How Do Blood Thinner Dosing Errors Happen?

More than 8 million people in the United States are currently taking a blood thinner to help treat or prevent life-threatening conditions like stroke, heart attack, and pulmonary embolism. While these medications save lives every day, they can be deadly if dosed incorrectly.

Why Are People Given Blood Thinners?

Blood thinners, sometimes called “anticoagulants,” are medications that help to decrease the body’s ability to form clots. Some blood thinners are given to people with an active blood clot to help dissolve it and prevent further damage. Other types of blood thinners are given to people with a history of stroke, heart attack, or pulmonary embolism to prevent another deadly clot from forming. Blood thinners are also given preventatively to people at high risk of developing dangerous blood clots, such as those with:

• atrial fibrillation
• heart valve surgery or replacement
• hip or knee replacement
• blood clotting disorders

Are Blood Thinners Dangerous?

While blood thinners are not dangerous per se, they can increase the risk of bleeding, so doctors and patients need to work together to determine whether the risk of a blood clot outweighs the risk of bleeding complications. When dosed appropriately, this risk is relatively low, but incorrect dosing or poor monitoring can make a dangerous bleed more likely.

One of the oldest blood thinners, warfarin, requires frequent blood tests, precise dosing, and potential diet modifications and has more than 200 drug interactions (both prescription and over-the-counter) that need to be taken into account when it’s prescribed. Warfarin also shouldn’t be used in people with recent trauma or bleeding, recent major surgery, a history of bleeding in the brain, severe liver disease, ulcers or bleeding in the gastrointestinal tract, or pregnancy. Despite all that, warfarin is still commonly prescribed, in part because it’s the most affordable blood thinner currently on the market.

Blood thinners given in the hospital are usually injected and are dosed based on weight. Because of this, a patient’s weight must be verified before their dosage is calculated and given. When weight is provided by the patient or a family member rather than weighing the patient in the clinic or hospital, the dose given may not be appropriate.

The more recently developed oral blood thinners typically have simplified dosing, fewer drug interactions, and don’t require any dietary changes, close monitoring, or blood tests. These drugs still have the potential to cause bleeding, but the risk is lower than with older drugs like warfarin. The recommended dosage can be different for people with liver or kidney disease, so liver and kidney function tests should be done before they’re prescribed. The biggest downside to these drugs is their cost, as they can cost hundreds of dollars every month for many patients. Because of their high cost, doctors must consider the potential risk of a patient not being able to afford their medication every month, leaving them unprotected from deadly clots when finances are tight.

While any blood thinner can increase the risk of minor bleeding, a dosage that’s too high may result in bleeding that won’t stop. This can be particularly dangerous if an individual is injured during a fall or accident, as internal bleeding may not be obvious until it’s caused significant damage. Head injuries, in particular, can result in dangerous bleeding in the brain.

How Do Errors Occur?

Blood-thinning medication dosing is complex, and many factors need to be taken into account when these drugs are prescribed. A patient’s liver and kidney function can affect their dosage; some medications are dosed based on weight, and drug interactions can also play a role. To make things even more complex, any of these dosing factors can change from one month to the next, and dose adjustments may be needed periodically. Kidney function can worsen, weight can fluctuate, and other medications may be stopped or started at any point, potentially affecting the way a blood thinner works. When it comes to warfarin, diet can also play a role. If someone changes their diet to include more or fewer foods that contain vitamin K, their dosage may need to be adjusted.

When Is It Malpractice?

While we’d like to assume that doctors prescribe medications correctly, that’s not always the case. A recent study showed that almost 1 in 6 Americans taking a blood thinner for atrial fibrillation are not receiving the correct dosage. Some doctors forget to check their patients’ liver and kidney function, which often results in overdosing and putting the patient at risk of bleeding complications. Some doctors are concerned about bleeding, so they give lower doses in an effort to reduce the risk. Unfortunately, reducing the dosage when it’s not actually indicated can mean that the patient is unprotected from deadly blood clots.

Doctors may ignore the other medications a person takes (particularly if they were prescribed by someone else), meaning that drug interactions can go unnoticed. Some patients are even prescribed blood thinners by more than one doctor, and they either aren’t told or don’t understand that they should stop one before starting another. When any of these circumstances result in tragic consequences, malpractice should be considered as a contributing factor.

Why Choose Ross Feller Casey?

If you or a loved one received the wrong dosage of blood thinning medication and suffered catastrophic injury or death, you should contact the legal team at Ross Feller Casey. Our expert lawyers and on-staff Ivy League-trained doctors understand that blood thinner medication dosing is complex and that healthcare professionals who cause harm by ignoring standard medical practice guidelines should be held responsible.

We’ve built an unmatched reputation for success in medical malpractice cases and have won billions for our clients. Contact us today for a free consultation, and let us put our experience to work for you. We handle all our cases, including those involving the wrong dosage of blood thinners, on a contingency basis. That means you will not pay a thing until a financial recovery is made in your case.