NAL, am a pharmacist though. Unfortunately doctors and pharmacists are human and while we desperately wish that we could practice without ever making a mistake, that is simply not possible. We do treat medication errors seriously though since they can cause significant harm so there are protocols in place for what to do when a potential error is reported.
The first thing you need to find out is who made the error. Did the pharmacy supply the wrong medication or did they supply as written but the prescription was incorrect in the first place?
In NSW, pharmacies are required to store dispensed prescriptions for a minimum of 2 years. As long as the pharmacy she went to is following the legal minimum requirements, they will have the copy of the prescription that was dispensed though they may need to retrieve it from storage.
Your sister or someone authorised to act on her behalf can call the pharmacy that dispensed the medication and request to speak to a pharmacist regarding a potential dispensing error. Let them know the date the script was presented and that you think the wrong medication was supplied. Some pharmacies store their records electronically and will be able to pull it up quickly, others keep paper copies and may need to offer a call back as it will take a bit of time to retrieve the prescription. You can also request that they email you a copy of that prescription.
If the pharmacy made the error, they will typically offer an apology and ask if the person involved is ok. They will make an incident report with their professional insurance so there is a record of the error and any fallout that may have occurred.
You can then report the pharmacist to the Pharmacy Board via AHPRA if you wish and they will investigate on your behalf to determine whether the incident resulted from human error or malpractice. It is up to your sister as to whether she also wishes to go down the legal path and sue for medical malpractice/negligence.
Hospitals will have a similar protocol in place if it turns out the prescription was supplied as written and the prescribing doctor was responsible for the error. Contact them and they will be able to refer you on to the correct department to follow up.
1. A healthy 18 year old taking a diuretic once a day is unlikely to cause major issues (you pee more, you get thirsty, you drink more).
2, If the pharmacy was located in the hospital, report it to the hospitals consumer advisor, and they will help you through th process.
3. If it was a community pharmacy, contacting AHPRA is the first point of call.
4. How did the diuretic help with her depression/anxiety? You may have stumbled on a novel off label use.
Unfortunate number of downvotes for something that is medically accepted, perhaps phrasing not completely true, but a proportion of the observed response to SSRI’s is due to the placebo effect.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172306/
As someone who works in pharmacy, handwritten scripts can be really tough to read! A lot of doctors writing is pretty much illegible which makes handwritten scripts unnecessary for most medications (some medications require a prescribers writing)
Especially when the doctors are often not contactable like out of hours, booked out, in a hospital etc. so we cannot confirm. The pharmacist can always refuse to dispense though so if they were unsure they should have waited to check with the doctor.
And they should have asked the patient if they were unsure what they were using the medication for, if they knew what it was, what kind of specialist or doctor they saw.. that way they can conclude from those answers what the handwriting can be.
Has she gone back to the pharmacy? They will be able to trace back who did it, ensure to speak to a manager or pharmacist in charge. Obviously too late now but at least they can check over who did it and ensure they are aware and can check their procedures
So I'm a nurse, and I've made many midnight phone calls to surgeons asking exactly what the fuck they prescribed my patient - not only for medication, but also for postop orders. If it was handwritten then the onus is on the doctor to make it legible. However if there is any doubt, the script should have been referred back to the doctor by the pharmacist and unfortunately they clearly failed to do so. There is a reason escripts or at least printed scripts are more common than handwritten ones.
On a personal note, I had a pharmacist give me the wrong medication even though it was a printed script. I don't go there anymore. Sometimes there's no excuse.
You can only really sue for damages actually incurred. So if your sister is alive and well (I would guess the med us frusemide given instead of fluoxetine), you can't really sue for damages because there is none/very little .
You can probably report the dispensing pharmacist to AHPRA though. They might get reprimanded and forced to take a safe dispensing course.
They would have misread the writing and typed it up as the diuretic. Then, when she looked at the medication, it would have been what she was expecting.
If there is doubt, they should check with the doctor. This is why printed/electronic scripts are better.
All qs for the insurer's legal to put forward, not for OP to consider. This is clear as day a very (I cannot stress this enough) serious breach of [hypothetical non-legal advice obligations] by the bad actor, whether that be the pharmacist or hospital.
Simply because a patient is okay now, does not mean that failure to correctly prescribe would not result in consequential outcomes down the line (and depending on her condition, those may have been incredibly severe [e.g. suicidal ideation; psychotic break; total loss of earning potential etc.]).
