Doctors Administer Incorrect Drug Dosage

Case Overview

This case takes place in Virginia and involves a male patient who presented to the ER with complaints of severe pain radiating from his lower back and hips. A CT was ordered and the patient was diagnosed with a minor back injury. He was prescribed a combination of drugs in order to treat the pain, discomfort, and swelling caused by the injury. At some point after beginning the drug regime, the patient was noted as suffering from an altered mental status, consistent with delirium. A long hospital stay, including an induced coma, and significant side effects prevailed, including partial paralysis. It is alleged that the patient’s treating physicians were negligent in administering the drugs at a much higher dosage than the patient required for treatment.

Questions to the Toxicology expert and their responses

Do you routinely dispense the medications listed in the case summary?

Yes, I currently review and verify orders for these drugs as pharmacist and as well prescribed them (not necessarily together) as a physician.

Do you have knowledge of the checks and protocols a pharmacist should take in order to avoid over-prescribing?

Yes, I am aware of the checks and protocols a pharmacist should take in order to assess for over/under-prescribing, as well as drug interactions.

Have you ever reviewed a similar case? Please explain

I have reviewed cases where these drugs have resulted in a drug interaction. I have testified in a case when a person took too much ultram. But not in a case that involved these three particular medications together.

Please explain why you are qualified to review this case.

I am qualified to review this case based on my experience as a practicing pharmacist, as well as being a practicing physician, as well as having a Masters in Pharmacology and Toxicology and further understanding of the mechanisms of these medications.

About the expert

This highly qualified expert earned a BS in Pharmacy at the Medical College of Virigina, and an MD and MS in Pharmacology and Toxicology at Virginia Commonwealth University. Formerly, he was a Pharmacy Manager at Wal-Mart Pharmacy. Currently, he serves as a Pharmacist at a major hospital.