Patient Suffers Fatal Heart Attack Due to Negligent Prescription

Joseph O'Neill

Written by
— Updated on September 28, 2017

Negligent PrescriptionThis case takes place in Nevada and involves a 70-year-old female who presented to a cardiothoracic surgeon for a lung biopsy after complaints of difficulty breathing and possible signs and symptoms of lung cancer. The CT surgeon prescribed Amiadarone; however the patient was already taking Ziprasidone and therefore Amiadarone was contraindicated. Upon presenting to the pharmacy with the prescription, the pharmacist was immediately aware of the contraindication and phoned the prescribing cardiothoracic surgeon. However, the prescribing cardiothoracic surgeon insisted that the patient would be fine and that he would monitor her with weekly EKGs. During the patients first 3 weekly EKG visits, the results were non-significant. However, she died of a heart attack before the 4th weekly EKG visit and the autopsy indicates the cause of her death was a drug interaction.

Question(s) For Expert Witness

  • 1. Do you routinely prescribe Amiadarone to patients like the one described above?
  • 2. If so, have you ever had a patient who was already taking Ziprasidone - and prescribed Amiadarone, even though it's contraindicated?
  • 3. Do you believe it's a departure from the standard of care to prescribe these two drugs alongside one another, knowing that they're contraindicated?

Expert Witness Response E-004465

I use Amiodarone routinely for similar patients. However, the literature is specific that the use of Amiodarone is contraindicated with Ziprasidone. The physician mentioned in this case overview should have known this. Since there are alternatives to Amiodarone, it would likely be a deviation from the standard of care to have prescribed it in this instance. Furthermore, insisting (to the pharmacist who was reluctant to fill the prescription) that the patient would be carefully monitored is not suitable reasoning for prescribing Amiodarone in this instance. I’d be happy to serve as an expert review of this matter on behalf of the plaintiff.

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