The Indiana Court of Appeals concluded that a pharmacist working in a Hendricks County CVS had a duty of care to a customer to either warn her of the side effects of a drug or withhold the medication. As a result, the judges reversed summary judgment in favor of the drug store and pharmacist in a negligence suit.
Christine Kolozsvari had a prescription filled for OsmoPrep to prepare her for an upcoming colonoscopy. She had the prescription filled at the CVS where she filled all her other prescriptions, including Lisinopril, an ACE inhibitor that treats hypertension.
When filling the OsmoPrep prescription, pharmacist Kelley Branchfield disregarded a warning on the computer screen that OsmoPrep posed a risk of renal failure because of Kolozsvari’s age. A document provided to pharmacists also says that using OsmoPrep may interact with Lisinopril and cause kidney damage.
When the drug didn’t work as scheduled, Kolozsvari’s doctor called in another prescription for the pill. Again, Branchfield ignored a computer-generate notification, this time that the prescription exceeded the amount considered safe in such a short period of time and could increase risk of renal failure.
After taking the pills both times, Kolozsvari had tingling sensations in her arms that increased after taking the second pill. She went to the hospital and was diagnosed with kidney failure. She now must undergo dialysis for the rest of her life or receive a kidney transplant.
She and her husband sued her doctor, doctor’s nurse, CVS, and Branchfield for negligence and loss of consortium. The trial court granted summary judgment for CVS and the pharmacist.
In Christine and Ivan Kolozsvari v. John Doe, M.D., Jane Doe, R.N., Kelley Branchfield, R.Ph., and Hook SuperX, LLC, No. 32A04-1008-CT-525, the appellate judges only addressed whether Branchfield and CVS were negligent in not warning Kolozsvari about the possible serious side effects. They cited Indiana Code Section 25-26-13-1, which deals with pharmacists and says they must fill all valid prescriptions unless an appropriate exercise of professional judgment indicates that honoring the prescription would be against the patient’s best interests or be contrary to the patient’s health or safety. The judges also referenced Pharmacy Board Rule 1-33-2, which says a pharmacist must initiate an offer to counsel the patient on matters concerning the drug, including side effects or interactions, and Hooks SuperX Inc v. McLaughlin, 642 N.E2d 514, 517 (Ind. 1994).
“Just as in McLaughlin, where the pharmacist knew that McLaughlin’s refill of his prescriptions was unreasonably rapid and this should have alerted the pharmacist to the substance abuse issues likely associated with this behavior, here, Branchfield had information that gave rise to a duty to exercise professional judgment under the statute,” wrote Judge L. Mark Bailey.
The judges remanded for further proceedings.