Life advice - always listen to the doctor when they tell you what they are prescribing and why. Then when you get the meds home google the Name on the packet. This is good to see what known side effects are, others people’s experiences etc. And in the rare instance you have been given the wrong meds, you can take action prior to taking any of them.
Not that the above excuses the pharmacist from dispensing the wrong meds, however, it is good to take notice and be informed about any medication you are taking.
I'm a pharmacist and I'm a little confused here.
You say your sister was on the medication for three months? That doesn't make sense, standard supply is 1 month, so she would have had to go back three times to pick up three months supply.
Did she get three separate scripts dispensed?
- what was written on the script.
- what was written in the discharge from the hospital
- is what was dispensed from the pharmacy the same thing that was written on the script
- did her usual GP write any scripts? Its unusual for a hospital to provide a larger quantity on a script and have repeats on there too
Legally, I believe it depends if harm has come to your sister.
Sorry but you’ve written that the hospital wrote a script for an SSRI. Therefore I would assume with that knowledge how is it their fault?
Also…. Do you mean ‘doh!’?
Would you not need to prove there was some sort of disability as a result of the medication error? As a doctor I can tell you that a diuretic will have been unlikely to cause this.
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How has it come to pass that she's had access to three months of the wrong drug?
Google "healthcare complaint [state]" for who to make a complaint to. That said, in your position, I'd likely be wanting to know more about who made the error/s and when.
Like others have said it is unlikely that 3 months of diuretic use has caused any damage to any bodily organ. However, untreated depression (or whatever illness your sister was prescribed the SSRI for) is the bigger concern for me.
You are right that potentially either:
a. the prescriber wrote the wrong medication - in this case you would speak with the consumer team within the hospital who normally deal with complaints. The hospital website should have more information.
b. the pharmacy misinterpreted the prescription and dispensed the wrong medication - in which case, you should go back to the original pharmacy that dispensed the medication and make a complaint. If it was the hospital pharmacy, then you just follow step a.
(i'm guess it was fluoxetine ----> furosemide?)
I would have thought it less likely to be option b, as furosemide is a different strength and pack size to fluoxetine, all of which a pharmacist would use to try and identify which medication had been prescribed if it was difficult to understand (and of course they should contact the prescriber if they really weren't sure).
Furosemide is also available in a large pack size, which makes sense as to why she wouldn't have had to go back to another pharmacy for another dispensing (which is a missed opportunity to intervene earlier in the error).
Was your sister given a small amount of medicine before leaving the hospital - some hospitals give 7 days supply, or did they give her a whole month? Had she actually started on the SSRI before starting the wrong medicine? So many questions!
Before making a complaint to anyone, your sister needs to have an idea of what she wants to achieve as a result of making a complaint? Is it an apology? Is it an explanation of how they are intending to improve processes? If it was a pharmacy error is it a refund of the cost of the diuretic prescription? Is there paperwork in your sisters medical record that contains errors as a result that she wants rectified?
Sorry to hear that this has happened to your sister. Not a lawyer but am involved in Pharmacy. Unfortunately mistakes do happen in pharmacy and wrong drugs, strengths and instructions are dispensed more often then we'd like. Many things are put in place to try to reduce accidents but unfortunately things can slip through.
Hand written hospital scripts are particularly notorious as it can be unclear if poorly written, often the patient has no idea why they are taking medications and contact details of the prescriber are often non-existent.
Make sure you speak with the GP, the Pharmacy involved and if necessary the team at the hospital to ensure that your sister is okay currently and importantly gets put on the correct treatment.
Pharmacists and doctors all have indemnity insurance so you may be able to make a claim if your sister has experienced costs from the incident, but I don't know if you will be able to claim anything from the mistake itself.
Reporting to AHPRA or legal advice is always an option if you feel you have not been given an adequate response by those involved, but this is generally for cases of gross negligence, not for mistakes that can unfortunately happen despite the best intentions.
You can also report this to the sponsor of the medicine. Their number is on the package. They have a system where they must record this sort of things and they may also report to the regulator. But they won’t be able to give any medical advice.
Highly doubtful. If it was something they were already taking and had run out of, they’d possibly just do an interim script with a small supply, but I’m not 100% sure how SSRIs fit into the NP scope for prescribing. RIPENs can’t prescribe, only supply and administer.
