Missouri Personal Injury Attorney Blog

From personal experience, I know the overwhelming grief and sorrow associated with losing a family member as a result of a tragic accidental death. I understand that the family of the deceased needs various forms of comfort and assistance to help them through this trying time.

As well, in the wrongful death cases I have handled, I am always concerned with sparing the family the agonizing process related to the official investigations, reports, and the legal process as a whole.

This is why early legal consultation and representation are vitally significant. While the legal recovery may be the last item of consideration to the grieving family members, in the weeks and months to follow the legal case will be tremendously important and may be the only source of
justice for the family.

From my professional experience, I know that early independent investigation is of chief importance in most cases of wrongful death or serious disabling injury. This is especially true in car and truck accidents, or in any fatality that occurs on the roadway. While many people rely upon Highway Patrol or local police investigations, these investigations are often done quickly under adverse circumstances. Moreover, because of the legal issues that will eventually arise in the case, an investigation of the accident scene is the preferred way of securing physical and photographic evidence.

Physical evidence such as surface conditions, obstacles, sun position, skid marks, etc. all may have a bearing on the investigation and fault aspects of the case. In some cases, an expert in accident reconstruction or a dangerous condition expert may be necessary to solidify the fault. Beyond the physical evidence, an early law firm investigation can identify all types of witnesses. In our past cases, witnesses identified in the early investigation have made a substantial difference in the case.

Over the years our law firm has successfully handled a number of wrongful death cases, including deaths arising from all types of car accidents, truck accidents, motorcycle accidents, medical malpractice, and hazardous/dangerous conditions. Additionally, we handle death cases arising from work injuries, falls, explosions, electrocutions, and chemical/toxic exposure.

Because every case has special considerations, I am prepared to help as soon as possible. Please contact me directly through secure e-mail at dhorn@hornlaw.com.

As the economic downturn deepens, expect a rise in truck accidents to cause a greater number of personal injury and wrongful death claims across the nation.

It can not be denied that the risk of motor vehicle accidents, including motorcycle collisions, are substantially increased as a direct result of business and industry budget cuts, particurlarly in the trucking business.

Specifically, as trucking firms reduce costs to keep their profitability margins, proper truck maintenance, safety programs, and driver training fall by the wayside.

For instance, when truck tires and wheels are not been properly inspected and maintained, the results can be tragic, especially at highway speeds. Tire underinflation, mechanical wear, and mismatched dual assemblies are common semi-truck tire maintenance issues that can cause tire failure and blowouts. Further, other internal truck malfunctions, such as those occurring in the steering mechanism and brakes, also increase as those are maintenance issues that can not be easily spotted in routine inspections.

Safety training and other company programs to help new and existing truck drivers with the safe operation of a tractor-trailer are also neglected when times get tough. Trucking companies know that safety and driver education programs all contribute to safe truck operation, but they are willing to put their own truck drivers and the public at risk as the pressures mount to keep costs down.

In a depressed economy, as firms try and limit transportation and delivery costs, semis and other trucks are frequently improperly loaded. When a semi-truck is not properly loaded or carrying too much weight the potential for collisions, tip-overs, or accidents with other vehicles greatly increase.

Moreover, as cutting costs becomes paramount, truck drivers are more fatigued as they drive longer hours with less breaks. Their ability to be alert is compromised and they tend to be irritated and will drive more aggressively at a higher than safe speed.

In the trucking cases we have handled, we always hold the trucking firm responsible for maintenance, safety, and driver education cuts, breakdowns, and failures. While it is too late to save our client from injury and/or tradegy at the point Horn Law gets involved in a trucking accident, we can make a difference by aggressively pursuing the case and giving the trucking company the clear incentive to invest in safety.

The FDA recently announced plans for a pilot project to help pharmaceutical companies select safer drug names. By “safer,” they mean names that are less likely to cause medication errors, which are the most common type of medical mistakes that are made.

Within the category of medication errors, mistakes most often involve a drug with a similar name to the medication a doctor actually prescribed. The Associated Press reported in September that drug name mix-ups account for about 25 percent of the 1.5 million Americans estimated to be harmed each year from medication errors.

Some estimates put the number of deaths due to pharmacy errors at 7,000 each year. Another startling statistic is that about 5 percent of all prescriptions filled annually in the United States are incorrect.

In my firm’s experience representing victims of medication errors, about 60 percent of our cases involve drugs with those that have a name similar to the prescribed medication. Take Lamictal and Lamisil, for example. They sound similar but are very different drugs: Lamictal is a medication sometimes prescribed for patients with epilepsy or bipolar disorder. Lamisil is used to treat fungal infections in fingernails or toenails. Serzone and Seroquel also sound kind of alike, but Serzone is for depression, and Seroquel is for schizophrenia.

I’ve also read that the Alzheimer’s drug name Reminyl changed to Razadyne after two deaths occurred over mistakes with a similar-sounding drug called Amaryl, a medication used to treat diabetes. Many drugs that are spelled similarly are stocked on pharmacy shelves right next to each other, since they organize medications alphabetically.

In the age of big-box pharmacies operating under corporate pressure, financial constraints and over-burdened or under-qualified staff, it’s no wonder that mistakes occur.

Although the FDA’s pilot program is a step in the right direction, the problem of drugs with similar names is going to continue to create confusion and error in our nation’s pharmacies.

