Expert Services

CASE EXAMPLES

Medication error, wrong medication, pharmacotherapy, adverse drug reaction, drug toxicity, pharmacy practice – A premature infant is given insulin instead of heparin in her intravenous total parenteral nutritional (TPN) infusion and suffers permanent brain damage. Several pharmacists and a pharmacy technician fail to identify the transcription error on the handwritten compounding sheet. The TPN is misbranded and administered to the infant. The pharmacist filling the TPN the following morning fails to investigate, correct, and report the error. [Plaintiffs’ Expert]

Medication error, wrong dose, pharmacotherapy, pharmacology, drug toxicity, wrongful death – Several nurse practitioners erroneously prescribe a twice daily dosing of Suboxone® (buprenorphine and naloxone) to 43-year-old woman with opioid use disorder enrolled in telemedicine Medication Assisted Treatment (MAT) program. The standard of care is to dose Suboxone® once daily or multiple times a week. The woman dies of dose-related opioid toxicity. [Plaintiffs’ Expert]

Medication adherence, adverse drug reactions, drug interactions, toxicology, post-mortem redistribution – A 46-year-old morbidly obese male veteran with uncontrolled Diabetes is found unconscious and in cardiopulmonary arrest with copious amounts of chewed food lodged in his throat and obstructing his trachea. Plaintiff claims the cause of death were drug interactions and cat scratch disease. Toxicology was confounded by use of aortic blood drawn six days postmortem and by postmortem redistribution. Evaluation of his problem list diagnoses, blood toxicology, medication interactions, and medication pill counts found to be noncontributory. [Defense Expert]

Medication error, wrong timing, subtherapeutic dosing, pharmacokinetics, pharmacology, wrongful death – A 56-year-old man with newly diagnosed non-ST elevation myocardial infarction (NSTEMI) is taken for immediate cardiac catheterization. One of the newly placed coronary stents fails to expand. He remained hospitalized awaiting urgent CABG surgery. The man was prescribed an Integrilin® (eptifibatide) infusion and oral Plavix® (clopidogrel) to prevent re-occlusion and infarction. The Integrilin® infusion was discontinued too early (nearly 13 hours pre-op) compared to the standard of care (2 to 4 hours pre-op). The man suffers a second massive heart attack just prior to his scheduled CABG surgery and dies. [Plaintiffs’ Expert]

Medication error, pharmacotherapy, drug toxicity, pediatric pharmacotherapy, pharmacy practice, wrongful death – A 3-year-old child (weight 15.5kg) with cerebral palsy and recent orthopedic surgery is found nonresponsive by her mother and dies. At her discharge from the hospital, the medical record indicates she was prescribed an adult dose of oxycodone; equal to a 3.23-fold overdose (5mg instead of 1.55mg). Several health care practitioners fail to review the oxycodone dose at discharge and fail to identify the transcription error. The dispensing pharmacist fails to obtain the infant’s weight, check the dose, and catch the medication error. The mother is dispensed a lethal dose of oxycodone. [Plaintiffs’ Expert]