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Contraindicated medication can cause a patient serious illness or injury
Nearly everyone takes medicine now and then.
But every time you do, you’re taking a calculated risk. Most medicine is safe and beneficial when taken correctly, but there are a lot precautions that need to happen for you to remain healthy and unharmed.
The field of medicine and the pharmaceutical industry are constantly changing. Scientists, doctors and researchers are always studying long-term (and longer-term) effects of medications, how they interact with other medication or treatment, and how best to use medicine or improve its use.
So, what does it mean when a medicine is contraindicated? In short, contraindicated medicine is any reason (including a symptom or medical condition) why a patient should not receive a particular medicine or treatment because it could lead to harm.
In other words, a medicine that is perfectly safe for another person might be contraindicated for you because of your own medical history or conditions.
Contraindication doesn’t apply only to medicine; it can include any procedure, surgery or other treatment that could harm the patient.
Why doctors prescribe contraindicated medicine
No doctor would prescribe a patient a contraindicated medicine on purpose.
But medication error is a big problem, notwithstanding the checks and balances in place to prevent it. A healthcare provider is responsible for knowing the function of any medication they prescribe and possible negative interactions it could have with the patient’s other medications, including over-the-counter drugs.
There are two main reasons why this happens:
1. The doctor doesn’t fully review the patient’s medical history, test results, diagnoses, etc. to know whether the medication would cause further illness. If you’ve been to the doctor in the past several years, chances are that you were asked to review your own medical history either online in advance or with the doctor or nurse at your appointment. Likely both. You might feel like it’s a drag to repeat everything again and again, but this is one of the safeguards medical professionals use so that they’re certain that nothing is overlooked.
Doctors do make mistakes, but sometimes the patient forgets something important or makes a mistake, too. That’s why repetition is important.
2. The doctor could be unaware of the medication’s interactions with other drugs or conditions. Yes, it’s the doctor’s job to know about the drugs they prescribe but a doctor is a human being who could make mistakes or forget things they should remember—it happens.
There are benefits to having a doctor who’s older and has been out of med school for a decade or two... they have plenty of experience and likely have seen all kinds of outcomes and rare diagnoses. But sometimes younger doctors are more tuned in to the most current research and information, so they might be more likely to be aware of new data on a drug interaction or use. Regardless of a doctor’s age, training, or expertise, they need to know how a drug works, what its interactions are and what are its risks and benefits for each individual patient.
|Absolute contraindications||Relative contraindications|
There is no reasonable explanation for the level of risk that would be caused by the course of treatment.
For example, if the patient has an allergy to a particular drug. You are likely asked at every medical appointment about your drug allergies, and for good reason. If you’ve had a severe allergic reaction to a particular medicine in the past, it’s contraindicated for you.
This means there is a possibility that your pre-existing condition might mean that a medication is contraindicated, but the benefit might outweigh the risk.
Alternately, your doctor might know that a specific medicine risks certain side-effects that could be profound for you based on your circumstances, but it would still alleviate some other problem.
Marr v. Saboo, et al.
70-year-old David Marr was a patient at the Dana Farber Cancer Institute in Boston. He visited the Institute in 2010 for a scheduled chemotherapy infusion as treatment of his cancer. Normally, he would first have a blood draw to check for his creatinine level, followed by a CT scan, then chemotherapy.
On August 24th, 2010, David’s creatinine level was elevated. However, before Dr. Sachin Saboo learned of his blood test result, he ordered a CT scan with contrast. Immediately following the CT with contrast, medical personnel realized that his creatinine was high. Marr suffered kidney failure and underwent dialysis three to four times per week for three years until he died from the underlying cancer.
Marr and his wife sued nurse practitioner Janet Kunsman and Dr. Saboo, along with several other physicians (including his internist and radiologists) for malpractice. The Marrs argued that the contrast dye used in the CT scan was contraindicated with elevated levels of creatinine and the administration of the contrast caused Marr’s complete kidney failure. They claimed that Kunsman was negligent in ordering the CT scan without waiting for the lab results and Saboo was negligent in running the CT scan without checking the labs.
They claimed that if the nurse practitioner and the doctor had waited for the blood test results, they would not have proceeded with the contrast dye and Marr’s kidneys would not have failed.
The jury awarded $1,383,635 to Marr’s estate for personal injury. The damages covered $1,200,000 for past pain and suffering and $183,635 for medical treatment and associated costs. Mrs. Marr was awarded $400,000 for loss of consortium.
Mrs. B & rhabdomyolysis
In another contraindicated medication verdict, Mrs. B began experiencing a condition called rhabdomyolysis, which caused permanent injury and suffering. Mrs. B had been prescribed statin therapy, which is often used for patients with high cholesterol. She was prescribed the antibiotic clarithromycin for a separate illness.
Rhabdomyolysis is a rare side-effect of simvastain, but it’s commonly known. It only affects about 1.5 of every 100,000 people who take statins, but the risk is increased when using statins along with drugs like clarithromycin.
Mrs. B’s physician was found negligent at trial for not recognizing the danger of prescribing clarithromycin to a patient already taking simvastatin. Mrs. B was awarded $600,000 in damages.
Is contraindicated medication medical malpractice?
It can be.
If the physician, pharmacist or other medical professional who prescribes or distributes the medication is negligent, an injured patient could file a lawsuit for medical malpractice.
That means they did not follow the commonly accepted standard of care that’s consistent with their training, experience, and the widely accepted standard in the immediate community.
However, there are some defenses the physician could raise. For instance, if you forgot to mention something in your medical history that would be relevant, or if you neglected to add an over-the-counter drug you’re taking that is contraindicated with what they prescribed, the physician is not negligent.
Another example is if you become pregnant while taking a medication that is contraindicated during pregnancy. If a drug is contraindicated during pregnancy, the doctor should take appropriate steps to ensure you’re not pregnant before it’s prescribed; they should either require a pregnancy test or other proof that you’re not pregnant. They should also provide adequate warning of the risks of becoming pregnant while taking the medication, including specific instructions about what you should do if you become pregnant. However, if you become pregnant and don’t share that information with your doctor—after you’ve been warned of the risks—then the doctor would not be negligent.
If you believe that you’ve suffered illness or injury because of a contraindicated medicine that was prescribed to you in error, there are three things you should do right away:
- Keep notes of all the symptoms that you think are attributed to the medication error. Keep a journal where you record how you feel each day (even if you feel fine). That way, if you do end up testifying about the effects of the medication, you have accurate records of how you were affected. Note specific dates and symptoms, along with any treatment you sought as a result.
- Get a diagnosis from a different doctor. If the prescribing doctor realizes they might have made an error, they could be motivated to protect their own interests. Seek an opinion or diagnosis from a different doctor; explain what happened, what you were prescribed and for what ailment. Ask the doctor if it’s possible that your new or current symptoms are the result of contraindicated medicine. If you were to go to trial, you’d need to prove that there is no other reason you would experience those symptoms except as a result of the contraindicated drug.
- Seek the advice of a personal injury medical malpractice lawyer. Your lawyer can’t reverse the physical effects of a doctor’s mistake, unfortunately. But they can help you to receive the compensation you need to cover your financial losses.
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