 100million is wasted destroying unused drugs from small pharmacies. Buthealth campaigners say hundreds of jobs will be lost and that small surgeries -which rely on prescription fees - will face financial ruin. Benny Hartson, of Hoveton and Wroxham medical centre in Norfolk, said: "If we lose our dispensary status it will have terrible consequences for patients and staff."

 

And GP Jeremy Phipps, who ha sa practice with a pharmacy in Lincoln, said some surgeries face losing pounds 500,000 a year, adding, "No surgery could possibly sustain such a loss and maintain its service."

 

A British Medical Association spokesman said: ‘It's vital patients inrural areas can continue to obtain medicines from local GP surgeries that theycan get to quickly.

 

"This is particularly vital for the elderly and those from disadvantaged backgrounds who may not havea car or cannot afford to travel long distances for prescriptions’”

 

( http://findarticles.com/p/articles/mi_qn4161/is_20080831/ai_n28057899/)

 

In many legal situations it will be found that those who pocket the profit shoulder theultimate responsibilty. In the NHS, however……………

[transistor]

Hi Tilly. Been reading this thread with interest and I'm so sorry to hear of your grandson's trauma.

With all medication errors, the member(s) of staff responsible should have been suspended from their work with immediate effect, pending a thorough investigation. Suspension itself does not imply guilt but gives the investigating body a chance to get on with the work of taking statements from every member of staff who was on duty at the time of this incident. The Investigation Manager should then present the statements together with a detailed summary to the Responsible Person aka Discliplinary Chair, who will decide on further action. If this situation is taken to represent abuse, the Safeguarding authority of your local council should be informed. You can do this yourself. This could lead to police involvement.

In fact, thinking about it, the Safeguarding Authority should be informed before an investigation commences as, if Safeguarding decide to inform the police, no other investigation can be commenced until the police have finished their enquiries.

I have a feeling that CQC are going to be taking over responsibility for GP's surgeries. A phone call to them would not go amiss. They would certainly be able to point you in the right direction.

The pharmacist involved with almost certainly have medical negligence cover through the MDU and would be advised to contact them.

Good luck, Tilly.

[Old Cogger]

Could report the incident to the proper authority, based in BATH, medical negligence case by the sound of it, google medical negligence - should come up with an address in Bath or there abouts, needs investigation to stop a repeat problem?

[terriersaregreat]

TAG's here again! Oh,oh! Little explanation:-

 

I have experienced wrong prescribing of medication within family on several occasions. One had devastating affect on my mother. For the record I accepted the mistake, no claim, also no apology other than nurse telling me that she wanted me to know that she had nothing to do with it. That's when I found out that mother had been given treatment for a condition she didn't have, medication caused severe fitting.

 

Hoping all going well with baby. Hoping all going well with Tilly and family.

 

Hoping pharmacist is dispensing correct medication for other patients.

 

That's all. xxx

[**Tilly**]

Would just like to say thank you for everyone's support and advice..will keep you all updated as things progress.

TAGS i'm so sorry you and your mum had to go through this as well x everybody is fine thank you just a bit stressed lol

 

Thanks Mike will look into that tomorrow well today now !!

 

To Transistor totally agree with you should have been suspended but was still working yesterday.Will also look more into your post tomorrow.

 

Thank you Nolegion have been doing the same trying to work out the legal structure...will deffo keep on going

 

Tills xx

[determindator]

Hi Tilly,

 

Did you manage to get hold of the Practise Manager yet? If you are getting vague feedback, which is bad practise, tell the Practise Manager you know about the Care Quality Commission and Safeguarding Children and want a response to that.

They should be taking a lead on this.

Edited June 27, 2011 by determindator