Legal Background

The case went to a jury trial which lasted several weeks. Mrs X’s husband tearfully testified about what his wife had suffered due to the kidney failure. The plaintiff presented experts who testified that a creatinine clearance level should have been obtained and checked by Dr R prior to his infusing zoledronic acid, and that a result from February for a July infusion was not recent enough. 

The defense argued that zoledronic acid is a widely used medication for osteopenia, and that the patient’s underlying ANCA vasculitis may have been an unforeseeable cause of death.

In the midst of the trial, the primary care physician, Dr P, opted to settle out of court for a modest sum, leaving Dr R as the only defendant in the case. 

As part of his defense, Dr R claimed that he assumed that his patients would look up the medications he recommended and do their own research when deciding. His attorney argued that Mrs X was partially at fault for her own issues because she failed to go for the bloodwork. In defense of his not checking Mrs X’s creatinine levels prior to infusing zoledronic acid, Dr. R claimed that her numbers had been normal for the past decade, and she’d had normal blood work 6 months before going on zoledronic acid.

After deliberating for 2 days, the jury found for the plaintiff and awarded the family close to $1.5 million.

Protecting Yourself

The plaintiff’s experts faulted Dr R for not making sure that Mrs X’s creatinine levels were normal before infusing the patient with the medication. They were correct. Mrs X’s other conditions put her at risk for kidney damage. The medication’s profile calls for caution in patients with renal insufficiency and warns that renal toxicity may be greater in patients with underlying renal impairment. The jury believed that Dr R had failed to adequately warn the patient about the dangers of the treatment, in addition to not obtaining a recent creatinine level. 

As to Dr R’s claim that he assumes that his patients will look things up and do their own research: yes, there are always patients who have gone on Google and come in with printouts and questions and articles. But for every patient like that, there are probably 10 that just assume that the physician will tell them what they need to know, and that they are ‘hiring’ the physician for this knowledge. 

You can never assume that your patient will do their own research or make an educated choice without your input. Dr R failed to properly assess the patient before infusing the medication and possibly failed to help her make the best medication choice for her situation.