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Doctor prescribed wrong medication

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thejaggers

Junior Member
What is the name of your state (only U.S. law)? CA

My doctor prescribed me a completely wrong medication by error. My pharmacy insurance requires that I receive all recurring prescriptions via mail-order pharmacy, so I do not know what I am getting until I open the package in the mail. I just trust that it is the correct prescription based on conversations with the doctor and his staff. I do not sign any prescription forms. The doctor's office simply fills out a prescription form and faxes it directly to my pharmacy insurance and I never see it. The outside of the box that the medication is shipped in also has no label or marking indicating what the contents are.

The medication I was supposed to receive - a generic drug that my insurance covers fully, minus a low copay - is not what I received. Instead, I received 3 months' worth of a brand name drug I do not need and have no intention of using. The bill from my pharmacy insurance is hundreds of dollars. My doctor's office staff says that I have to pay for it because it is my insurance billing me and they will come after me, even though it is clearly the doctor's office's error. I think that the doctor's office should pay for it because they prescribed me a completely wrong drug and are trying to hide from their mistake. They expect me to pay hundreds of dollars for a drug they erroneously prescribed that just happened to end up in my mailbox that I will never use.

What makes matters worse is that the same doctor's office faxed over a new prescription for me after I had several discussions with them when I made it clear which medication I needed and that I would only take a generic drug due to my insurance. I just received the second, "corrected" medication and it is the wrong drug AGAIN - though this time a different one. It is another brand name drug that has no generic form. I opened it to see it was again not what I needed and I was being billed another $75.

I think this is ridiculous. This cannot be legal, is it?? Do I have any legal recourse against my doctor or his office staff if they refuse to pay for my prescription bills when they have been grossly incompetent at prescribing the wrong medications? Please help. Thank you very much.

- JA, 28What is the name of your state (only U.S. law)?
 


LillianX

Senior Member
Did you receive the wrong drug entirely or did you receive the name brand form of a drug for which you expected to receive the generic?

Did you receive the drug your doctor prescribed? Did the drug have a generic form?
 

thejaggers

Junior Member
I received the wrong drug entirely both times. Neither of them had a generic form. The drug I requested and that they told me they were prescribing had a generic form that would have only cost me a $10 copay.
 

LillianX

Senior Member
If you received the drug your doctor prescribed you, you didn't receive the wrong drug. I know you said that you requested a different drug, but did the doctor discuss giving the drug you were prescribed with you?
 

thejaggers

Junior Member
The doctor and I did not discuss the medication he prescribed. We simply discussed the type of medication I needed, and I was very clear that it had to have a generic form, so my insurance would cover it. I mentioned a specific drug that I had used before that worked well (a generic drug) and the doctor indicated to me that that would be my prescription.

Because my insurance requires recurring medications to be sent via mail, I do not receive a prescription slip with the name of the prescribed drug on it, nor do I have the ability to turn away a drug when I reach the pharmacy counter if it is not what was discussed. I do not even sign the form that the office faxes over to my pharmaceutical insurance company. I also do not receive any email or notification whatsoever of the prescription that is submitted before or after it is shipped. They could literally be prescribing a case of Vicodin and I would have no idea until it arrives on my doorstep. Then, I have to pay for it -- whatever it is.

The doctor's staff (nurse or insurance contact... unsure of her exact position) is the one who fills out the prescription form and faxes it over. I assume the doctor has to sign it. They have twice now faxed incorrect prescriptions and I am left with $400 worth of bills for medication I cannot use. It does not seem that a doctor's office should be able to prescribe just anything without my expressed consent and I should be left with picking up the tab. As a patient, I should have more rights than that.
 

LillianX

Senior Member
I will agree with you that it does seem like a flawed system. As for the legalities of it, I honestly have no idea, so I'm going to bow out. Perhaps someone who does know the answers will be along to assist you. Good luck!
 

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