Up to 440,000 patients die every year in hospitals in the United States. Further, between 10 and 20 times that number suffer a serious injury as a result of medical malpractice. This is according to an article in the Journal of Patient Safety. Medical malpractice often stems from systems failures. And systems failures can stem from a number of areas, for example: doctors not spending enough time with their patients; not listening to their patients; or doctors not communicating with one another. In addition, doctors may not be up-to-date with the latest developments. In many cases, doctors do not order the necessary tests to get to the root cause of their patient’s medical problem.
Medical malpractice lawyers enforce patient safety rules and hold medical providers accountable for the consequences of violating patient safety rules. Accountability ensures that violations of patient safety rules are not repeated, and, therefore, protect every patient in our community.
In this case, a child died following a tonsillectomy. The doctor, who was unaware of the current FDA Guidelines which warned doctors, prescribed Tylenol with codeine. Codeine is an opiate, and the child died of an overdose.
The facts in this case
The Defendant doctor performed a tonsillectomy without any documented complications. The next day, the child developed a low-grade fever. The child’s mother contacted the doctor’s office and spoke with a receptionist, who spoke with the doctor. The receptionist advised mom that the doctor would call in a prescription for Tylenol with codeine. Mom gave the child the Tylenol (acetaminophen) with codeine as the doctor prescribed. The child went to sleep that night in the same bed as mom, while dad slept on the floor.
At approximately 3:20 a.m., mom checked on the child and found the child unresponsive and not breathing. CPR was started and 911 was called. The ambulance took the child to the emergency room as CPR efforts continued, but the child could not be revived and was pronounced dead shortly after arriving at the hospital.
Unexpected death of a child
The sudden unexpected death of anyone is shocking and alarming, but especially a child. After meeting with the child’s parents and grieving with them, we first obtained the autopsy report and looked at the cause of death. The autopsy report revealed the child died of respiratory depression. Respiratory depression is one of the known risks of Tylenol with codeine, and why it should never be prescribed to children following a tonsillectomy.
Following multiple deaths related to codeine being prescribed to children after tonsillectomies, the US Food and Drug Administration (FDA) issued a safety alert to the medical profession in 2012. In 2013, the FDA required “black box warnings” to be added to codeine labels and prescriptions containing codeine. Health care professionals and pharmacists were warned “to prescribe an alternative analgesic [to codeine] for postoperative pain control in children undergoing tonsillectomy and/or adenoidectomy.” Then the FDA advised the medical profession, including the Defendant doctor, not to prescribe medications containing codeine to children following tonsillectomies by adding a contraindication due to the harm being caused.
Risks of prescribing codeine to children
Like heroin, morphine, fentanyl, and oxycodone, codeine is an opiate. What many people do not realize is that codeine is metabolized by the liver into morphine, and it is the morphine which is responsible for pain-relieving effects, not the codeine itself, which offers no pain-relief. We learned that children metabolize codeine into morphine at different rates, some faster than others. Rapid metabolism increases the risk of breathing disorders and potentially a morphine overdose, one of the many reasons the FDA advised not to prescribe codeine to children following tonsillectomies.
Proving negligence, causation, and damages
At the Defendant Doctor’s deposition, when shown the FDA “black box warning” and “safety alerts” the doctor was unaware of them. Doctors must stay up-to-date on developments in their area of specialty. This is a fundamental patient safety rule. We argued this doctor had not stayed up-to-date on important safety alerts related to prescribing medications, therefore, violated the standard of care and was negligent.
This is the first element of “negligence” that must be proven by the plaintiff. The second element we had to prove was “causation”. In this case, the ill-advised prescription of Tylenol with codeine caused the respiratory depression leading to the child’s death. The third element is the damages caused: the parents’ loss of a child. When a child loses a parent, we call them an orphan, when a spouse loses their spouse we call them a widow or widower. But the loss of a child is so traumatic, there isn’t even a name to describe it. The damages speak for itself.
Enforcing patient safety rules
Medical malpractice lawyers enforce patient safety rules and hold medical providers accountable for the consequences of violating patient safety rules. Accountability ensures that violations of patient safety rules are not repeated, and, therefore, protect every patient in our community.