yeah alert fatigue is a real thing. if people are routinely getting false positive alerts that they override (rightly) then the system is broken. I would almost never consider charging a pharmacist or doctor in this case and would strongly consider something like a huge punitive fine against the software producer if their product just spews constant warnings that are dismissed as a matter of routine.
1 Like
dunno but if you’re a ship captain and run aground and people die doesn’t really matter what your excuse is, probably goin to jail
dont see how this is different
well if you want to make this the standard you wont have any pharmacists, nurses or doctors soon
2 Likes
The boat captain is in control of the boat. The doctors, nurses, and pharmacists are not not really. The math is just different on the two different scenarios in very relevant ways.
Although I’m somewhat biased as a healthcare provider, I can’t fathom why the physician would be charged criminally unless he willfully chose the dose/schedule despite knowing that it wasn’t standard. Nonetheless, even for an accident a malpractice payout would be reasonable.
I’d be more willing to consider criminal charges against the pharmacist if he was really reckless, since I assume that part of a pharmacist’s job is to check for contraindications on all of the known scripts. However, I don’t know enough about the pharmacy profession to know what their ethical rules are concerning the identification and handling of potentially lethal contraindications.
I think the doctor and the pharmacist made the same mistake ultimately, I don’t see how it should possibly raise to level of being criminal unless there was some sort of intentional ill will or they were drunk.
The they “overrode warnings” is the weakest shit ever. It’s just a way to push potential liability onto people instead of the software company. Doing some quick math I think I have to override aprox 35 warnings a day in our prescribing program just to do normal stuff that nobody would find even a little bit controversial
jesus christ
35x/day is insane
this absolutely demolishes the chance that a real warning is noticed. my guess is that it at least doubles the chances of missing a real alert, probably way more than that.
3 Likes
Yeah it’s crazy, I’ve complained but I don’t think companies are willing to sell software like this w/o the excess warnings because they don’t want to get sued if something bad happens that didn’t trigger a warning so instead you have to override/acknowledge to do almost anything and like you said of course you dramatically upping risk of missing the ones that actually matter.
yeah i override the vast majority of warnings I get and it’s easily about 10-15 per 10 hour shift. Psych meds are going to be weirder because there’s all sorts of allergies that aren’t allergies reported and whatnot.
I wish ours was stuff even potentially relevant like that.
If I prescribe 3 meds to a 66yo I get 3 separate warnings to override that the patient is over 65, it’s infuriating.
It gives warnings anytime you prescribe 2 antidepressants even if they are combinations that are accepted practice or even the specific FDA indication like abilify add on tx.
My personal favorite is if I have to free text a titration schedule, I get a 2 warning letting me know my rx wont be checked for other warnings.
If only George Bailey had been there to tell the pharmacist.
1 Like
I agree that short of inebriation or willful disregard of a known risk I wouldn’t want either one criminally charged, even though in this specific case it wasn’t some weird drug interaction but written, medical advice that was fatal when followed.
I’m curious how you and @CaffeineNeeded believe that the civil liability, if any, should be apportioned between the physician and the pharm?
There’s definitely civil liability for sure. That’s a clear medical error that caused harm to a patient, so in our stupid ass system that’s a pretty straightforward medmal case.
As to how to split it? Not sure, at the end of the day, it’s on the physician though.
I don’t know much about how that stuff usually plays out legally but seems like they would both be equally liable from a malpractice standpoint?
The doctor made (I assume) a typo that was dangerous and the pharmacist didn’t catch it. Obviously sucks for the patient and the providers that it required 2 mistakes so if just one of them hadn’t made a mistake then none of them would have had consequences
1 Like
There’s a nursing mistake here as well, but they’re not going to be held liable
I don’t have Twitter so couldn’t really read whole thing but I was assuming this was outpatient, but if nurse was administering med I would I agree they would have liability too
1 Like
lol! but they are! they could just not prescribe the med that kills the patient!
Is it true that captains of ships usually go to jail if someone dies due to an accident? Like sure if you are doing coke off strippers instead of captaining, but say they make a bad judgment call about weather or accidentally read a chart wrong I don’t see why that would necessarily be criminal?
No, I don’t really think that’s true. The last one was Schettino, but holy shit he seems to have deserved it. Boating laws are similar to driving laws. We even have boating while intoxicated. But if you just fuck up and the ship sinks, you’re not going to jail.
this is simply not true. even non captains go to jail for negligence. the bar is infinitely higher for a captain. if you’re found negligent you go to jail if someone dies.