Fertility: A Novel by Denise Gelberg Read Free Book Online

lately due to some bug that’s going around. Luckily, it’s missed me so far. This month I’ve been in four times already, and it’s only November eleventh. So I would say it’s uneven.”
    Sarah’s mind started to race. How much did Cappelli know about the new BCMA computer system? There had to have been training for all of the staff. Were Cappelli and other substitute pharmacists included? She decided to pursue that point before getting to his version of the previous day’s events.
    “Mr. Cappelli, were you given training for using the new computerized medication system, the BCMA?”
    Cappelli smiled broadly, shaking his head gently up and down. “I guess you’d have to call me a twentieth-century kind of guy. I was a practicing pharmacist long before computers were part of the landscape. Yes, they gave me a little tutorial, I guess you would call it, when I came in last week. I’d been hearing about it for months and I read up on it at home.”
    Sarah persisted. “Did you attend any training sessions offered by the hospital before the BCMA was instituted?”
    “Well, here’s the thing. The full-time people were given time off from their regular duties to go to these sessions. The subs like me, well, if we came in for the training, there was no compensation offered. And to tell you the truth, it wasn’t so complicated that I had to sit for hours to learn how to use it.”
    Joanne Marsh’s demonstration had certainly made the system seem straightforward, so Sarah could see how an experienced pharmacist would think he could take a pass on formal instruction. However, yesterday’s medication error exposed how wrong he was. She decided to get a sense of the depth of Cappelli’s grasp of the system. Given her own limited understanding, she knew she was taking a chance, but she thought it was worth a question or two.
    “So help me — as a layperson — and explain how the new system works.”
    “No problem. It’s really very logical. The order comes into the pharmacy by computer. The patient’s medication profile pops up. We can see any interactions, contraindications, etc. If there are no problems with the medication profile, we get the medication from supply, scan it and the computer pops out a label. We put the label on and send it through the pneumatic tubes. Everything is bar coded and scanned. It’s just like in the grocery store. Before the meds are administered, the nurse scans the patient’s wristband to make sure everything is simpatico. Very nice. Helps to keep down medication mistakes.”
    Cappelli’s explanation jibed with the one she had gotten from the head pharmacist. He clearly understood the broad outlines of the program. But a terrible error had still occurred, and current evidence indicated Cappelli could have been involved. It was time to find out how.
    “Mr. Cappelli, I’d like you to recall the orders for the infant Ariel Arkin that came in late yesterday afternoon.”
    “Sure. I filled hundreds of orders yesterday, but I heard there was a problem with the baby, so I racked my brain to remember exactly what I did with those scripts.”
    “And what do you recall about filling the scripts for the infant?”
    “The first thing I remember is that the orders came in as a hurry call, so they went to the top of the list of orders to fill. There were two: clindamycin — that’s an antibiotic, often used for staph infections including MRSA, the drug-resistant kind of staph; and heparin for an IV flush every eight hours. Now this is new. We rarely were asked for heparin for most of my career. It was just stocked by pharmacy techs on each floor — near the patients. And I think it’s still done that way in most of the hospital. But the powers that be decided that, as a way to prevent incorrect dosing, heparin would no longer be kept in the neonatal and pediatric patient care areas. I guess this was in response to overdoses that occurred around the country over the years. Personally, I