When a child is sick or recovering from surgery, parents place an immense amount of trust in the healthcare system. We rely on pediatricians, nurses, and pharmacists to provide the precise treatments necessary to restore our children to health. Among the most critical components of this care is the administration of medication. Whether it is an antibiotic for an infection or a complex intravenous drug in a Neonatal Intensive Care Unit (NICU), the margin for error is incredibly thin.
Unfortunately, medication errors represent one of the most common and preventable forms of medical malpractice in pediatric care. Unlike adults, children are uniquely vulnerable to dosing mistakes due to their size, developing organ systems, and the complex calculations required to determine a safe dose. At Fronzuto Law Group, we have seen firsthand how a single misplaced decimal point or a failure to double-check a weight-based calculation can change a child's life forever.
Why Pediatric Patients Face Greater Risks
It is a fundamental principle in medicine that children are not merely small adults. Their bodies process, distribute, and eliminate drugs differently than mature adults. This biological reality means that a medication error that might cause minor side effects in an adult can be catastrophic, or even fatal, for a child.
Most adult medications are available in standardized doses. If an adult needs a common pain reliever or blood pressure medication, the physician typically chooses from a few pre-set strengths. In pediatric care, however, almost every dose must be customized. Doctors and nurses must calculate the appropriate amount of medicine based on the child’s specific weight, usually in kilograms, or their body surface area.
This requirement for constant calculation introduces a high risk of human error. If a nurse uses a child’s weight in pounds instead of kilograms, the resulting dose could be more than double what was intended. Furthermore, many medications used for infants and children are highly concentrated, meaning that even a tiny increase in the volume of the liquid administered can lead to a massive overdose.
Common Types of Dosing Mistakes in Pediatric Settings
Dosing errors can occur at any stage of the process, including when the doctor writes the prescription, when the pharmacist fills it, or when the nurse administers it. Our team frequently investigates cases involving several specific types of negligence.
The Ten-Fold Error
The ten-fold error is perhaps the most notorious mistake in pediatric medicine. This occurs when a decimal point is misplaced or misread. For instance, if a child is meant to receive 0.5 milligrams of a potent drug but is instead given 5.0 milligrams, they have received ten times the intended dose. In the fragile system of a newborn or a toddler, a ten-fold overdose often leads to acute organ failure or neurological damage.
Weight and Measurement Confusion
Because pediatric doses are weight-based, any error in recording the child’s weight will ripple through the entire treatment plan. We often see cases where a child was not weighed recently, or where the weight was recorded incorrectly in the electronic health record. Additionally, confusion between units of measurement, such as milliliters versus teaspoons, remains a persistent problem in both hospital and outpatient settings.
Off-Label Use and Lack of Pediatric Data
Many drugs used in pediatric wards have never been specifically tested or approved by the FDA for use in children. This forces clinicians to use "off-label" dosing based on their best judgment. While this is a common practice, it requires a heightened level of vigilance. When a hospital fails to follow established protocols for these high-risk medications, the results can be devastating.
Failure to Account for Organ Maturity
A child’s liver and kidneys are responsible for clearing drugs from the system. In many pediatric patients, especially premature infants, these organs are not yet fully functional. If a medical team fails to adjust the frequency or amount of medication to account for a child’s reduced clearance rate, the drug can build up to toxic levels in the bloodstream.
The Role of Systemic Negligence in Medication Errors
While a specific individual may be the one to physically administer the wrong dose, medication errors are often the result of broader systemic failures within a hospital or medical facility. At Fronzuto Law Group, we look beyond the immediate mistake to identify the underlying negligence that allowed the error to happen.
Hospital understaffing is a significant contributor to these tragedies. When nurses are overworked and assigned too many patients, the likelihood of a "slip" increases. These professionals are often forced to work long shifts without adequate breaks, leading to fatigue that impairs their ability to perform complex calculations or recognize "red flags" in a prescription.
Communication breakdowns during "handoffs" between shifts are another common point of failure. If the outgoing staff fails to properly communicate the timing or dosage of a child’s last medication, the incoming staff may inadvertently double-dose the patient.
Furthermore, many facilities lack the necessary safety technology to prevent these errors. Modern hospitals should utilize barcode medication administration systems, which require the nurse to scan both the patient’s wristband and the medication before it is given. If a hospital ignores these safety standards or allows staff to bypass these protocols to save time, they are placing every child in their care at risk.
