Would a Steven Johnson Syndrome lawsuit against a physician be successful?

[MedicineZ0Z]

Lets say it was a standard med which caused it. Not one of the more likely ones that cause it hence the doctor didn't inform the patient about the risk. Could a lawsuit be successful in a case like this? If the doctor followed standard of care and prescribed a common drug?

Can't imagine going through every med out there and consulting patients on each risk. What if you give erythromycin and the patient has congenital prolonged QT, gets torsades and dies? Is it fair to be liable for every little risk and be expected (legally speaking) to inform the patient on every tiny risk?

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[arcus]

Lets say it was a standard med which caused it. Not one of the more likely ones that cause it hence the doctor didn't inform the patient about the risk. Could a lawsuit be successful in a case like this? If the doctor followed standard of care and prescribed a common drug?

Can't imagine going through every med out there and consulting patients on each risk. What if you give erythromycin and the patient has congenital prolonged QT, gets torsades and dies? Is it fair to be liable for every little risk and be expected (legally speaking) to inform the patient on every tiny risk?

You are asking two different questions.

Re: SJS, did the “standard medicine” have a black box warning on the label? Was there any mention of SJS in the label? Medmal lawsuits based on injury from prescription drugs revolve around the drug’s FDA Label

As for your second question, thats why we have mid level practitomers like NPs. lol

 

[sovereign0]

Not a lawyer, or even a doctor, but a few thoughts.

1.) What kind of lawsuit are you thinking? Medical malpractice? Negligence?

2.) Medications are not risk-free. Rare side effects do happen. I don't see how a physician could be liable if using a drug appropriately in the absence of hard contraindications and a known side effect occurs, even if it isn't a rare one like SJS. I know that the litigious culture behind medicine in the US is bad, but I have a hard time believing it's so bad that any every bad outcome that is no fault of the physician could be the basis for a lawsuit. Nobody could practice medicine - literally - unless performing a 100% risk-free procedure or prescribing a risk-free drug.

 

[Tenk]

There were lawsuits about tendon rupture for flouroquinolones long before the black box warning so yes, this can and does happen.

 

[mehc012]

There were lawsuits about tendon rupture for flouroquinolones long before the black box warning so yes, this can and does happen.

...against the company making the drug, though, no? OP was implied to be asking about lawsuits against the prescribing physician, which would be a totally different ballgame.

 

[Tenk]

...against the company making the drug, though, no? OP was implied to be asking about lawsuits against the prescribing physician, which would be a totally different ballgame.

These were and continue to be lawsuits against physicians. I know of a few people personally. It’s why I don’t prescribe fluoroquinolones hardly at all anymore.

 

[operaman]

Probably unlikely to be successful, but the devil is in the details. Medication side effects are a commonly litigated thing in med mal. Side effects of corticosteroids are a common one in our field, especially avascular necrosis and absence of informed consent from the treating physician. You do need to be aware of side effects and discuss them with patients and document that you have done so. While we always have written consent for procedures, we don’t do that for medications so your note becomes the documentation of consent.

I think a rare or unknown SjS reaction would be tough to litigate but if it’s a well known risk and you don’t discuss that ahead of time and document it, you could be vulnerable.

 

[The Knife & Gun Club]

My (M2 with a lawyer parent & sibling) understanding is that for a case to be SUCCESSFUL you need to show that the physician deviated from the standard of care or that he missed a warning sign/risk factor.

For SJS we don’t really know who’s at risk of developing it, it just randomly happens (someone correct me if I’m wrong). As for standard of care, youd have to show that there was another safer medical alternative that the doctor had no medical reason for forgoing (for example if they gave a quinolone to someone who could’ve just as easily been given a macrolide).

However nothing prevents angry patients/parents/lawyers from bringing a med mal case. I had a family member who was sued after a patient skipped all surgical follow up appointments, never filled his antibiotics, and un-suprisingly got gangreen. Insurance still settled for a few hundred thousand dollars.

 

[Oh_Gee]

My (M2 with a lawyer parent & sibling) understanding is that for a case to be SUCCESSFUL you need to show that the physician deviated from the standard of care or that he missed a warning sign/risk factor.

For SJS we don’t really know who’s at risk of developing it, it just randomly happens (someone correct me if I’m wrong). As for standard of care, youd have to show that there was another safer medical alternative that the doctor had no medical reason for forgoing (for example if they gave a quinolone to someone who could’ve just as easily been given a macrolide).

However nothing prevents angry patients/parents/lawyers from bringing a med mal case. I had a family member who was sued after a patient skipped all surgical follow up appointments, never filled his antibiotics, and un-suprisingly got gangreen. Insurance still settled for a few hundred thousand dollars.

carbamazepine's black box warning is SJS-TEN associated w/ HLA-B*1502 in Chinese people

lamotrigine's black box warning is also SJS-TEN.

