The difference between a healing dose and a harmful one can be surprisingly small for many medications. When healthcare providers prescribe, dispense, or administer incorrect dosages, patients may receive dangerous overdoses or ineffective underdoses that fail to treat their conditions. These dosage errors create liability for providers who failed to calculate or verify correct amounts.

The Critical Importance of Correct Dosing

Medication dosing involves far more complexity than simply following label instructions. Patient-specific factors including body weight, kidney function, liver function, and age significantly affect how drugs are processed and what amounts prove therapeutic versus toxic. A dose appropriate for one patient may be dangerously excessive or ineffectively low for another, requiring individualized calculation rather than standard amounts.

Many potent medications have narrow therapeutic indices, meaning the difference between effective doses and toxic doses is small. Drugs like warfarin, digoxin, phenytoin, and various chemotherapy agents require precise dosing with regular monitoring because even modest errors can cause serious harm. Medications with narrow therapeutic ranges demand heightened attention to dosing accuracy throughout the healthcare system.

Pediatric dosing presents particular challenges because children are not simply small adults. Drug metabolism differs in children, and dosing often requires weight-based calculations that busy providers sometimes perform incorrectly. Decimal point errors, unit confusion, and failure to verify calculations against appropriate references cause pediatric overdoses that proper attention would prevent.

Overdose Injuries

Medication overdoses can cause immediate toxic effects that vary depending on the drug involved. Opioid overdoses cause respiratory depression that can be fatal without prompt intervention. Insulin overdoses cause hypoglycemia leading to seizures, coma, and brain damage. Anticoagulant overdoses cause bleeding that may be difficult to control. Each medication category carries characteristic overdose risks that excessive dosing may trigger.

Some overdose injuries develop gradually as medications accumulate in the body over time. Drugs eliminated slowly may build up to toxic levels when prescribed at doses too high for a patient's elimination capacity. Kidney or liver impairment that providers should have assessed before prescribing may prevent normal drug clearance, effectively creating an overdose situation even when each individual dose falls within normal ranges.

The consequences of overdose injuries can be permanent even when patients survive the acute event. Brain damage from hypoglycemia, organ damage from drug toxicity, and lasting effects of bleeding episodes may leave patients with disabilities long after the overdose itself. Overdose injuries frequently result in claims for ongoing medical care, lost earning capacity, and permanent impairment.

Underdose Injuries

While overdoses cause direct toxic harm, underdoses cause injury through treatment failure. Patients receiving inadequate doses may not improve from conditions that proper treatment would address. Infections may spread, cancers may progress, and chronic conditions may worsen when medications fail to reach therapeutic levels.

Underdose injuries can be harder to recognize and prove than overdoses because the harm stems from absence of benefit rather than presence of toxicity. Establishing that a condition would have improved with proper dosing requires expert analysis of how the disease would have responded to adequate treatment. This counterfactual assessment introduces uncertainty that defendants may exploit in challenging causation.

The harm from underdosing may not become apparent until substantial time passes. A cancer patient whose chemotherapy was underdosed may not experience recurrence until months or years later. Connecting that recurrence to earlier dosing errors requires medical expert testimony explaining how inadequate treatment affected disease progression and ultimate outcomes.

How Dosage Errors Occur

Prescribing errors represent the most common source of dosage problems. Physicians may miscalculate doses, especially weight-based pediatric doses requiring mathematical computation. Electronic prescribing systems may default to incorrect doses that providers fail to adjust. Failure to check renal or hepatic function before prescribing drugs requiring dose adjustment for impaired organ function leads to relative overdoses in vulnerable patients.

Pharmacy errors alter prescribed doses during dispensing. Pharmacists may misread prescriptions, particularly handwritten ones with ambiguous numbers. Compounding pharmacies preparing custom medication formulations may measure ingredients incorrectly or use wrong concentrations. Generic substitution may inadvertently change doses if different manufacturers' products have different strengths available.

Hospital administration errors frequently involve concentration or rate mistakes with intravenous medications. Programming infusion pumps incorrectly can deliver drugs far faster or slower than intended. Selecting wrong concentration bags from storage leads to patients receiving doses vastly different from what physicians ordered. These errors can be catastrophic because IV medications act rapidly without opportunity for intervention once administered.

Proving Dosage Error Claims

Medical records documenting prescribed and administered doses provide essential evidence for dosage error claims. Comparing what records show was ordered against what the patient actually received establishes whether errors occurred. Pharmacy records, medication administration records, and nursing notes all contribute to reconstructing what happened.

Expert testimony typically establishes what dosing the patient should have received based on their individual characteristics and the standard of care. Experts explain how the dose actually given deviated from appropriate practice and how that deviation caused the patient's injuries. Pharmacology experts may address how the medication affected the patient's body at the dose received.

Causation analysis must connect the dosing error to specific harms. For overdose cases, this requires showing that the excess medication caused toxic effects. For underdose cases, this requires showing that inadequate dosing allowed progression of conditions that proper treatment would have controlled. Both analyses typically require expert medical opinion.

Pursuing Compensation

Dosage error claims may proceed against physicians who prescribed incorrect amounts, pharmacists who dispensed incorrect amounts, nurses who administered incorrect amounts, and institutions whose systems failed to catch errors at any stage. Determining which parties bear responsibility and in what proportion requires investigation of how the error developed and what safeguards failed.

Damages in dosage error cases reflect the injuries actually caused, including medical expenses for treating overdose toxicity or disease progression from underdosing, lost income during recovery and any permanent disability, physical pain and emotional suffering, and diminished quality of life. Severe dosage errors causing permanent injury or death support substantial damage claims.

Time limits apply to medical malpractice claims, making prompt consultation with an experienced attorney important for preserving your rights. Most malpractice attorneys offer free initial consultations and work on contingency fees, making legal help accessible regardless of your current financial situation. The sooner you act, the better your chances of preserving evidence and meeting applicable deadlines.

Conclusion

Dosage errors represent a significant category of preventable medication injuries. Whether resulting in toxic overdoses or ineffective underdoses, incorrect medication amounts can cause serious patient harm that proper calculation and verification would prevent. When healthcare providers fail to ensure correct dosing, injured patients may pursue legal claims for compensation while also encouraging the systemic improvements needed to prevent future dosing tragedies.