| Summary: | Worldwide, the prescription, dispensing and administering of medication
is the most common form of medical treatment. The number of
medication errors made in a medical care system/institution is regarded as
a good barometer of the general standard of care in that system or
institution. The number of medication errors that come to light, however,
is only the tip of the iceberg because such errors can be swept under the
carpet more easily than, for instance, botched surgery. Research also
indicates that the prescription of medication as form of treatment, is not
regarded as the high risk activity that it really is.
This research offers a comprehensive source regarding medication errors
as seen from a legal perspective. The extent and occurrence of
medication errors (prescription, dispensing and administration errors) are
discussed with the aim of bringing these to the attention of both lawyers
and health care workers. Doctors, pharmacists and nurses often
experience uncertainty about their legal position and how to deal with
problematic situations. Specific problematic areas are identified and
solutions are offered including the following:
⢠The more important legislation with regard to medication treatment
is discussed. Interaction between the different statutes and
regulations, as well as government policy declarations regarding the
prescription and dispensing of medication, is apparently not
sufficiently synchronised. This leads to uncertainty amongst health
care professionals and increases the chances of medication errors. It is suggested that these aspects be revised and harmonised on an
urgent basis.
⢠The âoff-labelâ use of medication is an international phenomenon
and part of the generally accepted and lawful use of medication.
The increased risk it poses to the patient, as well as to the medical
practitioner (with respect to legal liability) is discussed. In South
Africa no guidelines are supplied to doctors with regard to the âofflabelâ
use of medication. More assistance and balanced, objective
information from government and pharmaceutical companies is
imperative. An amendment to current legislation is suggested.
⢠The problems surrounding the administration of pain medication and
especially the failure to give sufficient pain medication, are
identified and discussed as one of the most prevalent forms of
medication errors. Proposals for legal liability are discussed.
⢠Causation and âloss of a chanceâ with the focus mainly on examples
of medication errors, are discussed and recommendations are made
in this respect.
⢠Suggestions regarding legislation with regard to training, legal
liability and the use of technology and reporting systems in the
prevention of medication errors, are discussed. The implementation
of a system approach is discussed and recommendations are made in
this regard.
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