Where does the madness end?
According to court documents, the plaintiff, Jeremy Arsenault, sued Peter C. McConarty, MD, alleging that Dr. McConarty discharged Israel Ortiz from the hospital without warning him about the potential risks of taking antiglycemic medications when blood sugar levels are low. About 45 minutes after Ortiz was discharged, he lost consciousness as a result of low blood sugar, crossed the center line of traffic and struck Arsenault.
(via This Makes Me Sick)
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- Patients managing their own care
- What is the best insulin regimen for patients with diabetes?
- Sued for side effects
- Lowering blood sugar
- Bribing patients to follow doctor’s orders
- You’re spending too much time with patients
- Who details concierge physicians?
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{ 9 comments }
Indeed, when will Kevin stop the madness of being for complete immunity for doctors based on anecdotal evidence and raging against every method of compensating them for their performance without offering workable alternatives?
Please, let this madness end.
Because of the lawsuit-happy culture of today and the need to constantly “cover myself”, I have to drive all the doctors crazy by faxing them every single time their patient has an elevated/below-normal BP or blood sugar. I also have to chart tiresome reports of patient phone calls documenting that I “advised the patient to seek immediate treatment at their doctor or the ER” for every little thing.
This is a real problem for sleep specialists. In a University or VA setting, it can take 6 months or longer to get a sleepy obstructive sleep apnea pt fully evaluated and treated. During that time, he is a real danger on the road.
“Physicians are getting sued by patients they never met
Where does the madness end?”
How about looking at the total picture? This is absolutely no different from a “physician group” terminating access to a patient simply because one doctor has a beef, real or imagined, with his patient. The patient may well have never met any of the other doctors, but s/he is denied access nonetheless.
I agree. Let this madness end!
You can expect now that every pharmacy will hand out prints of the PDR listing for drugs and their cautions and contraindications.
Too many of my patients are lucky to remember which medicine they are to take and when, and that is not for want of my taking time to explain and to write down instructions. They just can’t remember what they have been told. Many diabetics don’t check their glucose levels, even when they should. I doubt you could count on them to know when not to use their medicines for fear of hypoglycemia. And this is in an era of diabetic “management classes” for patients.
You can posit what you want on duty to warn, but patients still have to be willing to heed those warnings. There will be unintended consequences of this suit, and very serious ones for patients, if it isn’t thrown out quickly. The mere presence of this preliminary finding will be noticed by the risk-management bar, and the results will be seen in recommendations to carriers and their subscribers.
Don’t be surprised that diabetics and anyone else with serious medical problems like heart disease get an automatic medical down on initial diagnosis, with notice sent to the state. I wouldn’t be surprised by that at all, nor would I regret that consequence if my liability were to extend to how well my patients conducted themselves when driving.
I’d imagine that it is he say/she says problem with proving or disproving if a doctor failed to warn or if a patient failed to follow instructions.
What about the situations where doctor’s or pharmacist’s written instructions are clearly incorrect and following them leads a patient to injure others, wouldn’t you say whoever made the mistake in the instructions are responsible? Case in point: when I got my prescription for Prometrium the instructions on the bottle said “take one pill every morning“. I happened to know that one of the side effects of Prometrium is drowsiness or dizziness and that women usually take it in the evening. The instructions struck me as incorrect, and I immediately looked at the long small print package insert to read the details. And sure, among all the side effects there was a warning about drowsiness and the recommendation not to drive or operate heavy machinery soon after taking it and, yes, to take it at night.
Prometrium is micronized progesterone and there is really no reason to take it in the morning. This was clearly a mistake. But somebody who is less informed than I am could’ve easily follow what looked like a doctor’s recommendation and had a traffic accident. Wouldn’t whoever put the wrong instructions be at least partially responsible?
If you are sleepy when you are driving, or even if you do not feel well, it is your own responsibility to stop driving and rest until you are well enough to drive. Same thing goes if you feel you can’t see well enough to drive. Your doctor is not your all-seeing protector from your own folly and mis-judgment.
Lots of medicines can make you drowsy. There isn’t enough time in the world to give comprehensive warnings about every side effect of every medicine, and even if there were this kind of time, few would remember it.
This story sounds as if the driver was impaired and through whatever poor judgment of his own, did not stop driving. That could have been the case whether he took his medicine, or didn’t take his medicine, or didn’t eat on time or was sleep-deprived or even drunk.
This really seems to be a desparate search for a deeper pocket than the driver at fault, impaired as he might have been.
Trying to make a prescribing doctor the responsible party for the impaired driving habits of his patient is an abomination.
This is not a malpractice suit, as the other driver has no doctor-patient relationship with the physician. The case has to be made on terms of vicarious liability. That is a stretch.
By the same token, should a doctor be held responsible if a patient with a contagious disease sickens someone else?
Massachusetts’ law has started to lean toward the idea that people have a duty not to do something “that expose[s] others to unreasonable and foreseeable risks of harm,”
That creates an interesting setup for conflict of interest. A slight variant on this is tight control of diabetics with insulin. Tight glucose control is good for the patient, but inherently has more frequent episodes of hypoglycemia no matter how it is managed or how the patient is warned. Should the physician have to balance tight control for the individual patient (beneficial for the patient but increased incidence of blackouts) against looser control (bad for the patient, but less blackouts) that might prevent an injury to the public at large.
Society can decide to whom we owe a duty. Just remember please, that there are downsides for the individual when the physician has to act in the interest of the greater societal good.
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