Date of incident: 12/03/2013

Error type: dispensing error

Patient age: UNKNOWN

Patient sex: female

Brief summary of incident: Rx for Primolut N 5mg (norethisterone) tabs, with directions "i tid start 3 days prior to menses". So indication was to delay menses. I omitted the word "start" from the label, omitting start implies that the tab is only taken 3 days before menses, whereas it should be taken 3 days before and continued, until the menses can resume. Menses will occur 2 to 3 days after the tab is stopped.

Name of medication: Primolut N 5mg (norethisterone) tabs;

Level of harm that could have occurred: 1

The reason you think the potential harm is at the level you have chosen:
There was no life threatening issues with only having a few days cover of menses prevention.

Possible cause/contributory factors: Oversight

Reasons why incident occurred and actions required to prevent reoccurence:
Check the label before printing that exactly what is on the Rx is on the label.

Best description of this error/near miss:
omitted dose