As a Clinical Pharmacist, I assist law firms in cases that involve medications, often in the areas of personal injury and medical malpractice. I provide research, expert opinion and reporting that is knowledge-based and unbiased, allowing me to assist with either plaintiff or defense and my work is focused toward the specific needs of the case.

The distinction between research and opinion must be clear. Information that is researched through published medical literature is precisely referenced. A balanced approach to obtaining the information ensures a high standard of credible facts. Expert opinion involves assessing the available information and providing a coherent analysis of the facts and how they pertain to the case. This allows my legal partners to determine the significance of the conclusions and their strength in negotiation or in litigation.

Areas of potential liability are not always self-evident and need to be thoroughly explored. For example, a patient received the correct medication but at ten times the prescribed dose and took it for 30 days. Now, two very pertinent questions were presented by the attorney. One, can the symptoms that the patient experienced be explained by the dosing error? Second, is there a likelihood of long-term effects to the patient due to the dosing error and the length of time the patient took it? Both questions can be answered with a high degree of probability but there is an additional area that was not initially considered and could have a significant impact on the case. I wanted to determine how the error occurred in the first place. There are established procedures for receiving, processing, preparing and dispensing or administering a medication order. These procedures are established to prevent such an error from occurring and it is critically important to focus on where the breakdown occurred. This could be a potentially significant feature to the case in terms of liability and was not part of the attorney’s inquiry, until my initial review took place. This is a key point in the value of engaging expert opinion. There will almost always be factors to consider that are not apparent on the face of things.

There is considerable debate about the prevalence of medical errors. In 1999, The National Institute of Health published the landmark study “To Err Is Human.” The authors estimated that there were as many as 98,000 deaths annually in U.S. hospitals of preventable medical errors. In 2013, a study was published in The Journal of Patient Safety concluding that a more accurate estimate was at least 210,000 deaths annually and may be as high as 440,000 per year. Further, in 2016, The British Medical Journal published a Johns Hopkins study estimating annual deaths at 251,000. On the other hand, these studies are disputed in a Yale University study, published in 2020 that suggests an estimated 22,000 preventable deaths annually. It is apparent that this topic is wide open for debate but what is clear is that the impact, at any number, is devastating.

It is essential that there be scrutiny of methods of data collection and analysis in pursuit of reliable information. Specific citations for the above mentioned studies are available upon request.

Arthur Wernick, PharmD is the owner of Clinical Pharmacy Research Group.