VA Mail Order Pharmacy, Lancaster, TX (CMOP)

Issue: Patient A received a prescription intended for Patient B. Patient Bs name and type of medication was compromised. Patient A reported the incident to the medical center and a replacement has been requested for Patient B. Dallas Consolidated Mail Outpatient…

Outcome: CMOP staff was retrained in proper packing procedures.

Issue: Patient A received a prescription intended for Patient B. Patient Bs name and type of medication was compromised. Patient A reported the incident to the medical center and a replacement has been requested for Patient B. Dallas Consolidated Mail Outpatient…

Outcome: The CMOP employee was counseled and retrained in proper packing procedures.

Issue: It was reported to the Dallas Consolidated Mail Outpatient Pharmacy (CMOP) that Veteran A received two prescription packages but only one was the medication he ordered. Both packages had Veteran As mailing address, but one package was for Veteran B.…

Outcome: The CMOP reviewed the cold chain process with employees to ensure it is being followed correctly.

Issue: Patient A received a prescription package intended for Patient B. CMOP Dallas discovered the error internally and confirmed with a phone call to Patient A. Item for Patient A was scanned at packing but item for Patient B was placed…

Outcome: The Packer was counseled on error and Pharmacist received a review of manual toteless verification procedures.

Issue: As reported by the Medical Center Veteran A received a prescription belonging to Veteran B. He used that medication for 3 days but reported no ill effects to the Medical Center. Initial information provided by the facility was incorrect so…

Outcome: The packer was counseled and retrained in proper packing procedures.

Issue: Veteran A received Veteran B's prescription. Both veterans did have orders processed through the CMOP. However, Veteran A's order was processed 24 hours after Veteran B's order. Delivery documentation shows that both packages were delivered on the same day about…

Outcome: After a thorough review of the available documentation, the CMOP is unable to determine the cause of this error. Veteran A returned the medication to the Beaumont Medical Facility.

Issue: Patient A received a prescription intended for Patient B. Patient Bs name and type of medication was compromised. Patient A reported the incident to the medical center and a replacement has been requested for Patient B. Dallas Consolidated Mail Outpatient…

Outcome: The CMOP employees were counseled and retrained in proper packing procedures.

Issue: Patient A received a prescription intended for Patient B. Patient Bs name and type of medication was compromised. Patient A reported the incident to the medical center and a replacement has been requested for Patient B. Dallas Consolidated Mail Outpatient…

Outcome: The CMOP employees was counseled and retrained in proper packing procedures.

Issue: Patient A received a prescription intended for Patient B. Patient Bs name and type of medication was compromised. Patient A reported the incident to the medical center and a replacement has been requested for Patient B. Dallas Consolidated Mail Outpatient…

Outcome: CMOP employee was counseled and retrained in proper packing procedures.

Issue: Patient A received documents belonging to Patient B. Both veterans have the same last name and their orders were packed on the same day about one hour apart. The orders were packed by two different technicians located nine stations apart.…

Outcome: Packers were retrained in proper packing procedures.