Deadly pharmacy errors mount as companies push quotas, limit staff: ‘I am a danger to the public’
Every year, up to 9,000 people die in the US as a result of a prescription medication error.
That figure doesn’t include the hundreds of thousands of patients who suffer adverse effects from taking the wrong medication or taking meds in the wrong way, according to a report from StatPearls.
Now, an investigative report from the Los Angeles Times reveals that pharmacies make an estimated 5 million errors every year in California alone, according to the state’s Board of Pharmacy.
But even as pharmacy errors mount across the US, pharmaceutical lobbyists are pushing to keep reports of errors hidden from officials and the public.
The problem, according to pharmacists and others, is most acute at big retail pharmacy chains such as CVS and Walgreens, where overworked staff are pushed to the limit to meet sales quotas, despite desperate staffing shortages.
‘I am a danger to the public’
“At this point, it’s completely unsafe,” Christopher Adkins, a pharmacist who worked at CVS, told the LA Times. Adkins now works at an independent pharmacy company.
Other pharmacists echo his complaints: “The amount of busywork we must do while verifying prescriptions is absolutely dangerous,” another pharmacist wrote to the Pennsylvania regulatory board. “Mistakes are going to be made and the patients are going to be the ones suffering.”
“I am a danger to the public working for CVS,” one pharmacist wrote in an anonymous letter to the Texas State Board of Pharmacy, the New York Times reported in 2021.
Patients suffer and die
Indeed, many patients are suffering — and dying — from pharmacy errors: Last year, an Ohio patient picked up a prescription at a CVS for ropinirole, used to treat symptoms of Parkinson’s disease, restless leg syndrome and other conditions.
The patient “ingested approximately 27 tablets of the incorrect medication and experienced adverse effects including increased anxiety, rapid heart rate and sweating,” according to a report obtained by the Ohio Capital Journal.
Though the CVS prescription bottle was labeled ropinirole, the bottle actually contained digoxin, a drug used to treat heart failure and arrhythmia.
And Mary Scheuerman, 85, died in a Florida hospital after a Publix pharmacy dispensed a prescription of the antidepressant she was prescribed by her doctor.
But a pharmacy error, discovered too late, meant that she had actually been given a bottle of methotrexate, a potent chemotherapy drug that had built up to toxic levels in her body.
A Rite Aid pharmacist in California typed the wrong instructions on a prescription for anastrozole, a breast cancer treatment, telling the patient to take half a tablet twice each day, instead of twice a week as prescribed.
The patient took the drug according to the incorrect instructions for several days, according to a January citation, and suffered serious side effects as a result.
Pharmacists cry: ‘Please help’
Despite these ongoing problems nationwide, pharmacists complain that they face critical staffing shortages, as well as pressure from retail management to sell as much as possible.
Last month, Walmart asked some of its 16,000 pharmacists across the US to voluntarily take pay cuts and reduce their working hours in a bid to reduce costs.
Pharmacists said they’re harried by filling prescriptions; giving flu, COVID-19, shingles and other shots; tending the drive-through register; answering phones; working the front line cash registers; counseling patients; and calling doctors and insurance companies.
All the while, they’re struggling to meet performance metrics that they claim are unreasonable and unsafe, pushing them to do more work with fewer staff and less corporate support.
And any pharmacist who complains risks termination: “Any dissent perceived by corporate is met with a target placed on one’s back,” a pharmacist wrote to the South Carolina regulatory board.
“We are afraid to speak up and lose our jobs,” another pharmacist wrote anonymously in response to a survey by the Missouri Board of Pharmacy. “Please help.”
Corporations and lobbyists push back
Despite making millions of pharmacy errors each year, retail giants such as CVS and Walgreens insist these mistakes are rare.
“Patient safety is our highest priority,” CVS said in a statement to the LA Times. “When we learn of a prescription error, the first priority of our pharmacy teams is caring for the patient, taking steps to correct the error, working with the patient and the prescriber.”
Walgreens said it has “a multi-step prescription filling process with numerous safety checks to minimize the chance of human error.
“When errors do occur, we also have a robust mandatory reporting system in place that allows us to quickly identify root causes and to implement process improvements to prevent future errors.”
Customers’ legal rights curtailed
The consumers who bear the brunt of the retail pharmacies’ mistakes also give up some legal rights to contest those errors. Patients must agree to arbitration when asked to click a box to accept the company’s terms and conditions.
“You agree that CVS and you each waive the right to trial by a jury,” states the CVS agreement.
To combat the rising tide of pharmacy errors, the California State Board of Pharmacy is sponsoring a bill that would require pharmacies to report every error to a third party outside the government.
The bill would also allow the pharmacist responsible for the store to increase staffing if the workload has become too overwhelming to keep patients safe.
But the bill is opposed by the California Community Pharmacy Coalition, a lobbying group representing retail pharmacies, including the big chains.
The coalition believes pharmacy staffing requirements are too strict and it does not want the pharmacy board to have access to the error reports.
‘The public does not realize’
To prevent patients from taking the wrong prescription drugs, Consumer Reports advises that people ask their doctor to write out the dose and the names — brand and generic — of their medications.
While at the pharmacy, open the bag and inspect the bottle before leaving the counter to ensure it’s the right drug and the bottle has the correct name on it.
Given the ongoing need to ensure patient safety, pharmacists continue to find they’re squeezed between their corporate management and their duty as pharmacists to help their customers.
“The public does not realize what’s going on behind the counter,” Adkins said.