As far as I know they only do 1 month supplies with repeats, unless she picked up multiple repeats at once?
Ex-Pharmacist who used to work in both community and hospital pharmacy here:
It’s factually incorrect that hospitals don’t issue handwritten scripts anymore. The biggest hospital in aus by bed size still issues them mostly!
The script might’ve been for something like “sertraline” (an SSRI) and the hospital might’ve intended for it to be a month’s worth of what she was already taking (very common practice in hospitals — ssris are actually relatively low risk drugs) and the dispensing pharmacist *might*ve misread it and dispensed a diuretic like Spironolactone (which comes in a pack size of 100 tabs I believe, diuretics tend to come in big bottles) — which, if taken once a day, would’ve lasted the patient about 3 months.
Terrible situation — I’d encourage OP to speak to the dispensing pharmacy to seek clarification.
Maybe the script was written incorrectly (pharmacies are supposed to keep a copy of the script!) or maybe the pharmacist made an honest mistake that might have resulted in the OPs sister being harmed.
I suppose if OP wants to seek retributive justice, AHPRA is who they can go to to report either the pharmacist and/or the prescriber (they’ll do their own investigations as to who was at fault etc I think)
Lol. Well, as a pharmacy student, this pharmacist is going to get owned. Report this to the PBA. They deal with all the unethical conduct of pharmacists. They'll probably lose their licence. There goes a decade down the drain. Big whoops.
NAL, am a pharmacist though. Unfortunately doctors and pharmacists are human and while we desperately wish that we could practice without ever making a mistake, that is simply not possible. We do treat medication errors seriously though since they can cause significant harm so there are protocols in place for what to do when a potential error is reported. The first thing you need to find out is who made the error. Did the pharmacy supply the wrong medication or did they supply as written but the prescription was incorrect in the first place? In NSW, pharmacies are required to store dispensed prescriptions for a minimum of 2 years. As long as the pharmacy she went to is following the legal minimum requirements, they will have the copy of the prescription that was dispensed though they may need to retrieve it from storage. Your sister or someone authorised to act on her behalf can call the pharmacy that dispensed the medication and request to speak to a pharmacist regarding a potential dispensing error. Let them know the date the script was presented and that you think the wrong medication was supplied. Some pharmacies store their records electronically and will be able to pull it up quickly, others keep paper copies and may need to offer a call back as it will take a bit of time to retrieve the prescription. You can also request that they email you a copy of that prescription. If the pharmacy made the error, they will typically offer an apology and ask if the person involved is ok. They will make an incident report with their professional insurance so there is a record of the error and any fallout that may have occurred. You can then report the pharmacist to the Pharmacy Board via AHPRA if you wish and they will investigate on your behalf to determine whether the incident resulted from human error or malpractice. It is up to your sister as to whether she also wishes to go down the legal path and sue for medical malpractice/negligence. Hospitals will have a similar protocol in place if it turns out the prescription was supplied as written and the prescribing doctor was responsible for the error. Contact them and they will be able to refer you on to the correct department to follow up.
1. A healthy 18 year old taking a diuretic once a day is unlikely to cause major issues (you pee more, you get thirsty, you drink more). 2, If the pharmacy was located in the hospital, report it to the hospitals consumer advisor, and they will help you through th process. 3. If it was a community pharmacy, contacting AHPRA is the first point of call. 4. How did the diuretic help with her depression/anxiety? You may have stumbled on a novel off label use.
Not in NSW or QLD, they have an independent health complaints board.
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Here we go..
Unfortunate number of downvotes for something that is medically accepted, perhaps phrasing not completely true, but a proportion of the observed response to SSRI’s is due to the placebo effect. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172306/
Such as?
It’s super secret evidence that I can’t share!!
