[LMB] OT: Stupid Pharmacy

Shalom Septimus druggist at pobox.com
Fri Jun 27 19:34:48 BST 2008

On Mon, 23 Jun 2008 17:10:16 -0400, Marilyn Traber wrote:

>Byetta is an autoinject preloaded syringe with 60 doses in it [a 30 day 
>supply] that you screw a disposable needle into. *Very* convenient. It 
>comes in 2 dosages, a 5 microgram and a 10 microgram. 

You have to watch out especially with Byetta to ensure that it's
filled correctly, because both strengths have the same NDC, bar the
last two digits (which are *supposed* to reference the package size
*only*). [1] 

This causes a potential problem, because it fools the workflow
verification system. Before labeling the product, one scans the
package's bar code and the one on the label, and if you grabbed the
wrong bottle, it *should* warn you before you actually put the tablets
in the bottle (or if it's a unit-of-use pack, like your Byetta, before
you stick the label on the box). Now the scanner ignores the last two
digits of the NDC, because the computer doesn't care if your stock
bottle has 100 or 1000 tablets in it, as long as the contents are
correct... but with Byetta, the only way to distinguish the two
strengths is in the last two digits, which it didn't check, so the
tech can swipe the wrong strength and still get a verification.
Corporate sent us an e-mail about this a couple years back warning us
about this.

That's not what happened this time, though. I would say the medicine
was *filled* correctly (because the label matches the contents); but
it was *dispensed* wrong (because the contents don't match the bag). I
just mention this because as soon as I heard "Byetta" and "dispensing
error" in the same sentence, that's what immediately popped into my
head. This screw-up could have happened with any medicine, it's just a
weird coincidence that it had to happen with the one drug which is
more likely to be mixed up in this fashion than any other.

It's always a good idea, esp. when shopping at a high-volume store, to
peek into the bag at the counter just to make sure that what you
expect is what you got... Not trying to make excuses for the pharmacy,
here, it's definitely a mistake. This kind of thing is a pharmacist's
greatest nightmare, or one of them at any rate. I'm glad you caught
the error before taking the wrong thing. 

Yeah, I'm back. Only been, what, four years now?

[1] NDC == National Drug Code, which is a 10 digit number. First 5
digits identify the mfr/distributor, next four ID the product, last
two are the package size. The reason that 5+4+2=10 and not 11 is
because one digit is always dropped from one of the three groupings,
so you can have 5+4+1, 5+3+2 or 4+4+2, but when entering data into the
pharmacy computer you always use all 11 digits, with a 0 in the place
of the dropped digit. 

Shalom Septimus

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