Study Set Content:
An ethical breach is not necessarily a
legal breach
An example of an ethical breach that could result
in liability for the pharmacist would be a breach of
patient (), if that disclosure caused
damages (e.g., loss of employment or the misuse of
information gained in the course of employment).
confidentiality
You must
show that you had a ()
with the doctor you are suing this means you hired
the doctor and the doctor agreed to be hired. For
example, you can't sue a doctor you overheard
giving advice at a cocktail party. If a doctor
began seeing you and treating you, it is easy to
prove a physician patient relationship existed.
Questions of whether or not the relationship exists
most frequently arise where a consulting physician
did not treat you directly.
physician-patient relationship
In a study of DI requests, calls from consumers
raised () ethical issues than calls from health
professionals.
more
provides little guidance for disclosure
of DI for questionable purposes and pharmacists
must exercise independent professional judgment
and assume legal responsibility for that judgment
when exercised.
Current law
However, using outdated references or old editions
of textbooks would more likely constitute an
inadequate search.
In a German case, a court held a Business and
Patent Information Service to be responsible for not
having used
updated materials.
Recent cases against pharmacists have held that
pharmacists who gain information about the
unique susceptibility of a patient are()for
failure to warn of the risks.
liable
the court held the pharmacist
liable for failing to warn a patient of the interaction
of theophylline with erythromycin that produced
seizures and consequent brain damage.
Dooley v. Everett
the pharmacist failed
to alert either the patient or the physician of the
drug interaction between the patient’s
psychotropic drug and alcohol. The fact that the
medication profile indicated that the patient was
an alcoholic created a foreseeable risk of injury
and, therefore, a duty to warn on the part of the
pharmacist.
Hand v. Krakowski
the court ruled that by
advertising its drug interaction software, the
defendant pharmacy voluntarily assumed a duty
to use its computer technology with due care. The
pharmacy technician had overridden the drug
interaction between tranylcypromine (Parnate ®)
and clemastine fumarate/phenylpropanolamine
hydrochloride (Tavist D ®) that the system detected
from the patient’s medication profile. The patient
committed suicide after suffering a stroke from the
combination.
Baker v. Arbor Drugs, Inc
In another case, the pharmacist chose to override
the computer alert regarding an interaction
between (), resulting in
the patient’s death. A $6 million verdict was
returned against the pharmacy for failure to warn.
tramadol and methadone
clinician is negligent; the clinician is the DIRECT
CAUSE of harm
DIRECT CAUSATION
How can you say that the clinician is NEGLIGENT?
o if he or she fails to use the () that other
reasonably careful practitioner would use
in the same or similar circumstances
level of skill,
knowledge, and care
This level of skill, knowledge, and care is
sometimes referred to as
“the standard of
care” or “duty of
How about negligence in the pharmacy practice?
o wrong dispensing
o incorrect directions on a label or fails to
provide any instructions
o Not reviewing the drug with the patient
TORT LIABILITY TO THE PROVISION OF DRUG INFORMATION
a. Incomplete information
b. Inappropriate quality information
c. Outdated information
d. Inappropriate analysis
e. Dissemination of information
the court addressed the issue of
whether the pharmacist’s failure to dispense the
FDA mandated PPI for progesterone was the
proximate cause of a congenital eye defect that
occurred. Because congenital defects, but not eye
deformities, were specified in the PPI, failure to
provide the PPI could not be proven to be the proximate cause. Therefore, judgment was in favor
of the pharmacy.
Parkas v. Saary,
the
pharmacist counseled the patient regarding
drowsiness with Fiorinal ® (aspirin, butalbital,
caffeine), but failed to provide a warning not to
consume alcohol. The patient died presumably as
a result of combining the drug with beer. Here, the
DI provided was incomplete. The trial court did not
find the pharmacist had a duty to warn in this
instance. Although this case was decided before
Frye v. Medicare-Glaser Corporation,
with its mandatory patient counseling
provisions in effect, its outcome would not seem to
have changed as a result.
Omnibus Budget Reconciliation Act of 1990
(OBRA’90),
