Primary care physicians are increasingly prescribing medications to treat depression and managing their patients’ antidepressant use. While there are many reasons for this, and it is generally beneficial for patients, it does open the door to potential lawsuits, as we see in this months’ case.
Dr C, a 49-year-old family practitioner, worked for a busy medical office and typically saw a steady stream of patients from shortly after he arrived in the morning until the end of the workday. His ‘free’ time was often spent returning calls to patients, insurance companies, and pharmacies.
When he exited his office, the receptionist handed him a note from the medical assistant and told him that Mrs J had called. Mrs J, 55, had been the doctor’s patient for the past 5 years. She had a history of depression for which Dr C had prescribed venlafaxine about 3 years ago. Mrs J reported to the medical assistant that she had stopped taking the venlafaxine because she thought it was causing side effects such as poor sleep, mental strain, spontaneous crying, and gastrointestinal problems. She reported not having ‘felt right’ for the last 3 months and having to take more sleeping pills to deal with sleep issues.
After reading the note, Dr C changed the patient’s antidepressant to escitalopram, wrote a referral to a gastroenterologist, and had the medical assistant call Mrs J and tell her that she could pick up samples and a prescription for escitalopram from the office. He did not ask Mrs J to schedule an appointment to see him.
Mrs J picked up the prescription and filled it that afternoon. The following day, she took the entire bottle of pills and then fatally hanged herself in her garage. She was found by her husband. Mrs J did not leave a note.
Dr C felt sorrow when he heard about Mrs J’s suicide. He certainly hadn’t anticipated it. But he didn’t feel that he had anything to do with it until he was served with papers notifying him that he was being sued by Mrs J’s widower. Shocked at the lawsuit, he immediately contacted a defense attorney to discuss the case.