And other malpractice news
December 2015, Vol 3, No 12 - Inside Pharmacy

In This Article

Toprol Prescription Filled with Nortriptyline

The Case
The plaintiff, a man with atrial fibrillation, had been controlling his condition well with a prescription of Toprol XL. The plaintiff filled a new prescription of Toprol XL with the defendant pharmacy. The pharmacist did not fill his prescription with Toprol XL, but rather with Nortriptyline, an antidepressant. The plaintiff took the prescription as directed for about 4 months, but noticed that he had many more cardiac episodes than normal. He saw his physician and the error in prescriptions was discovered. The plaintiff’s condition—which was previously managed—was now worse, requiring ≥1 invasive ablation procedures. The plaintiff contended that his atrial fibrillation is now worse because of the error in depriving him of the correct medication. The defendant contended that the condition by nature is progressive, and the plaintiff’s worsened condition is simply a natural progression of the condition, not the error in medication.

The Verdict
The jury awarded $142,409 in medicals and $720,000 for future care, $400,000 for physical pain, suffering, and mental anguish, for a total award of $1,262,409.

Blanco v. Rite Aid, East Baton Rouge Parish (LA), District Court, Case No. 603404.

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Pharmacy Allegedly Failed to Notify Patient of Dangers of Nitrofurantoin

The Case
The plaintiff was prescribed 50 mg of Nitrofurantoin by defendant physician for a urological condition. The prescription was filled by defendant pharmacy. The plaintiff took this drug for approximately 6 years, until his prescription was increased to 100 mg. He continued to use the same pharmacy. Two years later, the plaintiff allegedly began to experience extreme shortness of breath. He underwent a computer tomography scan with contrast that revealed pulmonary fibrosis. The plaintiff asserted that the defendant physician was negligent in prescribing the medication without monitoring him for a pulmonary condition. He also asserted that the pharmacy was negligent in filling the prescription without warning him of the potential for a pulmonary condition.

The Verdict
A defense verdict was returned.

William Estes, Jr. and Claudia Estes v. Holiday CVS, LLC, d/b/a CVS Pharmacy #3229; and CVS EGL Atlantic Neptune Beach FL, LLC, d/b/a CVS Pharmacy #3229; Douglas Allan Swartz, MD; Integrated Community Oncology Network, LLC, d/b/a McIver Urological Clinic; and First Coast Urology, Duval Co. (FL) Circuit Court No. 16-2012-CA-0074606.

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Improper Coumadin Order Allegedly Resulted in Inability to Remove Hematoma

The Case
The plaintiff, a 68-year-old man, was admitted to the hospital from February 22, 2010, to March 1, 2010, for treatment of a Coumadin overdose. The defendant, a hospital pharmacist, consulted with the plaintiff, monitored his anticoagulants, and ordered that 2 mg of Coumadin be given to the plaintiff. The plaintiff alleged that he experienced an aggravation of his pre-existing Coumadin toxicity, and the worsening of an epidural hematoma that had been detected one day before the 2 mg of Coumadin was given. The hematoma had extended from C4 to T10 in the plaintiff’s spine, and surgery was scheduled. The plaintiff further alleged that the surgery could have been performed to evacuate the hematoma, had the Coumadin not been given. He claimed that the surgical resolution of the hematoma may have prevented the aggravation injury caused by the prolonged compression and existence of the epidural hematoma resulting from the additional Coumadin. The plaintiff alleged he suffered a permanent spinal cord injury, caused by the additional compression from the epidural hematoma. He concluded that as a result, he suffers from chronic back pain and an inability to sleep and perform activities that he once did prior to his hospitalization. The defendant claimed that there was no objective evidence of any worsening of the epidural hematoma. The defendant alleged the hematoma had reabsorbed into the body within weeks of the plaintiff’s discharge from the hospital. He further claims that there was no spike in the International Normalized Ratio levels in the days following the plaintiff’s administration of Coumadin. The defendant claimed that Coumadin played no negative impact on the plaintiff’s coagulopathy. The defendant concluded that the surgery had been cancelled before the plaintiff consulted with him, and before the order of 2 mg of Coumadin was given.

The Verdict
A defense verdict was returned.

Michael Ralph and Paula Ralph v. Cape Canaveral Hospital, Inc., and Marcia S. Minnich-Barnes, Brevard County (FL) Circuit Court No. 05-2011-CA-47219.

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Reprinted with permission from Medical Malpractice Verdicts, Settlements and Experts, Lewis Laska, Editor, Nashville, Tennessee, 800-298-6288.

A Note from the Editor-in-Chief

Effective systems—whether in healthcare or elsewhere—have built in checks and balances that include verification and validation. These case studies exemplify the serious, untoward outcomes that can occur when the systems fail. In the healthcare paradigm, and with the use of prescription medications, the pharmacist is often the last healthcare professional given the opportunity to validate and verify; one cannot overestimate the importance of this role in the dispensing of prescription medications.

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Last modified: December 21, 2015
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