The practice of pharmacy has greatly evolved from ancient times to the present. In colonial America, the village apothecary served as both doctor and pharmacist. Later, as "druggists," pharmacists acquired the skills to compound and formulate more complex medicines. The rise of the pharmaceutical industry after WWII diminished the pharmacist's role as compounder of drugs. Since the 1960s, the duties of the pharmacist have changed to encompass a need for patient education and monitoring of drug therapy.

Pharmacy's Expanded Role

The principal duties of the 21^st century pharmacist are:

Preparation and dispensing of prescription drugs and medical devices
Ensuring that prescriptions are filled accurately as to name of medication, dosage, form and directions for use
Maintaining and monitoring a profile of the patient's drug therapy
Counseling patients as to the correct use of the medication

The pharmacists must carefully consider possible harmful interactions with other drugs the patient is currently taking, as well as any drug allergies he or she might have. Computerized patient profiles must be kept up to date with all data and instructions entered correctly.

Legal Responsibilities of Pharmacists

In 1990 the U.S. Congress passed the Omnibus Budget Reconciliation Act (OBRA) which mandated certain pharmacy services for Medicaid recipients. Nearly all 50 states have now enacted OBRA-like statutes designed to improve the overall standard of pharmacist care. One of the most important provisions of these laws, drug use review, requires maintenance of patient profiles. Patients often have various prescriptions from different doctors. In such cases, the pharmacist might be the only health care provider able to identify all of the medications a patient is taking. Competent, thorough drug use review enables pharmacists to avert harmful interactions between drugs. Further, the patient profile provides valuable information as to the state of the patient's medical condition and known allergies. Another of OBRA's essential mandates is the requirement for patient counseling. At a minimum, pharmacists must offer guidance to patients and caregivers on the following subjects:

The name and description of the medicine.
The route of administration (oral or non-oral).
Dosage.
Proper medication storage.
Special instructions for preparing, administering and using the drug.
Common serious side-effects, adverse effects, drug interactions and contraindications the patient may encounter.
Techniques for patient self-monitoring.
Prescription refill information.
What to do in the event of a missed dose.

Legal Liabilities of Pharmacists

The expanding role of the pharmacist has also increased potential liability. Lawsuits for pharmacist negligence have involved harms such as those caused by compounding and preparation errors, wrong dosages, illegal substitution of generic drugs and failure to recommend and oversee patient monitoring, especially for those taking medications of high toxicity. Under the current standard of care, it is not enough to simply follow a written prescription to the letter. In Happel v. Wal-Mart Stores, Inc. (2002), an Illinois pharmacist was held liable for filling a prescription for Toradol (ketorolac), an NSAID contraindicated for patients with aspirin allergies, even though the patient had informed the pharmacy of her allergy. The patient developed life-threatening anaphylactic shock and required emergency treatment. The Illinois Supreme Court found that the pharmacist had a duty to warn the prescribing physician or the patient when the pharmacy's own records indicated a known contraindication. The patient counseling function has become such a vital element of pharmacy practice that pharmacists have been held liable for failure to counsel or for providing inadequate or incomplete counseling.

Contact The Orlow Firm Today

If you or a loved one has been harmed due to a pharmacist's negligence, the Orlow firm can assist you in determining the proper course of legal action.

Contact the experienced New York medical malpractice attorneys at the Orlow Firm at (646) 647-3398 or message us online to schedule a consultation.

Sources

H.R.5835 — Omnibus Budget Reconciliation Act of 1990 — Congress.gov
Happel v. Wal-Mart Stores, Inc. (2002) — Illinois Supreme Court, Justia
OBRA '90 at Sweet Sixteen: A Retrospective Review — U.S. Pharmacist

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