July 14, 2013

162017_132140396847214_292624_nOn July 12, 2013, a Washington judge awarded the family of a 4-year-old $15.2 million after a hospital physician prescribed Afrin, an over-the-counter decongestant that was contraindicated for the child because she had had a heart transplant almost four years earlier. The drug error caused the little girl to suffer cardiac arrest that led to a severe anoxic brain injury, a nearly two-month hospitalization, and resulted in her present need for around-the-clock medical care. The judge’s medical malpractice award followed a three-week trial that began on April 22, 2013.

The child was born in 2004 with a congenital heart defect that required that she have a heart transplant when she was only 110 days old. By all accounts, the successful heart transplant resulted in the little girl being able to live a normal, happy, healthy, and active life. Then, in November 2008, just after her fourth birthday, the little girl had nasal congestion that her pediatrician diagnosed as an upper respiratory infection. The child’s mother contacted the hospital transplant service that had taken care of her child in order to determine the appropriate treatment for her daughter’s congestion. The cardiology fellow working with the hospital transplant service returned her call after he consulted with the transplant cardiologist, who provided treatment recommendations and specifically warned that the child not be given Afrin because it can cause cardiac issues including hypertension.

Tragically, the cardiology fellow misunderstood the transplant cardiologist’s instructions and subsequently telephoned the child’s mother and instructed her to give her child Afrin. Within minutes of receiving Afrin, the child suffered cardiac arrest. Paramedics were called and arrived within minutes and were able to re-start her heart but not before she suffered irreversible brain damage due to the lack of oxygen to her brain.

The cardiology fellow testified during the medical malpractice trial that he had instructed the mother to give Afrin to her daughter and admitted that the transplant cardiologist advised him to not prescribe Afrin but he did not know how the miscommunication took place (the transplant cardiologist testified that he specifically instructed the cardiology fellow against prescribing Afrin). The medical malpractice defendants admitted medical negligence in prescribing Afrin but nonetheless argued to the judge that Afrin did not cause the child’s cardiac arrest despite the fact that the child went into cardiac arrest only minutes after being administered Afrin.


Afrin is the brand-name for oxymetazoline hydrochloride 0.05% nasal spray that is manufactured by Merck & Co., Inc. Afrin is an over-the-counter nasal decongestant. Afrin is a vasoconstrictor that can cause increased blood pressure, resulting in unnecessary cardiac stress for vulnerable pediatric heart-transplant patients.

This tragic case is a prime example of how a seemingly simple medical error or medical mistake or a moment’s bad judgment or miscommunication may cause a patient to suffer catastrophic and irreversible injuries resulting in life-long disabilities and severe cognitive impairment. This case should serve as a prime reason why non-economic damages caps imposed by some U.S. states in medical malpractice cases are unfair, unjust, unethical, unreasonable, and un-American.

If medical malpractice in Washington State has caused you or a loved one to suffer significant injuries or other substantial harms, you should promptly consult with a Washington medical malpractice attorney or a medical malpractice attorney in your state who may agree to investigate your medical malpractice claim for you and file a medical malpractice lawsuit on your behalf, if appropriate.

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