be exposed to Recalled product manufacturing distribution inappropriate storage and storage activities, prior conditions by the to the product reaching the wholesaler medication use system Pharmacy mistakenly Yes Drug label look-alike stocked the wrong drug in the automated dispensing Wrong drug stocked system. Reporter attributed the error to both Product packaging drugs being packaged in confusion similar sized vials with look-alike container labels. Product transcribing errors/communication issues Scenario Medication LLT Comment error? Healthcare provider Yes Transcription called in a prescription medication error for Drug A, but pharmacy wrote down the prescription as Drug B Pharmacy dispensed Yes Product data entry 800 mg strength error instead of 600 mg due to data error Wrong drug strength dispensed Physician ordered Yes Transcription insulin pens, but a medication error transcription error transpired with the Wrong device pharmacy and the dispensed patient was dispensed insulin in a vial with syringes instead Patient had an issue No Communication Despite the terms “issue” communicating and disorder and in “communicating” was given the possible the example, this is not a diagnosis of autism medication error and Autism should not be captured under LLT Product
be exposed to inappropriate storage conditions by the wholesaler Recalled product manufacturing distribution and storage activities, prior to the product reaching the medication use system Pharmacy mistakenly stocked the wrong drug in the automated dispensing system. Reporter attributed the error to both drugs being packaged in similar sized vials with look-alike container labels. Yes Drug label look-alike Wrong drug stocked Product packaging confusion Product transcribing errors/communication issues Scenario Medication error? LLT Comment Healthcare provider called in a prescription for Drug A, but pharmacy wrote down the prescription as Drug B Yes Transcription medication error Pharmacy dispensed 800 mg strength instead of 600 mg due to data error Yes Product data entry error Wrong drug strength dispensed Physician ordered insulin pens, but a transcription error transpired with the pharmacy and the patient was dispensed insulin in a vial with syringes instead Yes Transcription medication error Wrong device dispensed Patient had an issue communicating and was given the possible diagnosis of autism No Communication disorder Autism Despite the terms “issue” and “communicating” in the example, this is not a medication error and should not be captured under LLT Product
000199_companionptc_r1_01_jun2018.docx