In some instances, the equipment itself can be the source of the problem. Since our firm also specializes in product liability, we recognize that some dosing errors are caused by defective infusion pumps or malfunctioning medical equipment. In these cases, our investigation extends to the manufacturers of these devices to ensure every negligent party is held accountable. This comprehensive approach allows us to determine if your child’s injury was caused by provider negligence, a systemic hospital failure, or a dangerous product defect.
Serious Consequences of Pediatric Medication Errors
The physical toll of a dosing error on a child can be permanent. Depending on the type of medication and the severity of the overdose, a child may suffer from various life-altering conditions.
Brain injuries are a frequent result of medication errors, particularly those involving sedatives, anesthesia, or drugs that affect blood pressure and oxygenation. A period of respiratory distress caused by an overdose can deprive the brain of oxygen, leading to cerebral palsy or other cognitive impairments.
Organ damage is another grave concern. Toxic levels of certain antibiotics or pain medications can cause irreversible damage to the kidneys or liver, potentially necessitating a transplant or lifelong dialysis. In some cases, a medication error can cause cardiac arrest or severe allergic reactions, such as Stevens-Johnson Syndrome, which can leave a child with permanent scarring and chronic health issues.
Beyond the physical injuries, these errors cause immense emotional and financial strain on the family. Parents often find themselves forced to leave their jobs to provide round-the-clock care for a child who now has special needs. The cost of future medical care, therapy, and specialized education can reach into the millions of dollars.
Legal Rights of Families in New Jersey
In New Jersey, parents have the right to seek justice when medical negligence harms their child. However, proving a medication error case requires a deep understanding of both the law and complex medical protocols. To prevail in a pediatric malpractice claim, we must demonstrate that the care provided fell below the accepted standard of practice and that this failure directly caused the child's injury.
Our firm works with a network of highly qualified medical experts, including pediatricians, pharmacists, and nursing experts, to reconstruct exactly what went wrong. In New Jersey, medical malpractice cases involve a unique procedural hurdle known as the Affidavit of Merit. This is a sworn statement from a similarly licensed professional confirming that the care fell below the standard and that there is a reasonable basis for the claim. We meticulously review hospital charts, pharmacy logs, and internal communication records to secure the evidence needed for this critical document.
It is also vital for parents to be aware of the New Jersey Statute of Limitations. While there are specific rules regarding the timeframe for filing a claim on behalf of a minor, waiting too long can jeopardize your ability to recover compensation. Investigating these cases takes time, and the sooner we can begin gathering evidence, the stronger the case will be.
Why Specialized Representation Matters
Pediatric malpractice is a highly specialized field of law. The medical issues involved are vastly different from those in adult personal injury cases. Ernest P. Fronzuto, Esq. and our team have dedicated our practice to representing the most vulnerable victims: children. We understand the nuances of pediatric physiology and the specific safety standards that must be met in a pediatric environment.
We take a highly individualized approach to every case. We know that no two families are the same and no two injuries are identical. Our goal is not just to secure a settlement, but to ensure that your child has the resources they need for a secure and supported future through comprehensive life care planning. We are committed to holding negligent healthcare providers and large hospital systems accountable for the mistakes that should never have happened.
If you suspect that your child was the victim of a medication error, you may feel overwhelmed and unsure of where to turn. It is common for hospitals to be vague or defensive when a mistake occurs. We are here to provide the clarity and the advocacy you deserve. We will fight to uncover the truth and pursue the maximum compensation available under the law.
Contact Fronzuto Law Group Today for a Consultation About Your Case
If your child has suffered harm due to a dosing error or any other form of medical negligence in New Jersey, you do not have to navigate this difficult journey alone. At Fronzuto Law Group, we offer the compassion of a small firm combined with the resources and experience of a premier litigation team. We are prepared to investigate every detail of your case and advocate zealously for your child’s rights.
Our firm purposefully limits our caseload so that we can provide each client with the personalized attention they require during such a traumatic time. We serve families throughout Passaic, Monmouth, Hudson, Bergen, and Morris counties, bringing our specialized knowledge of pediatric malpractice to every community we serve. Whether your child was treated at a major regional medical center or a local outpatient clinic, we understand the specific standards of care expected of healthcare providers in Northern New Jersey.
Please contact us today to schedule a free initial consultation. You can reach our office at 973-435-4551 or contact us online to discuss your situation. We will listen to your story, evaluate your legal options, and help you determine the best path forward for your family and your child’s future.
Disclaimer: The articles on this blog are for informative purposes only and are no substitute for legal advice or an attorney-client relationship. If you are seeking legal advice, please contact our law firm directly.