School of Pharmacy


Incident Log
Incident Log


Date of incident: 20/03/2013

Error type: dispensing error

Patient age: None

Patient sex: female

Brief summary of incident: Assumption made within directions on label although SPC standard dose stated. Date from prescription not included in POR entry.

Name of medication: Tears Naturale eye drops;

Level of harm that could have occurred: 1

The reason you think the potential harm is at the level you have chosen:
It is an technical error on labelling, which will not not cause significant harm to patient as long as patient is counselled appropriately.

Possible cause/contributory factors: No clear direction on prescription.

Reasons why incident occurred and actions required to prevent reoccurence:
Confirm the dose with prescriber

Best description of this error/near miss:
Assumption ithi directions on label



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