A patient who suffers harm from a wrong medication, an incorrect dose or a failure to monitor how the medication is used may claim material and non-material compensation when the conditions are met. To identify the responsible person, the prescribed medication, the product dispensed by the pharmacy and the medication actually administered to the patient must be kept apart. A physician, nurse, pharmacist and hospital may all take part in the same process, but their duties and the legal grounds for their liability are not the same.
Not every side effect or allergic reaction is a medical error. On the other hand, failing to take the necessary precautions against a foreseeable risk, overlooking a recorded allergy, or responding late to a developing reaction may give rise to liability. A legal review must start not from the name of the drug alone, but from the patient’s characteristics, the manner of administration, the timeline and the harm that occurred.
When a medication error is suspected, the priority is the necessary health assessment. Treatment must not be delayed in order to gather legal documents, and the medication or dose must not be changed on the basis of personal guesswork. The product used and the existing documents should be shown to the health team; after that, evidence should be preserved.
Which situations does a wrong medication or dosing error cover?
Prescription, preparation, administration and monitoring errors
A medication error is not only the delivery of the wrong box. Selecting an active substance unsuitable for the patient, prescribing an incorrect dose or frequency, preparing the medication incorrectly, administering it to the wrong patient or by the wrong route, and failing to carry out the necessary monitoring are also situations that must be examined. Omitting a dose or repeating the same dose may also cause harm, depending on the nature of the illness and the treatment.
Milligrams and millilitres do not mean the same thing: one measures the quantity of the active substance, the other a liquid volume. In a legal file, the statement that “a measure was given” may not be sufficient on its own. The concentration of the product, the physician’s order, the quantity prepared and the quantity actually administered should be compared. This distinction shows what data an expert review needs; it is not a recommendation for calculating a treatment dose.
The child’s age and weight, organ function in some patients, concurrent medicines and known allergies may matter. However, it cannot be said that the same test is mandatory for every drug, or that every adverse outcome results from these data. The specific properties of the drug and the medical standard at the date of the event should be explained. The fact that the drug recommended by the physician was correct does not remove a later dispensing or administration error.
The difference between a side effect and preventable harm
A known risk of a properly chosen and properly administered medicine may materialise. In such a case, giving the medicine is not in itself necessarily considered a fault. However, if the patient’s personal risks were not assessed, necessary information was not given, or the findings that emerged were not addressed in time, the breach of different duties may be involved.
The inclusion of an adverse effect in the package leaflet also does not give all parties general immunity. The safety of the product, its suitability for the patient, information and the management of complications are separate questions. Likewise, the materialisation of a known risk must not hide another administration error linked to the harm. In a compensation review, the breach, the harm and the causal link are made concrete. [1–2]
How are the duties of the physician, nurse and pharmacist separated?
The physician’s responsibility for prescription and follow-up
The physician’s assessment may cover whether the medicine is necessary, its suitability for the patient, the dose and duration, interactions, instructions for use and the required follow-up plan. Important health information about the patient must be reasonably enquired about. The effect of any ambiguity in the prescription, conflicting orders or insufficient explanation on the later stages is examined.
A physician is not unconditionally liable for every piece of information the patient did not disclose. However, failing to notice information that is in the file, or that should have been learned through an appropriate history and assessment, is a different matter. The defence that “the patient did not say so” is assessed in light of the questions asked, the existing records, the patient’s ability to communicate and time pressure. The patient’s incomplete information may also be taken into account in proportion to its contribution to the harm. [1–2]
The nurse’s responsibility for administration and observation
A nurse’s role is not limited to carrying out a written order without any assessment. Checks within the scope of the nurse’s duties, covering the medication, the patient, the dose, the route, the time and the records, and observation after administration are important. The Nursing Regulation (Hemşirelik Yönetmeliği) governs the rule on written orders outside emergencies, and the duties to consult the physician, to keep records and to monitor where an act may harm the patient. [3]
This regulation does not mean that a nurse must set an independent treatment plan in place of the physician. The review focuses on whether a noticeable problem existed in the order, whether it was reported, what answer was given and how the administration was carried out. The existence of a physician’s instruction does not by itself remove an independent error, such as administering a dose that departs from the order.
Where a trainee or auxiliary staff member took part in the procedure, the allocation of authority, supervision and training should be examined separately. Who carried out the act matters as much as who was responsible for supervising it. Whether a general supervision statement drawn up afterwards is supported by concrete records from the time of the event should also be assessed.