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4172306/
As someone who works in pharmacy, handwritten scripts can be really tough to read! A lot of doctors writing is pretty much illegible which makes handwritten scripts unnecessary for most medications (some medications require a prescribers writing) Especially when the doctors are often not contactable like out of hours, booked out, in a hospital etc. so we cannot confirm. The pharmacist can always refuse to dispense though so if they were unsure they should have waited to check with the doctor. And they should have asked the patient if they were unsure what they were using the medication for, if they knew what it was, what kind of specialist or doctor they saw.. that way they can conclude from those answers what the handwriting can be. Has she gone back to the pharmacy? They will be able to trace back who did it, ensure to speak to a manager or pharmacist in charge. Obviously too late now but at least they can check over who did it and ensure they are aware and can check their procedures
So I'm a nurse, and I've made many midnight phone calls to surgeons asking exactly what the fuck they prescribed my patient - not only for medication, but also for postop orders. If it was handwritten then the onus is on the doctor to make it legible. However if there is any doubt, the script should have been referred back to the doctor by the pharmacist and unfortunately they clearly failed to do so. There is a reason escripts or at least printed scripts are more common than handwritten ones. On a personal note, I had a pharmacist give me the wrong medication even though it was a printed script. I don't go there anymore. Sometimes there's no excuse.
You can only really sue for damages actually incurred. So if your sister is alive and well (I would guess the med us frusemide given instead of fluoxetine), you can't really sue for damages because there is none/very little . You can probably report the dispensing pharmacist to AHPRA though. They might get reprimanded and forced to take a safe dispensing course.
And this is why handwritten scripts should go the way of the dodo
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They would have misread the writing and typed it up as the diuretic. Then, when she looked at the medication, it would have been what she was expecting. If there is doubt, they should check with the doctor. This is why printed/electronic scripts are better.
All qs for the insurer's legal to put forward, not for OP to consider. This is clear as day a very (I cannot stress this enough) serious breach of [hypothetical non-legal advice obligations] by the bad actor, whether that be the pharmacist or hospital. Simply because a patient is okay now, does not mean that failure to correctly prescribe would not result in consequential outcomes down the line (and depending on her condition, those may have been incredibly severe [e.g. suicidal ideation; psychotic break; total loss of earning potential etc.]).
Probs 1 bottle of 100 count frusemide . Takes 3 months to finish at 1 per day.
Life advice - always listen to the doctor when they tell you what they are prescribing and why. Then when you get the meds home google the Name on the packet. This is good to see what known side effects are, others people’s experiences etc. And in the rare instance you have been given the wrong meds, you can take action prior to taking any of them. Not that the above excuses the pharmacist from dispensing the wrong meds, however, it is good to take notice and be informed about any medication you are taking.
I'm a pharmacist and I'm a little confused here. You say your sister was on the medication for three months? That doesn't make sense, standard supply is 1 month, so she would have had to go back three times to pick up three months supply. Did she get three separate scripts dispensed?
1 box of 20 mg frusemide X 100 tabs instead of 1 box of fluoxetine 20mg X 30
- what was written on the script. - what was written in the discharge from the hospital - is what was dispensed from the pharmacy the same thing that was written on the script - did her usual GP write any scripts? Its unusual for a hospital to provide a larger quantity on a script and have repeats on there too Legally, I believe it depends if harm has come to your sister.
Also report to AHPRA. Get the name of pharmacist.
Why would it be the hospitals fault? You can complain to the pharmacy board NSW. https://www.pharmacycouncil.nsw.gov.au/make-a-complaint
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Yeah it’s pretty annoying.
because they could've written the wrong script? dough
Sorry but you’ve written that the hospital wrote a script for an SSRI. Therefore I would assume with that knowledge how is it their fault? Also…. Do you mean ‘doh!’?
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Would you not need to prove there was some sort of disability as a result of the medication error? As a doctor I can tell you that a diuretic will have been unlikely to cause this.
Welcome to r/AusLegal. Please read our rules before commenting. Please remember: 1. Per rule 4, this subreddit is not a replacement for real legal advice. You should independently seek legal advice from a real, qualified practitioner. This sub cannot recommend specific lawyers. 2. A non-exhaustive list of free legal services around Australia can be found here. 3. Links to the each state and territory's respective Law Society are on the sidebar: you can use these links to find a lawyer in your area. *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/AusLegal) if you have any questions or concerns.*
How has it come to pass that she's had access to three months of the wrong drug? Google "healthcare complaint [state]" for who to make a complaint to. That said, in your position, I'd likely be wanting to know more about who made the error/s and when.