When it comes to medication errors, some populations are more vulnerable than others. Take the elderly, for example. A U.S. Pharmacopeia study confirms that older people are more commonly affected by medication errors than other age groups.

This is true for a few reasons. Because the elderly are more likely to be taking multiple medications – sometimes prescribed by multiple doctors – they are more susceptible to harmful drug interactions. Elderly people are also more trusting, and so they are less likely to question health care providers or the medications they are taking. Also, physical ailments such as decreased mental capacity or vision difficulties make it more difficult for an elderly person to catch a mistake.

Ironically, some studies show that elderly patients may be at greater risk of falling victim to medication errors when they are confined in a hospital or nursing home. Many factors come into play that increase the risk of a medication error within a health-care facility, including over-burdened nurses, pharmacists, and doctors.

In a hospital setting, medication errors can happen at any step of the “delivery” process, the path a medication follows from the moment a physician writes a prescription to the time it is administered to a patient. Hospital medication errors are fairly equally distributed along the delivery process:

• Physician error – A doctor writes the wrong prescription;


• Hospital pharmacy error – Pharmacists or supporting staff either transcribe the prescription or they prepare the drug incorrectly;


• Bedside administration error – Nurses make a mistake administering the medicine.

Most medication errors in nursing homes occur due to medication timing issues. A medication is either given too often, not frequently enough or not at all. Timing is often a critical issue for the elderly, who may depend on the right drug, in the right dose, at the right time to sustain their life.

Another big concern at nursing homes that drives up the rate of medication error is staff issues. It is a fact that many nursing homes are not only downsizing staff due to financial constraints, but are also depending more and more on the remaining employees to take on additional responsibilities. That results in an over-burdened staff who, in many cases, is under-qualified to do some of the extra work, such as administer meds to elderly patients. Adding to the problem is a nationwide shortage of qualified nurses.

It would be short-sighted to simply blame the increasing medication error risk on individual carelessness of pharmacists, nurses, and other health-care workers. In fact, the root cause of medication errors among the elderly is a systemic problem that cuts to health-care managers. As long as profit rides above patient safety, medication errors will only increase.

In my medication error practice we have represented a number of children who have fallen victim to a medication error. These cases tend to be complex because small and sick children are usually less able to tolerate a wrong medication or an unintended overdose.

Our past legal case experience confirms the general evidence that children are more prone to medication error because most medications are formulated and prepared for adult usage. When a child is prescribed an "adult medication", the pharmacist must significant alter the dosage using a series of pediatric parameters. Obviously, when special preparation is required for a medication, the risk of medication error substantially increases.

While dosage mistakes represent a large portion of medication errors involving children, we have had several cases where the administration instructions on the label or insert information is incorrect. Again, most administration instructions are geared for adult use and therefore this is a fertile place for error.

Most pediatric medication errors are caused by performance neglect and carelessness in the preparation and delivery process. For example, pharmacy computer software safety alerts warning the pharmacist to take into account the age, weight, and medical history were either by-passed or ignored. Unfortunately, safety alert neglect is not uncommon in a busy retail pharmacy where a high number of prescriptions are being prepared in rapid order.

There is another note that deserves mention. Because child weight is a key factor in proper medication dosing, the child's present weight, in kilograms (kg) should be reflected on the pharmacy or medical records. Kilogram weight of the patient is required because the proper standard for prescription medication preparation is based on the metric system. However, if the weight of the child is reflected in pounds (lbs.), the possibility of medication error is increased because the patient's profile reflects a wrong weight.

Medication errors occur with children because full pharmacy and medical oversight is lacking. Safe dispensing of pediatric medications requires that every step of the medication delivery process is accounting for the special requirements of a child. When an error does occur, and the resulting case is properly handled, the valuable by-product is that the offending pharmacy or health-care facility will be far less likely to make a future pediatric error.

Medication errors are one of the nation's leading cause of death, killing more people each year than motor vehicle accidents, breast cancer, or AIDS. Further, experts agree that the majority of medication errors are preventable.

My experience with legal cases and claims confirms this. Over the years I have represented people across the nation who have been injured by a pharmacy mis-fill. My clients range from infants to the elderly and the majority of our pharmacy cases involve preventable error.

In almost every instance, errors in the pharmacy involve some sort of human error. For example, the pharmacist or pharmacy tech fails to ensure that the right customer receives the right medication in the right dosage with the right label and/or administration instructions. Other contributing factors include:

• Environmental Distractions - increasing customer demands, work interruptions such as ringing telephones, high noise levels, and other distractions common to a busy pharmacy.


• Staffing Issues - this usually concerns too few pharmacists and pharmacy techs, some of whom may not have the necessary experience or training.


• Procedure Breakdowns - polices, procedures and protocols designed to enhance safety are not always followed.

Add to this the profit objectives of the large retail pharmacy, and pharmacy errors represent a growing problem with potentially fatal consequences.

While pharmacy errors may be a reality of our present day, customers of pharmacys can keep themselves safe by making sure they carefully inspect their medication before leaving the pharmacy.

Moreover, if a re-filled medication looks different in color, shape, size, or appearance, talk to your pharmacist before you take the medication. I have had at least 20 cases where my client assumed that the different looking medication was from a different manufacturer or was a so-called generic drug.