As the pharmacy landscape evolves and pharmacists’ responsibilities expand, so do the associated risks and exposures. In collaboration with Healthcare Providers Service Organization, CNA released the third edition of our Pharmacist Professional Liability Exposure Claim Report, which identifies noteworthy trends and loss patterns in several categories – including medication errors and associated injuries, license protection matters, claim expenses and more – to help pharmacists minimize liability exposures and enhance their practice. By recognizing these critical trends, pharmacists will be better informed to develop risk mitigation strategies to ensure safe and effective patient care.

Here are some of the top findings in this year’s report:

1. The average total incurred for professional liability closed claims is increasing
   The dataset from our 2023 report included 187 professional liability closed claims with paid indemnity attributed to CNA-insured pharmacy professionals and entities. Compared to our 2018 report, the average total incurred for pharmacist liability claims increased by 2.9%, from $132,185 to $136,000. Notably, independent or individually owned pharmacies or pharmacy franchises reflected approximately a 40% increase in average total incurred, from $76,701 to $167,647 – primarily ascribed to wrong drug errors, the most common pharmacist professional liability claim allegation.
    
2. Wrong drug and dose allegations remain high
   In both the 2018 report and the 2023 report, claims asserting that the wrong drug was dispensed remained the top allegation against pharmacists. In 2023, the second most common claim allegation was attributed to wrong medication dose or strength. This category represented a 46% increase in the average total incurred – from $49,901 to $72,972 – ascribed to several high-severity claims, including organ injury and patient death. Calculation and preparation errors also were revealed in the most common allegations, and while the latest technology can help reduce the potential for error, mistakes may still occur.
    
3. Compounding pharmacy claims can be severe
   Compounding pharmacies prepare and dispense customized medications for patients based upon a provider’s order. They also account for some of the most severe claims involving individual patient prescriptions and batch medications compared to other pharmacy types, with an average total incurred of $438,221. Claim severity is typically characterized by the significance of the injury and the number of patients involved. In one claim allegation, a patient who sought care for blurry vision was given a medication whose strength was 100 times greater than what was prescribed, resulting in a settlement of more than $450,000. An investigation revealed that the pharmacist was working alone, and, therefore, the pharmacist’s calculations did not undergo independent review.
    
4. Professional conduct is critical to license protection
   As licensed professionals, pharmacists are required to conduct themselves in an ethical manner as defined by state laws, regulations and professional association guidelines. Allegations related to pharmacists’ professional conduct accounted for 41% of all license defense closed matters, with 14.6% attributed to misconduct. Other professional conduct allegations included drug diversion, criminal acts, substance use, fraud, inventory maintenance and security. The importance of professional conduct cannot be overstated. As the latest dataset revealed, approximately 70% of license protection matters led to some type of state board action against the pharmacist’s license.
    

For more information on pharmacist professional liability claims, as well as tools and resources to help strengthen pharmacy practices, see our full 2023 report or visit www.hpso.com.