PHARMACY LITIGATION REVIEW: HOSPITAL ADMINISTRATION AND THE PHARMACY DEPARTMENT
David B Brushwood

OBJECTIVE: To review some essential legal points in the relationship between hospital administration and pharmacists, and outline some of the responsibilities both groups have to one another and to the institution that employs them.

CASE SUMMARIES: Issues discussed in the seven case summaries presented include whether: (1) a hospital can be liable for negligence if an error is made by a nonpharmacist and it is likely the error would not have occurred if a pharmacist had been on staff; (2) nurses may routinely compound intravenous admixtures for administration by other nurses when this practice is the responsibility of pharmacists; (3) practices falling below the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) guidelines automatically fall below standards of care applicable in malpractice cases, negating the need for expert testimony; (4) a hospital is liable for failure to meet the standard of care when no expert has testified to such standards, and the plaintiff has relied solely on JCAHO standards, the Physicians' Desk Reference, and the drug package insert; (5) a hospital's formulary system establishes a standard of practice for medical staff practicing at the hospital; (6) the responsibility of a hospital to control drug distribution within the hospital extends to purchases of nonprescription drugs by patients in the hospital gift shop; and (7) state statutes or public policy shield quality assurance activities from discovery in malpractice litigation brought against a hospital.

CONCLUSIONS: Institutional responsibilities have become a significant focus of pharmacist attention. When institutions have responsibilities related to drug distribution or the use of medicines, they turn to pharmacists to find ways of meeting these responsibilities. As these case studies show, the legal ramifications of both groups individually and to each other within an institution are complex and require continued study.

J Pharm Technol 1999;15:118-29.

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