Pharmaceutical Expert Witness Opines on Methotrexate Toxicity
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Case Overview
This case involves a twenty-four-year-old male who underwent a kidney transplantation. The patient was on dialysis and immunosuppressive therapy. He also had hypertension due to his renal manifestations. To manage his hypertension, his primary care physician prescribed the patient minoxidil 2.5 mg. Upon filling his prescription, the patient was given methotrexate (MTX) by the pharmacy, an immunosuppressive drug used to treat various diseases. Its mechanism of action is to interfere with cell growth. The physician must closely monitor the use of this drug in their patients. Throughout the course of his treatment, the patient was never prescribed methotrexate. The label on the prescription bottle was labeled with minoxidil, but contained 90 methotrexate tablets. After ingestion of the MTX for ten days, the patient became severely ill and was hospitalized. The diagnosis later was known to be MTX poisoning. The plaintiff alleged that the following injuries occurred due to MTX poisoning: fatigue, anasarca, congestive heart failure, coma, paralysis, multiple blood transfusions, dialysis, retrograde amnesia, tooth deterioration, physical and emotional distress.
Questions to the Nursing expert and their responses
What are the long-term complications of methotrexate toxicity?
These delayed effects may include certain types of cancer, such as leukemia. Along with their needed effects, medicines like methotrexate can sometimes cause unwanted effects such as blood problems, kidney problems, stomach or liver problems, loss of hair, and other side effects.
About the expert
This expert has been a practicing pharmacist for almost 10 years. She has experience working with influenza vaccines in a setting similar to Walgreens, having worked at a Rite Aid pharmacy for a number of years. This expert has a certificate of achievement in Pharmacy-Based Immunization Delivery and is very familiar with the protocols involved in delivering flu shots. A current Assistant Professor of Clinical Pharmacy, this expert is highly qualified to review the standard of care received by the plaintiff.

E-006915
Specialties:
About the author
Dr. Faiza Jibril
Dr. Faiza Jibril has extensive clinical experience ranging from primary care in the United Kingdom, to pediatrics and child abuse prevention at Mount Sinai Hospital, to obstetrics in Cape Town, South Africa. Her post-graduate education centered on clinical research and medical ethics. Dr. Jibril is currently Head of Sales in the US and Canada for Chambers and Partners - a world leading legal ranking and insights intelligence company.
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