Nursing Home Medication Errors: Liability for Staff Failures

Common Types of Medication Errors

Medication errors in nursing homes take many forms. The most common include wrong medication, wrong dose, wrong route, wrong time, wrong patient, omitted or missed doses, and expired medications. These errors often result from understaffing, inadequate training, poor communication, and failure to follow the Five Rights of medication administration.

• Wrong medication — Administering a different drug than prescribed, often due to look-alike/sound-alike (LASA) errors
• Wrong dose — Giving too much or too little, including calculation errors and decimal point errors
• Wrong route — Administering by the wrong route (oral vs. IV, topical vs. oral)
• Wrong time — Administering at the wrong time, dangerous for timed medications like insulin
• Wrong patient — Giving medication to the wrong resident
• Omitted doses — Missing doses of critical medications like antibiotics or anticoagulants

The Five Rights of Medication Administration

The standard of care for medication administration requires verifying the Five Rights: right patient, right medication, right dose, right route, and right time. Failure to verify any of these rights is evidence of negligence. Modern nursing homes should use Barcode Medication Administration (BCMA) to verify the Five Rights electronically.

High-Alert Medications

Certain medications carry particularly high risks in nursing home settings. Anticoagulants (warfarin, apixaban) can cause fatal bleeding. Insulin can cause hypoglycemia or hyperglycemia. Opioids can cause respiratory depression. Psychotropic medications (antipsychotics, benzodiazepines) are sometimes used as chemical restraints — a serious violation of resident rights.

Liability for Medication Errors

When a medication error causes harm, multiple parties may be liable: the nursing home for understaffing and inadequate training, the nurse or CMT for failing to follow the Five Rights, the pharmacy for dispensing errors, and the physician for prescribing errors. Under New York Public Health Law § 2801-d, nursing homes can be held liable for violations of resident rights — including the right to proper medication administration.

Frequently Asked Questions

The value of a medical malpractice case in New York depends on several factors, including the severity of the injury, the strength of liability evidence, and the economic and non-economic damages involved. New York is one of the few states with no caps on medical malpractice damages, meaning there is no artificial limit on what you can recover. Below are typical settlement ranges based on injury severity.