The pharmacist’s responsibility for dispensing, checking and informing
In the pharmacy, the important matters are the correct evaluation of the prescription, the delivery of the right product and pharmaceutical form, storage conditions and the necessary instructions for use. Filling an unreadable or clearly contradictory prescription on the basis of a guess does not show the same care as resolving the ambiguity with the physician. The fact that an employee made the delivery does not prevent a separate examination of the responsibility of the business and of auxiliary persons. [1, 4]
Dispensing a substitute medicine is not in itself the dispensing of a wrong medicine. Equivalence must be assessed by the active substance, strength, form, applicable rules and the patient’s specific situation. By contrast, dispensing by mistake a product with a different active substance, merely because the names are similar, is a different problem. Not only the name on the box, but also the barcode, the prescription and the sales record must be compared.
In legal doctrine, a pharmacist’s liability for compensation is examined through correct delivery and professional care, together with contract, tort and the conduct of auxiliary persons. This framework does not mean that every pharmacy dispute has the same legal nature and the same limitation period as the doctor–patient mandate relationship. [4]
When do the hospital and other parties become liable?
Errors arising from organisation and electronic systems
Storage that makes it easy for similar-looking packages to be mixed up, gaps in the handover of duties, failure to resolve illegible orders, failure to verify the patient’s identity and failure to keep medication administration records reliably may require institutional review. The use of an electronic system alone is not proof of safe administration; who saw the warnings and how the process was completed matter.
A hospital cannot escape liability in every case by saying “the fault belongs to the employee”. In private law, the debt arising from the contract, the acts of auxiliary persons and organisational duties are assessed; in public service, the establishment and functioning of the service are assessed. However, to which hospital or legal entity a staff error is attributed must be determined by the concrete working and service relationship. [1, 5]
Multiple errors and manufacturer liability
As a hypothetical example, consider an event in which a wrong dose is written, an obvious contradiction is not noticed at the pharmacy, and a recorded warning is also overlooked during administration. Where several acts contribute to the same harm, each responsible party must be assessed. However, it is not right to assign equal fault to each person or to bring automatic actions against all parties.
Where it is alleged that a medicine is non-compliant in production, content or safety, a product liability review separate from the administration responsibility of health personnel is needed. The conditions and time limits for manufacturer and importer liability under Law No. 7223 on Product Safety and Technical Regulations (Ürün Güvenliği ve Teknik Düzenlemeler Kanunu) are separate. A misapplication of a box and a product inside the box being non-compliant are not the same legal question. Where the acts jointly cause the harm, the relevant liability and recourse provisions are addressed separately. [1, 6]
How is a wrong medication or dosing error proved?
Comparing the prescribed, dispensed and administered medication
Three groups of records are at the centre of the file: the physician’s order, the pharmacy delivery and the actual administration. Without matching these groups, it cannot be assumed merely from the prescription that the dose actually applied was the same. For outpatients, the usage instructions and the patient’s actual use are important; for inpatients, the administration chart and staff records are particularly important.
| Stage examined | Examples of evidence | Basic distinction |
|---|---|---|
| Medication selection | Prescription, changes to orders, allergy and previous treatment records | On what information was the treatment planned? |
| Dispensing and preparation | Pharmacy receipt, barcode, box, batch information, preparation record | Is the product delivered the same as the one requested? |
| Administration | Medication administration chart, time, quantity, route, administering person | What was actually given? |
| Monitoring | Nurse observations, laboratory results, time the physician was informed | What was done when the reaction was noticed? |
| Harm | New treatment file, reports, expense and income documents | What additional loss did the error cause? |
The box, the package leaflet and the remaining product should be kept under safe conditions; in photographs, the product name, barcode, serial or batch number and expiry information should be legible. Re-use of the medicine or its administration for testing purposes is not a method of collecting evidence. A copy of the hospital file may be requested; for persons other than the patient, representation or authority to access the file is also important. [2]
Records should be requested not only as screenshots but, where possible, as examples that show the date, the action and the change history. An incomplete record alone may not be proof of an error, but it matters in the assessment of control and proof. For evidence at risk of being lost, preservation of evidence (delil tespiti) through the appropriate judicial route may be considered. [7]
How should the expert examine fault and causation?
The report should compare the treatment the patient should have received with what was actually administered, and show whether the alleged error explains the harm that occurred. The patient’s underlying illness, other medicines, pre-existing conditions and later interventions should be considered as alternative causes. Where one event follows another in time, this alone does not prove causation.
The examination should, where necessary, cover the relevant clinical specialty, pharmacology, pharmaceutical knowledge and nursing practice. Where it is unclear which data the report relied on, or where the difference between the prescription and the administration has not been explained, a request for a supplementary report or a fresh examination with specific questions may arise. The final legal assessment of liability belongs to the court.
Why is the Constitutional Court’s (AYM) decision in S.G. and Others important?
