The consequences of this court ruling could be very interesting

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Pharmacy faces negligence lawsuit after painkiller overdose

http://drugtopics.modernmedicine.com/managed-healthcare-executive/news/pharmacy-faces-negligence-lawsuit-after-painkiller-overdose?page=0,0

Should a pharmacy or pharmacist be liable for filling valid and legal prescriptions written by a doctor? Pharmacy industry observers are watching closely as that answer is likely to be provided in a Florida court.

An appeals court recently ruled that Daytona Discount Pharmacy and its owner, Manish Patel, should stand trial for the overdose death of a patient who filled his anti-anxiety and painkiller prescriptions at that pharmacy.

Doctors writing fewer painkiller Rxs

According to an article in the Daytona Beach News Journal, 34-year-old Steven Porter died in 2011 after taking a combination of Xanax and hydrocodone. His mother filed a negligence lawsuit against her son’s doctor, the pharmacy, and the pharmacy’s owner. The doctor settled.

The pharmacy was accused of filling at least 30 prescriptions in a two-year span, even though it should have known that the previous prescriptions had not been depleted.

Lawyers for the pharmacy argued that it had no duty to Porter other than filling “valid and lawful prescriptions.” Circuit Judge William A Parsons agreed with the pharmacy and dismissed the case. 

However, a three-judge appellate court in Daytona Beach overturned that ruling. In its opinion, the judges wrote: “A pharmacist’s duty to use due and proper care in filling a prescription extends beyond simply following the prescribing physician’s direction…. Pharmacists are required to exercise that degree of care that an ordinarily prudent pharmacist would under the same or similar circumstances.”

At least one legal analyst called the appellate court decision questionable. “Do not forget that this pharmacy did nothing more than fill valid and lawful prescriptions, which the patient’s doctor kept writing over a period of years,” attorney Steven Boranian wrote on Lexology. “We can see imposing a duty to avoid mistakes in dispensing and compounding products, and one of the cases that the court cited provides a possible example….But the duty imposed in [this case] is considerably broader and somewhat nebulous.”

Boranian added: “Does a pharmacist have a duty to suggest different dosage based on what he or she knows about the patient? Does a pharmacist have a duty to suggest alternate drugs or otherwise second guess physicians? Does a pharmacist have a duty to question a patient about other medications he or she may be getting from other pharmacies, which is common drug-seeking behavior? Does a pharmacist have a duty to warn of a prescription drug’s known and reasonably knowable risks? The answer to all these questions clearly is No.” 

Like all other things that are put out there.. the facts that are presented typically reflects only the tip of the iceberg of the entire set of facts. We know the medications involved… but not the strengths or the number of doses/mgs that the pt was taking per day. We all know that docs are notorious for not truthful with Pharmacists in what they tell the pt or allow the pt in how many doses they can take per day.

The bottom line is that any patient getting controlled meds, that they have on hand enough to OD when they first get a Rx filled… if they are so inclined to.

If the courts rule in favor of the Pharmacy/Pharmacist, IMO… it could blow all those Pharmacist out of the water that are just “not comfortable” filling controlled meds for Rxs that have been written by a properly licensed prescriber and otherwise the medication(s) are on time and most likely medically necessary. Could this ruling set into motion that a Pharmacist could be equally liable for denying, reducing or otherwise changing what the prescriber has prescribed… as they would be for filling too many/too early Rxs and/or dispensing the wrong medication or dose ?

One Response

  1. That’s why I never fill anything controlled more than 3 days early, period. Been in the trenches now over 20 years and have seen it happen just like that time and time again. My regulars are fine with it and folks that aren’t have plenty of other choices in the marketplace.

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