Incorrect dispensing of medications by community pharmacies can lead to accidental poisonings. This may not be considered by emergency medicine physicians in patients describing vague symptoms. We present a case of a paediatric ingestion of amlodipine, resulting from a community pharmacy dispensing error, that was recognized by the child’s mother, and consider the liability implications.
National Coordinating Council for Medication Error Reporting and Prevention. About medication errors, www.nccmerp.org/about-medication (2020, accessed 5 January 2021).
2.
SarkarULópezAMaselliJH, et al.
Adverse drug events in US adult ambulatory medical care. Health Serv Res2011;
46(5): 1517–1533.
3.
CampbellPJPatelMMartinJR, et al.
Systematic review and meta-analysis of community pharmacy error rates in the USA: 1993–2015. BMJ Open Qual2018 Oct 2;
7(4): e000193.
4.
GillaniSWGulamSMThomasD, et al.
Role and services of a pharmacist in the prevention of medication errors: A systematic review. Curr Drug Saf2021;
16(3): 322–328.
5.
SnoswellCL.A meta-analysis of pharmacists and pharmacy technicians' accuracy checking proficiency.Res Social Adm Pharm. 2020 Jun;
16(6): 760–765.