A resident at the Fon Du Lac Rehabilitation and Health Care Center in East Peoria, Illinois was hospitalized after being administered the wrong medication. The resident was given Clozaril, an antipsychotic and Wellbutrin, an antidepressant. The combination resulted in a swollen tongue, hallucinations, and an inability to walk or grasp objects.
Before distributing any medication, a nurse needs to follow a checklist that assures they are providing the right medicine to the correct patient, in the prescribed dosage, at the proper time, and in the appropriate form (liquid, pill, etc.). Because of the serious nature of distributing medications, it is a duty that can only be assigned to a licensed nurse. In addition, because of the increased chances of a medication error, a medication that is not used immediately needs to be destroyed.
While the resident at Fon Du Lac did not suffer any long term negative consequences, that does nothing to lessen the seriousness of the medication error. According to the written report, the nurse in charge of distributing medications was preparing medications in advance and storing them in the medication cart, a clear violations of nursing home policy.
In addition to the aforementioned medication error, another resident was given medications for weeks after the prescription was discontinued. According to the administration of Fon Du Lac Rehabilitation, the nurse was dismissed from her position as a result of these violations.
Medication errors that result in symptoms like those experienced by the resident at Fon Du Lac can easily result in serious injuries. Hallucinations and a loss of coordination can easily result in nursing home falls or even a wrongful death.