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« Restraints in Nursing Homes: Potentially Harmful, Yet Still Used | Main | Pressure Ulcers May Indicate Problems with Nursing Home Care »

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

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.

As Elder Abuse and Nursing Home Neglect Attorneys, we at the Young & Wallin Law Firm remain concerned about the numbers of reported and unreported medical errors in California nursing homes. Last year, a report from the Institute of Medicine estimated that more than 800,000 injuries and deaths in nursing homes and long-term care facilities are caused by medication errors. It's unsettling to know that the health and safety of over 110,000 elderly residents in California nursing homes are at such high risk of injury from medication errors.

More unsettling is that often medication errors in nursing homes are not formally reported and nursing home staff frequently fails to report medication errors to nursing home residents or their families unless the error resulted in injury or death.

In 2003, the Institute of Medicine, a branch of the National Academies, conducted the most extensive study ever of medication errors, in response to previous reports on medical errors and a request made by Congress, upon the passing of the Medicare Modernization Act of 2003.

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

Serious adverse events reported in nursing homes included:

- Delirium or hallucinations
- Falls resulting in fracture
- Hemorrhaging resulting in transfusions
- Hypoglycemia
- 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
- Drug-induced drowsiness.

The study also concluded that nursing home patients 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.

Antipsychotics, often described as "chemical" restraints, 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 interaction between staff and nursing home residents. Such practices could be considered physical abuse or neglect, under California Elder Laws.

Other research, conducted by the Division of Geriatric Medicine, University of Massachusetts Medical School, studied the quality of antipsychotic drug prescribing in nursing homes and found that the practice of prescribing antipsychotic medications in nursing homes has increased since the availability of atypicals, or second-generation antipsychotic agents. The report also revealed that most atypicals were inappropriately being prescribed, going beyond the prescribing guidelines for doses and for reasons not upheld by strong clinical evidence.

A primary key to quality care in California nursing homes and long-term care facilities is the safe administration of medication and effective monitoring. Individuals who have suffered due to lack of quality care or who have experienced injury from a medication error in a California nursing home or long-term care facility, should contact a California Nursing Home Neglect Lawyer or California Elder Abuse Attorney, immediately. We Represent nursing home neglect cases throughout California including Orange County, Los Angeles, Bakersfield, Riverside, San Bernardino, Sacramento, Fresno, Santa Barbara and San Diego.

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