I am really getting tired of the ethical dilemmas which are being presented to us, and then being told to take the non-ethical path. So I decided that we'll play a game and see what you do.
Patient calls us stating that we shorted her 20 of the 90 Lortab 7.5s she received today. She also states that this has happened the last two times she had this drug filled. Looking at her profile you notice that almost everything is either Hydrocodone or Diazepam. Since she's a fairly regular customer, you know that she looks more or less like a crackhead (not to be rude, but she does).
Now also realize that that drug is counted by our robot, a ScriptPro SP 200. For those of you who are unfamiliar with that type of robot, it counts the tablets by causing them to break a laser. This records the number that go into the vial. Now it does happen where two tablets will fall simultaneously and they will get counted at one. It is very very rare for these things to under count something because of this.
Now say you also run tests on it and kick out 14 vials of 90 count Hydrocodone 7.5s just on the off chance that it is counting wrong. Out of the 1,260 tablets you request you get... 1,260 tablets.
Therefore that patient claims we consistently short her tablets, which you have effectively demonstrated is highly unlikely. Additionally the fact that it would miscount nearly 25% of the prescription is even more absurd.
The question is: Would you give her the 20 tablets we 'shorted' her?
I said no for obvious reasons. You can guess what the pharmacist I was working with chose to do.
So, what would you do?
8 comments:
Doesn't the robot show a record of how many pills are put into each vial? Please don't tell me the pharmacist gave her them. Next time she comes in, stand in front of her and make her count them out before she leaves being it's supposedly happened so many times. ARGH what a frickin pain
I agree with anonymous. I might give her the benefit of the doubt the first time. After that I'd double-check the quantity by hand and get her to do the same.
Funny how people never mention that you give them too many tablets, isn't it? :)
We are required to double-count any controlled drugs out of ScriptPro. It takes a little extra time, but occasionally the count is off by 1-2 tablets (not 20 though!)
anom - yes it keeps a record of how many were put in there, and it was verified twice
the pharmacist did give her the tablets. he's the same one I've had ethical issues with before which I have posted about.
mrhunnybun - ya know I was thinkin the exact same thing...
I'm guessing this happened at Liggies?
I remember a day when I actually told a customer how the robot worked mechanically and electrically to point out that it is IMPOSSIBLE for the robot to undercount by 20 on only one prescription (I think I may have even started writing out some basic C++ code for them). If it is shorting the fills by that many, it would be happening on ALL prescriptions, no just her lortabs.
-S
This is coming from the consumer side of the fence as I am not a pharmacist but am a disabled person that is currently prescribed Albuterol but no other prescriptions - I never count the Albuterol doses I am given as to do so would involve irrevocably emptying the canister. However, in the past I was on other prescriptions. If I had any reason to think I might not be getting the right amount of a countable medicine, I would be totally willing to count out the amount of doses in front of the pharmacist at the time of pickup so that there would be no question of whether or not there was an error. Not only that but there is also the not small matter of the cost to make a second round trip to the pharmacist if I discovered an error later.
Even an idiot can see this woman is full of shit. No way in hell am I giving her another 20 and future bottles should be confirmed with her before she leaves. My guess is she'd find a new pharmacy.
I'm consistently shorted on my Zomig 5mg but I know this is due to human error...unless there's a robot that opens boxes and rips apart blister packs. I ALWAYS check my script before I leave. ALWAYS.
My retail job has the smaller Scriptpro machine and it's virtually impossible for it to miss that badly. If it did, we catch it because that location double counts all controls regardless of where they come out of. So I wouldn't have given them either and am quite adament when pointing out that the pills came out of an automated machine that we double-check.
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