According to Statistics Canada, two-thirds (67%) of Canadians reported taking or being prescribed medication in the last 12 months. Over 600 million prescription medications are dispensed in Canada every year, according to the Canadian Pharmacists Association.

Prescription medications can cure or manage disease, reduce symptoms and improve quality of life. Medications can also, unfortunately, be extremely harmful and even lethal if prescribed or administered in error.

Medication errors are preventable events that may cause or lead to inappropriate medication use or patient harm. The degree of harm caused to a patient can range from minimal (or non-existent) to lifelong serious disability and even death.

TYPES OF MEDICATION ERRORS

According to the authors of a 2023 medical publication entitled “Medication Dispensing Errors and Prevention“, the following are the common types of medication errors that can occur:

• Prescribing: prescribing the wrong drug for the patient that may end up causing harm;
• Omission: failing to prescribe the proper drug for the patient which deprives the patient of the medication they require thereby causing harm;
• Wrong time: either ordering the wrong timing of the administration of the drug or failing to adhere to the required timing of the administration of the drug;
• Unauthorized drug; 
• Improper dose;
• Wrong dose prescription/wrong dose preparation;
• Administration errors: such as the incorrect route of administration (ex. intramuscular versus intravenous), giving the drug to the wrong patient, extra dose, or wrong rate;
• Monitoring errors: which would include failing to take into account patient liver and renal function, failing to document allergy or potential for drug interaction; and
• Compliance errors: such as not following protocol or rules established for dispensing and prescribing medications.

CAUSES OF MEDICATION ERROR

The most common causes of medication errors result from:

• failure to communicate drug orders,
• illegible handwriting,
• wrong drug selection chosen from a drop-down menu,
• confusion over similarly named drugs,
• confusion over similar packaging between products, or
• errors involving dosing units or weight.

Medication errors may be due to human errors, but they can often result from systemic errors with inadequate backup to detect mistakes. 

WHEN DO MEDICATION ERRORS OCCUR?

The authors of the article referenced above note the fact that medication errors can occur at many steps in patient care, from ordering the medication to the time the patient is administered the drug.

In general, medication errors usually occur at one of these points:

• Ordering/prescribing,
• Documenting,
• Transcribing,
• Dispensing,
• Administering, or
• Monitoring.

Medication errors are most common at the ordering or prescribing stage. Typical errors include the healthcare provider writing the wrong medication, the wrong route or dose, or the wrong frequency. These ordering errors account for almost 50% of medication errors. Data show that nurses and pharmacists identify anywhere from 30% to 70% of medication-ordering errors. It is obvious that medication errors are a pervasive problem, but the problem is preventable in most cases. 

For more information about medical malpractice and medication errors, watch or listen to Medication Errors and Malpractice Cases, an episode of Inside Medical Malpractice.