Like others have said it is unlikely that 3 months of diuretic use has caused any damage to any bodily organ. However, untreated depression (or whatever illness your sister was prescribed the SSRI for) is the bigger concern for me. You are right that potentially either: a. the prescriber wrote the wrong medication - in this case you would speak with the consumer team within the hospital who normally deal with complaints. The hospital website should have more information. b. the pharmacy misinterpreted the prescription and dispensed the wrong medication - in which case, you should go back to the original pharmacy that dispensed the medication and make a complaint. If it was the hospital pharmacy, then you just follow step a. (i'm guess it was fluoxetine ----> furosemide?) I would have thought it less likely to be option b, as furosemide is a different strength and pack size to fluoxetine, all of which a pharmacist would use to try and identify which medication had been prescribed if it was difficult to understand (and of course they should contact the prescriber if they really weren't sure). Furosemide is also available in a large pack size, which makes sense as to why she wouldn't have had to go back to another pharmacy for another dispensing (which is a missed opportunity to intervene earlier in the error). Was your sister given a small amount of medicine before leaving the hospital - some hospitals give 7 days supply, or did they give her a whole month? Had she actually started on the SSRI before starting the wrong medicine? So many questions! Before making a complaint to anyone, your sister needs to have an idea of what she wants to achieve as a result of making a complaint? Is it an apology? Is it an explanation of how they are intending to improve processes? If it was a pharmacy error is it a refund of the cost of the diuretic prescription? Is there paperwork in your sisters medical record that contains errors as a result that she wants rectified?
Sorry to hear that this has happened to your sister. Not a lawyer but am involved in Pharmacy. Unfortunately mistakes do happen in pharmacy and wrong drugs, strengths and instructions are dispensed more often then we'd like. Many things are put in place to try to reduce accidents but unfortunately things can slip through. Hand written hospital scripts are particularly notorious as it can be unclear if poorly written, often the patient has no idea why they are taking medications and contact details of the prescriber are often non-existent. Make sure you speak with the GP, the Pharmacy involved and if necessary the team at the hospital to ensure that your sister is okay currently and importantly gets put on the correct treatment. Pharmacists and doctors all have indemnity insurance so you may be able to make a claim if your sister has experienced costs from the incident, but I don't know if you will be able to claim anything from the mistake itself. Reporting to AHPRA or legal advice is always an option if you feel you have not been given an adequate response by those involved, but this is generally for cases of gross negligence, not for mistakes that can unfortunately happen despite the best intentions.
You can also report this to the sponsor of the medicine. Their number is on the package. They have a system where they must record this sort of things and they may also report to the regulator. But they won’t be able to give any medical advice.
It took her 3 months? Whilst clearly a mistake has been made, there has to be some sort of accountability taken - it took her 3 months?
Could have been given a 3 months supply, 100 tablets is not uncommon.
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Hand written prescriptions definitely do still exist! Source: I’m an RN in a rural urgent care.
Would a physician or NP/RIPEN provide a handwritten script for 3x months worth of medication at your urgent care?
Highly doubtful. If it was something they were already taking and had run out of, they’d possibly just do an interim script with a small supply, but I’m not 100% sure how SSRIs fit into the NP scope for prescribing. RIPENs can’t prescribe, only supply and administer. As far as I know they only do 1 month supplies with repeats, unless she picked up multiple repeats at once?
3x months worth of medication to treat a chronic health condition*
Yeah, this story is weird.
Ex-Pharmacist who used to work in both community and hospital pharmacy here: It’s factually incorrect that hospitals don’t issue handwritten scripts anymore. The biggest hospital in aus by bed size still issues them mostly! The script might’ve been for something like “sertraline” (an SSRI) and the hospital might’ve intended for it to be a month’s worth of what she was already taking (very common practice in hospitals — ssris are actually relatively low risk drugs) and the dispensing pharmacist *might*ve misread it and dispensed a diuretic like Spironolactone (which comes in a pack size of 100 tabs I believe, diuretics tend to come in big bottles) — which, if taken once a day, would’ve lasted the patient about 3 months. Terrible situation — I’d encourage OP to speak to the dispensing pharmacy to seek clarification. Maybe the script was written incorrectly (pharmacies are supposed to keep a copy of the script!) or maybe the pharmacist made an honest mistake that might have resulted in the OPs sister being harmed. I suppose if OP wants to seek retributive justice, AHPRA is who they can go to to report either the pharmacist and/or the prescriber (they’ll do their own investigations as to who was at fault etc I think)
Lol. Well, as a pharmacy student, this pharmacist is going to get owned. Report this to the PBA. They deal with all the unethical conduct of pharmacists. They'll probably lose their licence. There goes a decade down the drain. Big whoops.