Anticoagulant Errors

The anticoagulant Warfarin remains one of the most frequently prescribed medications in the United States. It appears on the Institute for Safe Medication Practices list of high-alert medications because over- or under-anticoagulation has significant consequences for the patient. In addition, medication errors that lead to adverse drug events may be more common with warfarin because it has many drug-drug and drug-food interactions, and there is a need for increased INR monitoring. (The INR, or international normalized ratio, is used to check if you have a blood clotting problem.)

Wright B, Medication Errors in Adults-Case #1: Warfarin. Patientcareonline.com. 2013.
https://www.patientcareonline.com/view/medication-errors-adultscase-1-warfarin

How Do Doctors Over or Under Anticoagulate Patients?

Doctors can over-anticoagulate or under-anticoagulate a patient when the anticoagulant is improperly administered, withheld, or discontinued during hospitalization, see image. For example, a doctor may stop an anticoagulant when a bleeding patient enters the hospital, even though the patient takes the drug to prevent atrial fibrillation and brain hemorrhage. Likewise, a doctor may decide not to prescribe an anti-coagulant for a patient even though the patient has a clear indication for the drug. Or a doctor may fail to monitor a patient who takes the medication for signs of excessive bleeding. Finally, a doctor may discontinue an anticoagulant for an injured patient out of concern for the risk of bleeding, even though there is also a high risk of a stroke.

Anticoagulant Misadventures Give Rise to Malpractice Claims, 2019, Relias Media

warfarin sodium - Drug Summary

Warfarin can cause major or fatal bleeding. Warfarin is contraindicated in patients with conditions in which therapy with warfarin may result in uncontrolled bleeding including hematological disease; GI bleeding, genitourinary bleeding, respiratory tract bleeding, retinal bleeding, or intracranial bleeding; head trauma; hemorrhagic stroke; aneurysm; aortic dissection; pericarditis or pericardial effusion; bacterial endocarditis; threatened abortion; eclampsia and preeclampsia; recent or planned surgery of the central nervous system, eye, or following trauma that results in large open surfaces; diagnostic or therapeutic procedures with potential for uncontrolled bleeding including epidural anesthesia, spinal anesthesia, spinal puncture and lumbar puncture; and malignant hypertension.

If you have experienced a Medication Error in Wicomico, Worcester, Talbot, and Queen Anne’s County, MD, don’t hesitate to Contact Us

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