July 10, 2019

The United States Court of Appeals for the Fourth Circuit (“Federal Appellate Court”), in its opinion published on June 12, 2019, held: “this case is remanded to the district court so it can determine whether the expert opinions that [the plaintiff’s] taking some of the misdirected medications was the cause of her injuries and death satisfy the Daubert standards for expert testimony.”

The Underlying Facts

On November 19, 2013, the plaintiff ingested prescription medications that were sent to her by mistake by the defendant mail order pharmacy, which fills prescriptions for health care plans and other pharmacies. The plaintiff was accustomed to receiving medications in the mail. On the day she ingested the pills, the plaintiff received a package addressed to her home in North Carolina that contained six prescription medications. The package was similar in size and color to the packages containing the medications she normally received.

The defendant mail order pharmacy filled the plaintiff’s prescription order with prescription medications intended for a patient in California. The defendant mistakenly shipped the wrong package of prescription medications to the plaintiff, which contained the pills the plaintiff ingested. Although the outside of the package contained the plaintiff’s name and address, the label on each bottle listed the California patient’s name, the California patient’s prescribing doctor and the name of the medication. However, the plaintiff, who was elderly and barely literate, did not read the labels of the bottles before taking the pills.

After ingesting the pills, the plaintiff began to experience confusion and hallucinations. A few days later, she fell and fractured her leg. She was admitted to the hospital for her leg, but stayed for almost a month. During that time, the plaintiff was treated for several other medical problems that arose during her stay. She died on January 2, 2014, approximately ten days after being discharged.

The elderly woman’s son filed a lawsuit on behalf of his mother’s estate, alleging claims for negligence, negligence per se, and breach of the implied warranty of fitness for a particular purpose against the defendant. The district court granted the defendant’s motion for summary judgment, holding that the plaintiff was contributorily negligent as a matter of law which completely barred her recovery in North Carolina. The district court held that the plaintiff acted unreasonably by neither reading the labels on the medications nor heeding the warnings of her adult daughter. Alternatively, the district court held that the relationship between the plaintiff taking the medication and her death was too attenuated, and thus precluded a finding of proximate cause. The plaintiff appealed.

The Federal Appellate Court stated that under North Carolina law, if an issue of contributory negligence is raised as an affirmative defense, and proved, it completely bars the plaintiff’s recovery for injuries resulting from the defendant’s negligence. However, summary judgment is rarely appropriate for issues of contributory negligence because the standard used in contributory negligence cases, that of reasonable care, usually requires a jury determination.

The Federal Appellate Court stated that North Carolina courts have not addressed a case like this one where a plaintiff ingested misdelivered prescription medications without reading the label. The Federal Appellate Court held: “we, sitting in diversity, cannot say that as a matter of law that [the plaintiff] was contributorily negligent for failing to read the labels on the medications.”

With regard to the proximate cause issue, the Federal Appellate Court stated that only when the facts are all admitted and only one inference may be drawn from them will the court declare whether an act was the proximate cause of an injury or not. Because that is rarely the case, what is the proximate cause of an injury is ordinarily a question for the jury. In the present case, the plaintiff proffered experts who described a chain of events beginning with the ingestion of the medications and ending in the plaintiff’s death.

The Federal Appellate Court stated, “The district court’s assessment of the opinions of [the plaintiff’s] experts may be correct. However, at this stage of the case and without first evaluating the admissibility of the expert testimony, the court’s assessment results from improperly weighing the evidence. [The plaintiff’s] expert testimony, if admissible, is evidence from which a jury could conclude that [the plaintiff’s] ingestion of the misdelivered pills was the proximate cause of her death. In light of that testimony, the district court erred in determining there was no genuine issue of material fact. Therefore, we reverse the district court on the issue of proximate cause.”

Source Small v. Welldyne, Inc., No. 18-1638.

If you or a loved one suffered serious harm (or worse) as a result of a medication error in North Carolina or in another U.S. state, you should promptly seek the legal advice of a medical malpractice attorney in North Carolina or in your state who may investigate your medication mistake claim for you and represent you in a pharmacy negligence case, if appropriate.

Click here to visit our website or call us toll-free at 800-295-3959 to be connected with pharmacy malpractice lawyers in your U.S. state who may assist you.

Turn to us when you don’t know where to turn.