In its decision of 30 October 2024 in S.G. and Others, the Constitutional Court (AYM) addressed harm that developed after an injection given to a child patient. The debated issues included whether the administration was carried out by a trainee, supervision, the characteristics of the injection and whether the claims concerning information had been adequately addressed. The decision shows that merely calling something a “complication” may not answer all concrete objections. [8]
Under Article 17 of the Constitution, the Constitutional Court found a violation and ordered a retrial. This decision is not a direct finding of a wrong medication or an excess dose, and it does not mean that every injection injury automatically leads to compensation. Retrial was deemed sufficient redress, and the additional compensation claims made before the Constitutional Court were rejected. The importance of the decision lies in the requirement that concrete objections be examined effectively and with reasons.
Which court should be applied to, and how are time limits calculated?
Distinction between public service, private health service and pharmacy
For harm arising from health services provided within public duties in a public hospital, the general rule is an application to the relevant administration and a full remedy action before the administrative courts. In disputes of a consumer transaction nature at a private health institution, the consumer court and mediation as a condition precedent to litigation may arise. Whether the Consumer Arbitration Committee (Tüketici Hakem Heyeti) has jurisdiction, and other exceptions, are checked separately. [5, 9]
In a pharmacy transaction, the consumer relationship, the claimed harm and the capacity of the defendant must be determined. The contractual basis asserted against a physician should not be copied over to the pharmacist. Where a public hospital, an independent pharmacy and a product manufacturer are involved in the same event, it cannot be assumed that all claims will be heard in the same court. Jurisdiction (görev), the proper defendant (husumet) and connection (bağlantı) are examined separately.
A consumer may also bring an action before the consumer court at their place of residence. However, the judicial route and the conditions for bringing an action must be settled before the territorial jurisdiction of the court is considered. Where a foreign patient receives medication or treatment in Türkiye, the foreign element, representation, translation of documents and service should be added to the file plan.
Principal time limits
| Claim or application | Basic time limit | Avoiding wrong generalisation |
|---|---|---|
| Harm from an administrative act | Application to the administration within 1 year of learning of the harm, and in any event within 5 years of the act | Where harm becomes apparent late, the starting point is examined concretely. |
| Action after a rejected administrative application | Generally 60 days from service of the rejection notice, or from the lapse of 30 days without response | A complaint record is not always a properly made compensation application. |
| Tort (unlawful act) | 2 years from learning, under Article 72 of the Turkish Code of Obligations (TBK); as a rule 10 years from the act | Longer criminal limitation conditions are examined separately. |
| Mandate claim (vekâlet alacağı) | 5 years under Article 147/5 TBK | Not every pharmacy or hospital contract is of the same nature. |
| General contractual claim | 10 years under Article 146 TBK, where no special period applies | Maturity (muacceliyet) and special consumer provisions are examined separately. |
| Product compensation under Law No. 7223 | 3 years from learning of the harm and the liable party; in any event 10 years from the occurrence of the harm | A claim of manufacturing defect must be distinguished from an administration error. |
This table does not replace an individual calculation of the final date for the file. The date the claim arose, the grounds for suspension or interruption, and the earlier legislation that applies are important. In particular, elective rights arising from defective goods or services and compensation for bodily injury should not be placed under a single time limit. [1, 5–6, 9]
Complaint, criminal investigation and their relation to compensation
A complaint to the health institution, a professional inspection and a complaint to the public prosecutor serve different purposes. For criminal liability, the nature of the act and its result, the conditions of negligence (taksir) and the investigation procedure applicable to the health personnel concerned are examined separately. Lodging a complaint does not by itself ensure that compensation is paid or that all time limits are suspended.
For this reason, evidence collection, time-limit calculation and the legal application plan should not be left to the outcome of the criminal file. If a settlement or payment offer is received, it should be clarified which harms the document covers, whether it has the effect of a release (ibra) or waiver, and whether future treatment needs have been assessed. Receiving a payment and giving up all rights are not the same act.
Which material and non-material losses may be claimed?
Additional treatment costs, loss of earnings and working capacity, the need for care, reduced capacity to work and losses relating to the economic future may be examined in the concrete case. Non-pecuniary compensation depends on the legal assessment of the pain and life impact arising from bodily injury. Claims of relatives in cases of serious bodily injury or death, and loss of support, are also dealt with separately. [1]
Refund of the price of the medicine and compensation for the bodily harm caused by the medicine are not within the same scope. Where the wrong product was noticed before use, bodily harm may not exist; even so, rights arising from the transaction itself may be assessed. Conversely, where a cheap medicine causes serious harm, compensation is not limited to the price of the box.
