California pharmacies make an estimated 5 million errors every year, according to California’s Board of Pharmacy.
Officials at the regulatory board say they can only estimate the number of errors because pharmacies are not required to report them.
Most of the mistakes that California officials have discovered, according to citations issued by the board and reviewed by The Los Angeles Times, occurred at chain pharmacies such as CVS and Walgreens, where a pharmacist may fill hundreds of prescriptions during a shift, while juggling other tasks such as giving vaccinations, calling doctors’ offices to confirm prescriptions and working the drive-through.
Christopher Adkins, a pharmacist who worked at CVS, and then at Vons pharmacies until March, said that management policies at the big chains have resulted in understaffed stores and overworked staff.
“At this point it’s completely unsafe,” he said.
Adkins now works at an independent pharmacy company in Los Angeles. He isn’t the only pharmacist worried that heavy workloads and distractions are leading to errors.
In a survey of California licensed pharmacists in 2021, 91% of those working at chain pharmacies said staffing wasn’t high enough to provide patients adequate care.
While the pharmacy board requires pharmacies to document errors internally, inform patients about mistakes in certain cases and learn how to prevent them from occurring again, only 62% of chain pharmacists said stores were following those rules, according to the survey.
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MISTAKES WITH DEADLY CONSEQUENCES
Medication errors can harm patients, sometimes seriously.
One patient took prednisone, a powerful steroid, for 89 days after a Walgreens pharmacist in Santa Clara confused the drug with Prilosec, the heartburn drug that had actually been prescribed, according to a citation issued in June 2022. Research has shown that Prednisone can decrease bone density within weeks of starting the drug, increasing the risk of fractures.
CVS and Walgreens declined to make executives available for interviews but sent written statements saying that the errors were rare. Rite Aid did not respond to messages.
As many as 9,000 Americans die each year from prescription errors, according to one study.
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THE FIGHT FOR MORE ACCOUNTABILITY
Rarely does the public learn of the mistakes. Not only does the state not require the reporting of errors, but the big pharmacy companies often ask consumers to sign agreements demanding that they take any dispute not to court but to private arbitration panels.
Patients typically agree to arbitration when they are asked to click a box to accept the company’s terms and conditions when they pick up a prescription.
“You agree that CVS and you each waive the right to trial by a jury,” states the CVS agreement.
To begin understanding the frequency of the mistakes, the pharmacy board sponsored a bill that would require pharmacies to report every error — not publicly but to a third party outside the government. The bill would also give the pharmacist responsible for the store the ability to increase staffing if they believe the workload has become too heavy to keep patients safe.
The legislation is opposed by the California Community Pharmacy Coalition, a lobbying group representing retail pharmacies, including the big chains.