In a disturbing pharmacy mixup, a pregnant woman was given an abortion drug that could cause miscarriage or birth defects. Now she has to wait to see if her pregnancy will be affected — and pharmacies all over the country need to figure out how to keep this from happening again.
According to ABC, 19-year-old Mareena Silva went to a Safeway pharmacy in Ft. Lupton, Colorado to get antibiotics for a bacterial infection. Instead, the pharmacist gave her methotrexate, a chemotherapy drug that's also sometimes used to terminate early pregnancies. The methotrexate was intended for another patient with the same last name and a similar first name, but the pharmacist apparently didn't check the labels carefully — even though methotrexate is a "high alert" drug, meaning pharmacists are always supposed to discuss its use with patients. The Safeway pharmacist apparently talked about Silva's pregnancy with her, recommending vitamins and giving congratulations — but, crucially, did not double-check the medication that could now end it.
Silva got medical attention soon after taking the drug, but it's not yet clear whether it will affect her fetus — an expert tells ABC that the odds of birth defects are about 50-50 if the fetus survives, and that some may not be detectable until birth. Safeway has apologized and offered to pay Silva's medical expenses, but she says, "Sorry's not going to cut it. I'm going to have to deal with this for a long time. My baby could have deformities. There's a lot that goes with it."
She's right — and beyond apologizing, Safeway clearly needs to take steps to ensure something like this never happens again. Both ABC and Colorado's 7News affiliate point out that pharmacy mistakes are distressingly common, and can be fatal. 7News spoke with pharmacist and University of Colorado professor Gina Moore, who has some recommendations for improvement: "If we mandated counseling, there'd at least be a conversation about, 'do you know why you're taking this medicine?'" Pharmacists, she adds, "should absolutely engage the person in a meaningful conversation about what their medicine is, why it's being used and what they need to watch out for." And, "for any new medication, what we teach and we hope that pharmacists are doing in the community is asking open-ended questions and engaging the patient in a discussion about the medication."
Silva's case may well be politicized, but it's really not about the ideology of abortion or abortion drugs. And, unlike the horrifying case of the Idaho woman who was refused an ant-bleeding drug because she might have had an abortion, it's not about provider-conscience laws either. It's a wake-up call for pharmacists everywhere to do a better job of talking to their patients, pregnant or not.