Patient drops the methadone bottle

[medical6969]

If I hand a bottle of methadone to the patient, and then they drop it and it spills everywhere, can I re-dispense it, or do I need a new script?


How about if it's actually at the point when both I and the patient both have our hand on the paper bag, and it suddenly drops. Can I assume it was not dispensed and simply redo it?

[lamzee]

Just re-dispense it and put a second entry in register "patient dropped bottle on shop floor" or something. If they drop it in the street, make them get another rx.

[DavidS]

I would normally expect the patient to return to the cdt and get another script, if they dropped it. I would not wish to encourage carelessness, particularly with methadone, it would take a good long time to mop up, for one thing, and a couple of staff (i.e. ALL the staff) to make sure no kids got in it.

I would offer to phone the cdt as a witness to confirm what had happened.

If I drop it while handing it over, that's different. Doesn't happen because I put the bag in the patient's hand, and the bag is wrapped around the bottle - by which I mean I don't hold it suspended from the top to eliminate the trap-door effect. Signed statements all round, including from the patient, entry in register, a delay while its cleaned up, then redispense.

I did once tip 60ml down the sink: I was disturbed when dispensing, and thought I was still rinsing the bottle. Tricky, as no witnesses. Just entered it in the register in as usual a way as possible, and by the time the page was turned over no-one ever noticed.

Many many years ago now. Register long since shredded. If indeed I'm not making it up lol.

[cymru72]

I would normally expect the patient to return to the cdt and get another script, if they dropped it. I would not wish to encourage carelessness, particularly with methadone, it would take a good long time to mop up, for one thing, and a couple of staff (i.e. ALL the staff) to make sure no kids got in it.

I would offer to phone the cdt as a witness to confirm what had happened.

If I drop it while handing it over, that's different. Doesn't happen because I put the bag in the patient's hand, and the bag is wrapped around the bottle - by which I mean I don't hold it suspended from the top to eliminate the trap-door effect. Signed statements all round, including from the patient, entry in register, a delay while its cleaned up, then redispense.

I did once tip 60ml down the sink: I was disturbed when dispensing, and thought I was still rinsing the bottle. Tricky, as no witnesses. Just entered it in the register in as usual a way as possible, and by the time the page was turned over no-one ever noticed.

Many many years ago now. Register long since shredded. If indeed I'm not making it up lol.

Completely agree. If the drop occurs in handover, then re-supply. Other than that - tough!

I do remember once, years ago, doing a script for 385mls of methadone for a weeks supply @ 55mls, supplied in one bottle. Measured 300mls and 85mls and poured into a bottle and gave out. Went to measure the next methadone about 10 mins later, and thought 'that's funny, why is that 100ml measure already full of methadone?' - turns out I had forgotten to pour it into his bottle. Couldn't get hold of him, and he turned up as normal the next week none the wiser! - as with DavidS, of course, this could be a complete fabrication and not a possible true version of events!!!

[cymru72]

My other favourite methadone story involves AAH. Delivery driver turns up with a full crate of TWELVE bottles of Physeptone S/F. After scratching heads as to who had ordered this when we only used to use a bottle a week and had a CD cupboard tighter than a pair of posh spice's jeans, we checked the invoice - which was for twelve boxes of temazepam 10mg! Ringing the CD room at AAH produced a stunned silence on the other end, as any CD errors were supposed to be a sackable offence, and this was probably as big a cock-up as you can get! The branch manager rung us back and tried to convince us to keep the stock and get a new invoice to us along with the temazepam to 'tidy up' the paperwork. I told him this would be completely acceptable as long as he could send us a new safe and someone to fit it! He then turned up personally about twenty minutes later to collect the rogue stock!