What Are The Three Types of Medication Errors?

Gregg Hollander | November 16, 2025 | Uncategorized

Medication errors in hospitals are not just technical glitches. When the wrong drug or dose is involved, the consequences can be life changing or fatal. A surprising number of hospital malpractice cases trace back to something as simple as a bad order or a misread label.

In a hospital setting, medication mistakes usually fall into three main categories:

1. Prescribing Errors

These are on the healthcare provider who writes the order. Common examples include:

  • Prescribing the wrong drug
  • Prescribing the wrong dose of the right drug
  • Ignoring known allergies or contraindications

2. Dispensing Errors

These occur at the pharmacy level. For example:

  • Filling the prescription with the wrong medication
  • Filling the right medication but in the wrong strength
  • Mislabeling bottles so the wrong patient receives the wrong drug

3. Administration Errors

These typically fall on nursing staff in the hospital. They involve the actual act of giving the medication and can include:

  • Giving the right drug to the wrong patient
  • Giving the wrong dose
  • Giving medication at the wrong time or by the wrong route (for instance, IV instead of oral)

Legally, we look at every step in the chain. Many serious cases involve more than one failure, not just a single mistake.

How Do Hospitals Track Medication Errors?

Most hospitals now use electronic health records or barcode based medication administration systems. You will often see a nurse scan a barcode on the medication, then scan the barcode on a patient’s wristband. This is supposed to enforce the “five rights” of medication safety:

  • Right patient
  • Right drug
  • Right dose
  • Right route
  • Right time

Hospitals also have internal reporting systems for medication incidents. Staff are expected to file medication error reports when incidents occur so the hospital can study what went wrong and improve systems.

In practice, many errors go unreported. That is less about technology and more about culture. Staff worry about blame, discipline, and reputation. So the paper trail often underestimates the true number of medication errors.

What Are the Two Drugs Often Associated With Errors?

Technically, almost any drug can be involved in an error. Many of those do not cause real harm. In the serious cases I see, two types of medications show up again and again:

  • Insulin
  • Anticoagulants (blood thinners) such as heparin

Both require very precise dosing. Even a small mistake can have severe consequences.

  • Too much insulin can cause life threatening hypoglycemia, seizures, coma, and death
  • Too much anticoagulant can cause uncontrolled bleeding, including intracranial hemorrhage or massive internal bleeding

Because of that, hospitals should have especially strict protocols around ordering, verifying, and administering these drugs. When those protocols are weak or ignored, the outcome can be catastrophic.

Case Example: A Medication Error That Ended in Severe Brain Bleeding

I have handled multiple cases where patients on anticoagulants were not properly managed. In one, the patient’s blood thinner was not adjusted despite alarming lab results. Nursing staff and physicians failed to respond to early signs of bleeding and neurologic decline.

By the time the problem was recognized, the patient had suffered a devastating brain bleed. That did not happen just because the drug is dangerous. It happened because:

  • The order was not appropriate for the patient’s condition
  • Lab abnormalities were ignored
  • The hospital’s monitoring and communication broke down

That is how a medication error moves from an internal “incident” category into the realm of medical malpractice.