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Medication Errors in Nursing Homes Cause Alarming Number of Adverse Drug Events

More than 110,000 individuals reside in California nursing homes and long-term care facilities. During the past year, several California nursing homes have been cited for medicating residents without adequate documented need or consent, over-medicating nursing home residents and for harmful medicine errors. One parent company of approximately 27 nursing homes throughout California was fined $18,000, in May of 2006, for medical errors leading to hospitalization.
Last year, a report from the Institute of Medicine estimated that medication errors cause more than 800,000 injuries and deaths in nursing homes and long-term care facilities. Despite their frequency and potential clinical impact, medication errors often are not formally reported. Nursing home facilities also frequently fail to report medication errors to patients or their families unless the error resulted in harm or death.

Following up on previous reports on medical errors of all kinds, the Institute of Medicine, a branch of the National Academies, embarked upon the most extensive study ever of medication errors, in response to a request made by Congress in 2003, when it passed the Medicare Modernization Act of 2003.

This extensive report on adverse drug events due to medication errors in U.S. nursing homes concluded that of all adverse drug events noted, 42 % were preventable, and of the serious, life-threatening and fatal adverse events, 61% were preventable. Failure to monitor residents for side effects and prescription dosages are cited as the top most common causes of adverse drug events in nursing homes and long-term care facilities.

The most common serious adverse events documented have been delirium or hallucinations, falls resulting in fracture, hemorrhaging resulting in transfusions, hypoglycemia and kidney problems. Less serious adverse drug events in nursing homes included skin rashes, falls without associated fracture, internal bleeding that did not require transfusion or hospitalization and drug-induced drowsiness. Nursing home patients who are prescribed psychoactive medications (antipsychotic agents, antidepressants, sedatives/hypnotics) along with anticoagulants, diuretics, and antiepileptics (mood stabilizing medications) are at increased risk of suffering from an adverse drug event.

Last year, researchers from the College of Pharmacy, University of Georgia, concluded that propoxyphene, a narcotic pain reliever, was a particular culprit in adverse drug reactions. The most serious interactions affecting propoxyphene are with those drugs that also cause sedation, such as antihistamines, antidepressants, tranquilizers and sedatives, which are commonly dispensed to nursing home residents.

In another study last year, the Division of Geriatric Medicine, University of Massachusetts Medical School conducted research on the quality of antipsychotic drug prescribing in nursing homes. The research revealed that prescribing of antipsychotic drugs has been increasing in nursing homes since the availability of second-generation antipsychotic agents, also known as the atypicals. The study also concluded that most atypicals were not appropriately prescribed, going outside the prescribing guidelines for doses and beyond indications not upheld by strong clinical evidence.

Antipsychotics have often been described as “chemical” restraints, and have been used to sedate and subdue patients in an attempt to compensate for poor nursing home staffing levels and to minimize the need for staff interaction with nursing home residents.

If you suspect medication errors have occurred in a California nursing home facility that you, or a loved one, reside in, you should contact a qualified Nursing Home Neglect & Elder Abuse Lawyer, immediately.

Important Medication Monitoring Tips for Families of Nursing Home Residents

• Ask questions about the medicines prescribed to your loved one
• Know what medicines the nursing home is administering to your loved one
• Inquire about why your loved one is being prescribed a particular medication
• Inquire about the possible side effects associated with the medications

Medication administration and monitoring is a primary key to quality care in California nursing homes and long-term care facilities. If you or a loved one has suffered due to lack of quality care in a California nursing home or long-term care facility, please contact a California Nursing Home Neglect Lawyer or California Elder Abuse Attorney for more information.


Young & Wallin handle California elder abuse and nursing home abuse and neglect cases throughout the state of California including Southern California elder abuse and nursing home abuse and neglect cases in Bakersfield, Barstow, Fresno, Los Angeles, Orange County, Riverside, Roseville, Santa Barbara, San Bernardino, San Diego, San Jose, San Francisco, Sacramento, and Ventura, California. As elder abuse attorneys and nursing home abuse attorneys, we also handle elder abuse and nursing home abuse cases out of state on a case-by-case basis.

If you or a loved one thinks you may have been a victim of elder abuse, nursing home abuse or neglect, contact us immediately.

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©2006 The Law Offices of Young & Wallin

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