Medicines are central to almost every episode of care within our healthcare systems. From a routine antibiotic prescribed by a GP to complex chemotherapy delivered on a hospital ward, the safe use of medication depends on a chain of people and systems all working correctly. When one link in that chain fails, the consequences for a patient can range from mild discomfort to lasting harm.
Here at McCarthy + Co, our medical negligence team regularly assists clients who have experienced medication-related harm. This article explains what a medication incident is, how often these incidents occur, why they happen, and when the harm caused may give rise to a legal claim.
What is a medication-related incident?
A medication incident is any preventable event that may cause, or lead to, inappropriate medication use or patient harm. It can happen at any stage of the process, including prescribing, dispensing, preparation, administration, and monitoring. Common examples include:
- A dose being omitted or given late, for instance when a patient misses a scheduled tablet on a busy ward.
- The wrong medicine, the wrong dose, or the wrong strength being given.
- A medicine being given to the wrong patient.
- A known allergy or a dangerous drug interaction being overlooked.
- Poor communication when a patient moves between services, such as at admission or discharge.
Not every incident results in harm. The health service records “near miss” events, which are caught in time, “no harm” events, and events that do cause injury. Reporting all three is important because it allows the system to learn and improve.
How common are medication incidents in Ireland?
The scale of the issue is significant. Data obtained by the Medical Independent under Freedom of Information law, and extracted from the National Incident Management System, showed that 22,863 medication incidents were reported by HSE services in the 30 months from January 2022 to June 2024.
The great majority of these, more than 21,000, were “near miss” or “no harm” events. A smaller but serious number resulted in injury. According to the same data:
- 549 incidents caused harm requiring medical treatment.
- 500 incidents involved harm requiring first aid, and a further 713 caused harm that did not require first aid.
- More than 20 incidents resulted in long-term disability or incapacity.
- A small number of deaths were recorded, although the HSE did not release exact figures.
A wider analysis by the State Claims Agency, covering data from 2019 to 2022, found that the most common category of medication incident was an omitted or delayed dose, and that antithrombotic agents, which are medicines used to prevent blood clots, were the subgroup most frequently involved.
These figures reflect only what is reported, and reporting is uneven. Notably, just 3.9 per cent of incidents were reported by doctors, which the analysis identified as an area for improvement. The true number of incidents is therefore likely to be higher.
Why do medication errors happen?
Medication errors are rarely the fault of one careless individual. They usually arise from a combination of human and system factors. The World Health Organisation estimates that harm from medicines accounts for nearly half of all preventable harm in medical care, and it points to weak medication systems together with human factors as the underlying causes.
Contributory factors commonly include staff fatigue and burnout, chronic staff shortages, high patient numbers, illegible or unclear records, similar-looking or similar-sounding drug names, and poor handovers between teams.
When a medication incident may amount to negligence
It is important to be clear that not every medication incident amounts to medical negligence. To bring a successful claim, an injured patient generally needs to establish three things:
- That a duty of care was owed, which is almost always the case in a treating relationship.
- That the care provided fell below the standard of a reasonably competent practitioner.
- That this failing caused an injury, or made the patient’s outcome materially worse.
The second and third points are decided against the standard expected of a reasonably competent professional, and they require supportive evidence from an independent medical expert. A dose given slightly late that causes no harm is unlikely to form the basis of a claim. A serious overdose, a missed allergy, or a critical medicine omitted over several days that leads to a stroke, a bleed, or another injury may be a very different matter.
What to do if you have been affected
If you believe you or a loved one has been harmed by a medication error, there are some practical steps you can take:
- Request a copy of the relevant medical and prescribing records.
- Ask the service for an open disclosure meeting, where staff explain what happened.
- Make a note of dates, medicines, and the effects you experienced while they are fresh in your memory.
- Seek early legal advice, because a strict two-year time limit generally applies, running from your date of knowledge.
Speak to our medical negligence team
Medication-related harm can be distressing and confusing, and it is not always obvious whether what happened was avoidable. If you are concerned about the care you or a family member received within HSE services, our team can review your circumstances and advise you honestly on your options. To discuss your situation in confidence, contact our medical negligence team using our quick and confidential online form.
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