Prescription errors are one of the most common subjects for a claim notified to the MDU. Although generally damages payments for these claims are not particularly high, the error can nevertheless cause significant anxiety for both the patient and the prescriber. And even though the majority of prescription error claims notified to the MDU don't result in ongoing harm to the patient, in occasional cases the results can be catastrophic.

Historically, the source of an error might have been the prescriber's handwriting. But with the advent of electronic prescribing, the error more commonly relates to accidentally clicking on the wrong drug or wrong dose from a drop down menu. This can then be compounded if the medication is put on repeat prescription, and so several prescriptions may be issued before the error is picked up. The patient may suffer not only side effects from the wrong medication, but also problems due to a lack of the intended medication.

Cases and claims

An analysis was carried out of all closed cases between 2011 and 2015 which related to prescription errors. There were a total of 217 cases closed over this five year period, and of these, 137 (63%) were successfully defended. This is slightly lower than the MDU's rate of successfully defending claims overall, which is almost 75% over the last 10 years, and reflects the fact that prescription errors can be hard to defend in terms of breach of duty. It may however be possible to defend a case on the basis that although a prescription error was made, no harm was caused to the patient.

Damages paid to patients ranged between from £900 to almost £2 million. The latter concerned hypoxic brain injury following cardiac arrest due to excessive morphine. However, more than half of the claims resulted in damages payments under £15 000, and only 6% in a payment over £100,000, the majority of which were due to excessive prescribing of sedating analgesics.

The majority of cases involved GPs, but 5% of claims were from members in private practice.

Types of drugs

Over 50 different drugs or drug types were involved, and there were also claims related to devices and method of drug delivery (prescribing eye drops rather than ear drops, for example). The most common cause of drug errors was analgesics other than non-steroids (mainly opiates), followed by NSAIDs. The other most frequently involved drugs were penicillins, then other antibiotics, followed by anti-epileptics and then anti-depressants. The chart below illustrates the 10 most common types of drug involved in prescription error claims:

Drugs involved in prescription claims

Prescription errors

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Dr Claire Wratten

Prescription errors