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  Protect Yourself
  from Writing that's
  Hard to Decipher

Picture this: You get a prescription from the doctor for Celebrex to treat your arthritis. You bring it to the drug store where the pharmacist tries to read your doctor’s handwriting, but mistakes the prescription for Cerebyx.

You’re not going to be getting any help for your arthritis, because Cerebyx is used mostly for seizures. If he mistakes the prescription for Celexa, you’ll be getting a drug used to avoid depression. Unfortunately, if you take the wrong medicine, you’ll still be suffering from the symptoms of arthritis and you could suffer side effects from the unintended drug.

A Case of Fatal Penmanship

    One of the best-known prescription-related
medical errors happened in Texas.
    A cardiologist wrote a prescription for 20 mg of Isordil for angina. A pharmacist misread the prescription and dispensed 20 mg of Plendil, double the maximum daily dose for that drug, which is used to treat high blood pressure.
    The patient had a heart attack and died days later.
    In 1999, a jury attributed the patient's death to the illegible prescription. The jury found the pharmacist and physician both liable and awarded the family of the deceased $450,000.
    Although the case raised the issue of legibility, Texas has no law covering the issue.

The Institute for Safe Medication Practices, a not-for-profit group, warns that hundreds of drugs like these have similar names and could be confused with one another. At the same time, patients and pharmacists are dealing with the problem of doctors’ hard-to-decipher handwriting.

The good news: In some states, the days of illegible prescriptions are coming to an end. Florida and Washington State have enacted new laws aimed at cleaning up physicians' writing, and other states are expected to follow the lead. The Florida law requires that prescriptions be:

 Legibly written or typed.
 Contain certain information.
 Be dated and signed by the prescribing practitioner on the day issued.
 Provide an effective date.

Moreover, all dates must be spelled out rather than indicated by digits (for example, 01-01-2003 is no longer allowed.) The legislation doesn’t contain penalties for violations. It is up to the Florida Board of Medicine to determine discipline. For the first year, the board will contact violators and educate them about the law. After that, offenders face possible discipline.

The FDA is also discussing its role in ensuring that private sector prescriptions contain useful information and are legible and understandable. No concrete action has been taken.

Another solution for the problem involves electronic prescribing. In addition to ensuring legibility, electronic prescriptions can theoretically be processed more quickly. That shortens the wait for the customer.

However, widespread use of these systems in more states won't happen in the near future. The changes are costly and there are challenges integrating the technology with other systems.

In the meantime, take these prudent steps to ensure the medicine you get is indeed what the doctor ordered:

1. Have the doctor or nurse tell you exactly what is being prescribed and the dosage. Make sure dosage instructions include the milligrams or ounces rather than just  “two pills a day.” The pills you got in the hospital may have been half the strength of what you're getting at the drug store.

2. Try to read the prescription and instructions yourself before leaving the doctor’s office. If you can’t read it, there's a good chance the pharmacist won't be able to either. Ask the doctor to rewrite it so you can read it.

3. Write the information yourself after being told, if you are worried about forgetting it.

4. Don’t let the doctor or nurse rush through the instructions. Remember: They’re busy professionals, but they work for you.

5. Ask the pharmacy to verify the prescription to you before filling it. Even if you can read it, the pharmacist may misread it. A few extra seconds can help ensure there aren’t avoidable complications later.

6. Check the label on the prescription to ensure that it matches what you understood from the doctor or nurse. Ask about any discrepancies.


Some final precautions:
You can further check prescriptions if the individual pills are labeled by name. And to keep medicines straight, use “seven-day pill holders” that have the days of the week on them. They can be found in most grocery stores as well as pharmacies.


This article is provided as a service by: L.S. Sherman Litigation Consulting.

LSSLC is a group of complex litigation specialists helping attorneys prepare successful complex litigation through the management of detailed technical information and engagement of experienced testifying experts of unsurpassed quality.

Contact Linda Sherman: 610-642-7755

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LSSLC, LLC provides the information in this newsletter for general guidance only, and does not constitute the provision of legal advice or professional consulting of any kind. The information provided herein should not be used as a substitute for consultation with professional tax, accounting, legal, or other competent advisers. Before making any decision or taking any action, you should consult a professional adviser who has been provided with all pertinent facts relevant to your particular situation. 

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