Date of incident: 06/02/2013

Error type: dispensing error

Patient age: 66

Patient sex: female

Brief summary of incident: Dispensed Losartan Potassium as a twice daily dose instead of a once daily

Name of medication: Losartan Potassium;

Level of harm that could have occurred: 5

The reason you think the potential harm is at the level you have chosen:
Overdose

Possible cause/contributory factors: Reading the dosing in the bnf too quickly

Reasons why incident occurred and actions required to prevent reoccurence:
If im under pressure, stop and start again without rushing

Best description of this error/near miss:
wrong dose strength