Drug-Related Adverse Events on the Rise: Protect Yourself from Claims

Medication-related errors involving narcotic analgesics are not only a patient safety concern but are also a cause of significant professional liability for physicians and other prescribers.

Over the past decade, the number of adverse events related to inappropriate prescribing, misuse, and abuse of prescription painkillers has substantially increased in the U.S. In 2010, 2 million people—nearly 5,500 a day—reported first-time, nonmedical use of prescription painkillers during the previous 12 months.1 Such drugs cause more deaths than heroin and cocaine combined,2 and drug-related deaths exceed deaths from traffic fatalities.3

Narcotic analgesics are the most common class of medications that can lead to a medication-related error claim, according to a study by The Doctors Company, the nation’s largest medical malpractice insurer. Some 5.8 percent of 2,646 closed claims analyzed by The Doctors Company in 2011 contained medication-related errors. Of these, narcotic analgesics were the most common class of medications identified (17.5 percent of claims).

The U.S. Food and Drug Administration (FDA) has mandated a Risk Evaluation and Mitigation Strategies (REMS) program for prescribing extended-release and long-acting opioid analgesics. The FDA will implement this voluntary program on March 1, 2013. As part of the program, the FDA is requiring opioid manufacturers to provide grants to fund continuing medical education (CME) programs to advance prescriber understanding and safe use of pain medications.

In addition to completing CME programs, doctors can reduce risk by incorporating electronic prescribing, also known as e-prescriptions, into their practice. Electronic prescribing removes the time-intensive process involved with tracking paper prescriptions, voids opportunity for alterations, and allows direct connection to pharmacists to ensure accurate prescriptions.

Other tips for avoiding narcotic analgesics claims include:
  • Require office visits for obtaining controlled medication prescriptions.
  • Note actual amounts prescribed, and give matching numerals to discourage prescription alterations (e.g., thirty/#30).
  • Attend seminars to educate yourself on safe prescribing practices.
Contributed by The Doctors Company. Learn more about prescription security at www.thedoctors.com/prescribing or visit www.thedoctors.com/articles for more safety articles.


1. Substance Abuse and Mental Health Services Administration. Results from the 2010 National Survey on Drug Use and Health: Summary of National Findings. NSDUH Series H-41, HHS Publication No. (SMA) 11-4658. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2011. http://oas.samhsa.gov/NSDUH/2k10NSDUH/2k10Results.htm#2.16.
2. Centers for Disease Control and Prevention. Prescription painkiller overdoses in the U.S. Vital Signs. Published November 2011. http://cdc.gov/vitalsigns/PainkillerOverdoses.
3. Drug deaths now outnumber traffic fatalities in U.S., data show. Los Angeles Times. September 17, 2011. http://articles.latimes.com/2011/sep/17/local/la-me-drugs-epidemic-20110918

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