An Alabama woman who mistakenly received a powerful and potentially dangerous steroid instead of the painkiller she was prescribed has won a $2 million judgment against Rite Aid, the pharmacy chain that employed the pharmacist who made the dispensing error. According to the Montgomery (AL) Advertiser, the woman developed Cushing’s syndrome after taking high doses of oral dexamethasone instead of the drug her doctor had prescribed. The woman’s husband received a related $500,000 judgment for being deprived of his wife’s companionship while she suffered from muscle weakness, rapid weight gain and other symptoms that can mark Cushing’s syndrome.
Reports of the suit do not specify which painkiller the woman should have received. However, the authoritative Merck Manual notes that dexamethasone was once sold under the brand name Decadron and that the name could be mistaken for Percodan. Physicians often prescribe medications by brand name, leaving it to pharmacists and pharmacy technicians to identify and substitute generic equivalents. Generic substitution is legal and rarely creates problems for patients because generic prescription medication approved for sale in the United States must have active ingredients that are exactly the same as the brand name drugs they replace. Percodan combines aspirin with the narcotic medication oxycodone. Dexamethasone does not relieve pain, and side effects from taking the corticosteroid can include Cushing’s-like problems.
Prescription drug dosing, dispensing and administration errors are among the most common medical mistakes, and their effects can be severe. As medication experts, pharmacists have legal and professional obligations to ensure that prescriptions are filled correctly. Companies and health care facilities that employ pharmacists have the duty of ensuring pharmacists meet their obligations.
Rite Aid has announced that it will not appeal the jury’s verdict in this case, which shows that the pharmacy chain is accepting its responsibilities. The chain and its employees should also take this incident as an opportunity to learn how to prevent similar mistakes in the future.