Losses linked to the event must be documented in the calculation of harm. Invoices, employment and income records, reports showing the need for care and treatment plans are important. Future expenses that are not yet final are assessed on a reasonable medical basis; hypothetical total expenditure is not automatically accepted. Duplicate charges and the nature of payments already made are also examined separately.
Litigation costs, expert examination, the risk of having to pay the opposing party’s attorney fees and, where the conditions exist, legal aid should be assessed from the outset. An exemption from consumer court fees does not mean the absence of all costs. After the judgment, appeal remedies, enforcement and payment matters under insurance are followed separately; the existence of insurance does not guarantee winning the case or collecting the award. [5, 7]
Conclusion
In wrong medication and dosing error files, liability is determined by examining separately each stage through which the medicine passed before reaching the patient. The degree of agreement or conflict between the prescription, dispensing, administration and monitoring records is fundamental to explaining what happened. The existence of a side effect alone does not establish fault; nor does the existence of a physician’s instruction or a warning in the leaflet alone show the absence of liability.
While the health assessment is ongoing, documents must be preserved, the link between the harm and the alleged error must be investigated, and the appropriate time limit for each addressee must be determined. An effective compensation claim must go beyond the statement “the wrong medicine was given” and show, by evidence, who breached which duty and at which stage.
Frequently Asked Questions
Can everyone who experiences a side effect receive compensation?
No. The materialisation of a risk and a breach of the duty of care are distinguished. Medication selection, information, administration and the management of the reaction that develops are assessed together; harm and causation must also be shown separately.
Does a pharmacist commit an error when dispensing a substitute medicine?
A mere difference of brand does not mean an error. Equivalence, strength, pharmaceutical form, applicable rules and the patient’s specific circumstances are examined. Dispensing by mistake a product with a different active substance is a separate situation.
If the physician wrote the wrong dose, is the nurse never responsible?
There is no such general rule. The controls within the nurse’s scope of duties, the detectable risk, notification to the physician and the actual administration are assessed. The power to make medical decisions and the duty to administer safely must be kept apart.
If I threw away the medicine box, do I lose my rights?
No; however, identifying the product may become more difficult. The prescription, pharmacy and sales records, photographs, barcode information, hospital records and other evidence may be investigated. Missing documents do not automatically remove the entire claim.
If I notice the wrong medicine before using it, can I claim compensation for bodily harm?
Compensation for bodily harm requires that such harm occurred and that the link between them is shown. Rights relating to the product price or other concrete losses may be assessed on different grounds; the mere possibility of an error does not produce the same compensation result.
After making a complaint, should I wait before bringing an action?
Time limits for compensation may continue to run while the outcome of a complaint is awaited. The calendar of applications should be set up separately for public or private service, pharmacy transactions and product liability.
Sources and legal bases
- Law No. 6098, Turkish Code of Obligations (Türk Borçlar Kanunu), in particular Articles 49–56, 61, 72, 112, 115–116, 146–149, 502, 506. Ministry publication.
- Ministry of Health. Patients’ Rights Regulation (Hasta Hakları Yönetmeliği), Official Gazette of 1 August 1998, No. 23420; in particular Articles 15–18, 24, 42/A. Official institutional publication.
- Ministry of Health. Nursing Regulation (Hemşirelik Yönetmeliği), Official Gazette of 8 March 2010, No. 27515; Article 6. Ministry legislation index. LEXPERA publication of the Official Gazette text.
- Doğan, Murat. “Eczacının Tazminat Sorumluluğu” (Pharmacist’s Liability for Compensation), Erciyes Üniversitesi Hukuk Fakültesi Dergisi (Erciyes University Faculty of Law Journal), Vol. VII, No. 3–4, 2012, pp. 1–18. Full text.
- Law No. 6502 on Consumer Protection (Tüketicinin Korunması Hakkında Kanun), in particular Articles 3, 11–16, 68, 73, 73/A. Ministry of Trade publication.
- Law No. 7223 on Product Safety and Technical Regulations (Ürün Güvenliği ve Teknik Düzenlemeler Kanunu), in particular Articles 6, 21, 26. Ministry of Trade publication.
- Law No. 6100 on Civil Procedure (Hukuk Muhakemeleri Kanunu), in particular Articles 190, 266, 281, 334 et seq., 400 et seq. Ministry of Justice legislation record.
- Constitutional Court. S.G. and Others, Application No. 2021/60720, 30 October 2024; in particular §§24–35 and the operative part. Constitutional Court meeting and decision record. Republished full text of the decision.
- Administrative Procedure Law No. 2577 (İdari Yargılama Usulü Kanunu), in particular Articles 7, 13, 31. Revenue Administration legislation publication.