One of the most common causes of medical negligence and a leading reason for medical malpractice lawsuits is the misadministration of drugs in a hospital setting. Whether it is giving the wrong drug or too much of the right drug, these acts of negligence can kill or forever injure patients.

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Justin Hill: Welcome to Hill Law Firm Cases, a podcast discussing real-world cases handled by Justin Hill and the Hill Law Firm. For confidentiality reasons, names and amounts of any settlements have been removed, however, the facts are real and these are the cases we handle on a day to day basis.

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Justin: I'm here with Brian Steward on this new edition of Hill Law Firm Cases, discussing medical malpractice. Brian's not a specific medical malpractice lawyer, but he's had a long history of handling medical malpractice cases from the plaintiffs and the defense side. He's somebody I would go to with questions regarding medical malpractice because in my career, for the most part, medical malpractice cases had been very limited by the laws in the state of Texas on what is viable and what kind of cases can actually be brought anymore.

On the last episode, Brian and I discussed one of the first cases that got him involved in medical malpractice lawsuits and it involved the misadministration or misprescription of a prescription drug. What was it, Brian?

Brian Steward: The drug was actually a chemotherapy drug called dynemicin and it's a drug that's used through an IV to pediatric patients who suffer from cancer, specific types of cancer. The case, which was 1992, involved the over administration of that drug, which means that this child who is already suffering from cancer gets-- I think it was five times the accepted dose of this medication.

Any of you who've dealt with cancer or loved ones who've dealt with cancer, know that there's a balance in prescribing chemotherapy and radiation. The balance is you want to stop the cancer while also allowing the host, the person, to survive. With dynemicin, if you overprescribed it to that extent, it essentially shut the host down and ultimately took the life of this child. It's one of those things where we think about misprescriptions, and you hear about it all the time.

You hear about the person who goes to the pharmacist and they're supposed to get one drug and they take this drug for two days, then they realize it's not the correct drug and they go back. That's the tip of the iceberg on these cases. I think if you look at the literature and you look at the history, in hospitals currently, the misadministration of medications is probably the most prevalent malpractice that's committed because of the system and the way drugs are prescribed and ultimately used.

Justin: Brian, where's the failure in that? Is that the doctor prescribed the wrong amount, the tech administering or the hospital pharmacist? Where's the chink in the chain?

Brian: It's a systemic failure and part of it is language. I handled a case out in West Texas about six years ago, doctors use and nomenclature for the prescription of drugs and it says Q1, which is once a day, Q2 which is twice a day, Q4 which can be four times a day. Now, that's fine if the doctor and the nurse are on the same page, if the nurse is not on the same page as that doctor, and you see a Q4 that can be four times a day, that can be four times an hour, that can be four times a week. It's a mess.

The big hospitals' systems, all have pharmacy software. They have pharmacy hardware in place to take in these pharmacy orders from the doctors and make sure that the actual medication has been ordered is appropriate. The problem is there's the human factor, and the human factor is the pharmacist that types that in, can override the system. Even though there's a system that says, "This is too much", that pharmacist can say, "No, this is exactly what's ordered on this standing order from this doctor and I'm going to prescribe it." That's also cost hundreds of people across the nation, their lives.

Justin: I think it was Corpus Christi maybe 10 years ago. I don't know if you recall, but maybe the pediatrics ward or the newborn ward, I don't know what you call it, but they were administering heparin at something like a thousand or a hundred times. I can't remember if they were missed labeled bottles or what it was, but it was 30 children that were injured

Brian: The heparin issues across the nation, it's a fascinating story. I've been waiting for a movie spotlight to do heparin, because heparin was one of those things where it was so commonly used that the hospitals disregarded the fact that there were different dispensers, meaning there were different packaging for those heparin bottles. When a shipment would come in, they would ordinarily just take whatever it was and utilize the same system, and to administer their heparin with really tragic results in that, they were prescribing and administering doses of heparin which are absolutely inappropriate. If you asked them in their deposition, absolutely believe that they were doing the right thing.

Justin: In my former life at the other plaintiff's firm, I was assigned to work on heparin cases and that arose out of the Corpus Christi incident, but the cases we had revolved around, they contaminated batch of heparin. Heparin had a lot of bad press rightfully so for a real short amount of time. I learned in that, that people can flight multiple issues but we were dealing with- because Heparin's made from actual pigs if I recall correctly, and they were getting contaminated batches out of China which were sickening people and, at the same time, you have these wards that are over administering.

It was a real strange time for whoever makes heparin. It was a bad time for them.

Brian: I think that limited the companies that created heparin for about three or four years, now it's back up and running because it's a huge profit center. In this industry, in the pharmaceutical world, they are looking for profit centers and heparin is an easy one despite the downside.

Justin: I intended to cover a lot of different areas with Brian on this episode, but we just got stuck on and rightfully so the wrong administration of medicines or their wrong prescription of medicines in the hospital setting or the medical malpractice setting. But I'm going to get them on again and we're going to talk about some of the other causes of medical malpractice, he can enlighten us on which ones are still viable and which ones the state of Texas has said, "We can't bring any more".

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