Woman Burned Alive by Medication: Pharmacist Found Guilty

Quick Overview

The pharmacist in the case where a woman suffered severe injuries from Lamictal (lamotrigine) titration was found not guilty because the expert testimony presented by the defense suggested that following the manufacturer's guidelines, which state the dose should not exceed 50mg daily for the first four weeks for patients not taking valproate, would have virtually eliminated the risk of Stevens-Johnson Syndrome (SJS), implying the error was in the prescribing, not the dispensing.

Key Points: The patient lost her medical malpractice appeal after suffering severe injuries, including permanent disability and scarring, from Stevens-Johnson Syndrome (SJS) after taking Lamictal. The initial prescription started at 25mg daily for one week, followed by 50mg daily for three weeks, which the expert witness testified was an incorrect titration schedule, leading to the SJS. A 2017 analysis shows the incidence of SJS with Lamictal is 0.04% for most adults, but factors like age, race, and co-infections (like HIV) increase this risk. The prescribing nurse practitioner increased the dose to 100mg daily on Day 18 (Week 2.5), skipping the manufacturer's recommended 50mg maximum for Weeks 3 and 4 for patients not taking interacting drugs. An expert medical doctor testified that the incorrect titration caused the SJS and that it was completely avoidable if the prescription was written correctly or if the pharmacist had verified the schedule. The jury found the pharmacist not guilty, despite the expert testimony suggesting the pharmacist should have called the prescriber to correct the titration schedule, which would have avoided the entire situation.

Context: This video analyzes a medical malpractice case where a woman developed the life-threatening Stevens-Johnson Syndrome (SJS) after being prescribed the anticonvulsant/mood stabilizer Lamictal (lamotrigine) for bipolar disorder. The core issue revolves around the rapid dose escalation detailed in the initial prescription (25mg for one week, then 50mg for three weeks) which deviated from standard manufacturer guidelines, a deviation that experts testified was the direct cause of the severe rash and subsequent permanent disability.