 

[shisong]

carbamazepine's black box warning is SJS-TEN associated w/ HLA-B*1502 in Chinese people

lamotrigine's black box warning is also SJS-TEN.

you racist LOL HLAB1502 is not only chinese but all asian 🙂 -i remembered this cuz im asian myself haha

 

[mehc012]

you racist LOL HLAB1502 is not only chinese but all asian 🙂 -i remembered this cuz im asian myself haha

They let 12yr olds into med school now?

 

[mk04447]

Plenty of naive snowflakes in medical school these days. In my former life, I'd sue you for leaving the toilet seat up after giving you permission in writing.

 

[MilkIsGood]

you racist LOL HLAB1502 is not only chinese but all asian 🙂 -i remembered this cuz im asian myself haha

no its not. that association is specifically linked to han chinese. But the fda recommends genotyping all asians for it prior to starting carbamazepine.

 

[AMEHigh]

These were and continue to be lawsuits against physicians. I know of a few people personally. It’s why I don’t prescribe fluoroquinolones hardly at all anymore.

Were the plaintiffs all successful in their claims?
There are definitely meds I'm very hesitant or cautious to use after hearing these types of stories even if they are technically indicated, I always try to find alternatives if I can.

 

[mehc012]

Were the plaintiffs all successful in their claims?
There are definitely meds I'm very hesitant or cautious to use after hearing these types of stories even if they are technically indicated, I always try to find alternatives if I can.

Doesn't really matter once you've dragged someone into paying court fees, hiring a lawyer, and/or possibly settling to avoid the time/money sink.

 

[libertyyne]

People can sue for anything. Most of the time it is only a question if it is worth the lawyers time to file.

 

[Mad Jack]

There were lawsuits about tendon rupture for flouroquinolones long before the black box warning so yes, this can and does happen.

The lawsuits tended to target pharmaceutical companies, not physicians.

 

[Mad Jack]

carbamazepine's black box warning is SJS-TEN associated w/ HLA-B*1502 in Chinese people

lamotrigine's black box warning is also SJS-TEN.

There's also a substantial South Asian population that can suffer SJS/TEN due to HLA risk factors, it's not just Han Chinese.

 

[Tenk]

Were the plaintiffs all successful in their claims?
There are definitely meds I'm very hesitant or cautious to use after hearing these types of stories even if they are technically indicated, I always try to find alternatives if I can.

Most of them settled.

 

[Tenk]

The lawsuits tended to target pharmaceutical companies, not physicians.

No. They pull in everyone they can.

“Doctor you prescribed this fluoroquinolone with a steroid. You should have told me not to play tennis. You ruptured my Achilles. Now I have permanent pain and disability! This is all your fault!!!!!”

I wish you were right but you’re not.

 

[Mad Jack]

No. They pull in everyone they can.

“Doctor you prescribed this fluoroquinolone with a steroid. You should have told me not to play tennis. You ruptured my Achilles. Now I have permanent pain and disability! This is all your fault!!!!!”

I wish you were right but you’re not.

I was specifically referring to pre-warning SJS cases. I can't find a single final claim in the legal history from before the official issuance of the warning that names a prescribing physician.

 

[Tenk]

I was specifically referring to pre-warning SJS cases. I can't find a single final claim in the legal history from before the official issuance of the warning that names a prescribing physician.

I wasn’t talking about that at all :0!

 

[Mad Jack]

I wasn’t talking about that at all :0!

I can't find any lawsuits about physicians and achilles tendon rupture before the black box days either. Again, it's all pharma companies.

 

[arcus]

I can't find any lawsuits about physicians and achilles tendon rupture before the black box days either. Again, it's all pharma companies.

you are correct

You dont succeed in winning a medmal lawsuit on a claim of drug that allegedly injured you by simply filing such a claim, and much less as an individual plaintiff.

Flouroquinolones are alive and well. Litigants who filed against makers of FQ didn't see the rewards they had hoped. If anything their attorneys got the money. check the history YTD on the United States District Court - District of Minnesota

Fluoroquinolone MDL | United States District Court - District of Minnesota

Current Developments
Last Updated: September 6, 2017

May 31, 2007

Status Conference held on May 31, 2017

1. Status of Litigation
Counsel reported that there are approximately 265 pending in the MDL that involve Bayer or Merck as defendants. Of those cases, approximately 180 are Bayer-only cases and 85 are combination cases. Counsel reported that all but two of the related cases filed in 2015 in Pennsylvania state court have been dismissed. Of those two cases, one is expected to be dismissed and the other is currently scheduled for trial in June 2018.