Crider v. Cattie – Medical Malpractice Verdict Affirmed


Does a doctor have a responsibility to read prescription orders he or she is required by law to sign?

According to a jury in North Carolina, in a verdict reluctantly affirmed by the North Carolina Court of Appeals: No.

The case underscores the different way in which medical malpractice lawsuits are weighed as opposed to other types of negligence cases. In order for a doctor to be held liable for injuries sustained by a patient, the fact of an adverse health outcome is not so important as whether that doctor breached the applicable standard of care for his or her specialty. This is established through expert witness testimony, as provided by other health care professionals similarly situated.

Plaintiffs present their expert witnesses, defense presents their expert witnesses and then it’s up to the jury to decide with whom they agree.

In the case of Crider v. Cattie, a patient suffered serious harm when the intravenous nutritional supplements he was prescribed following an infection resulting from a routine surgery did not contain a proper amount of a critical vitamin. As a result, he suffered permanent brain damage and physical disability.

The nutritional supplement was required under state law to be prescribed by a physician, necessitating his signature. However, in cases where such a supplement is prescribed, there is typically a team of health care professionals who help to oversee the process. These professionals include a doctor, a nurse, a dietician and other professionals. It’s designed this way because when someone is placed on a “total parenteral nutrition plan,” as this patient was, it’s considered a very complex and complicated process that requires careful consideration and monitoring in order to meet the individual’s nutritional needs.

While the base formulas for these supplements are pre-manufactured, it is through prescription that the formula can have certain components/vitamins/minerals added or subtracted.

In this case, the vitamin thiamine was omitted, per the prescription forms, which were signed by the doctor. Patient developed a condition known as Wernicke’s encephalopathy as a result, and now suffers permanent disability.

The doctor had signed off on that prescription. His defense, however, was that he didn’t read the prescription. In fact, he never did in these instances, instead relying on the dietician to approve the proper formula. His expert witness testified this was the industry standard, for doctors not to read prescriptions they signed in cases where other health care professionals were developing the plan. It was simply part of the administrative process.

Of course, this seemingly defeats the purpose of requiring these professionals to work together as a team, but nonetheless, jurors returned a verdict favoring defendant doctor, finding he had not breached the standard of care.

In a review by the North Carolina Court of Appeals, the court noted this tragic case was the result of the fragmentation of the medical community. The appellate panel lamented the fact that it had to affirm the verdict on legal technicalities, but noted plaintiffs failed to approach this action from a number of different legal angles. For example, plaintiffs could have likely challenged defense expert witness testimony regarding the requirement to read the prescription before signing it as outside the scope of his expertise. However, they did not.

Plaintiffs argued that by the doctor relying on a dietician to formulate the prescription, he was essentially allowing the unauthorized practice of medicine. Although the court found this argument compelling, it was not entirely persuasive given the case law history.

Because the trial court had not erred as a matter of law, the appeals court said it had no choice but to affirm.

Our Boca Raton medical malpractice lawyers recognize that although this was an out-of-state case, Florida also follows the “standard of care” doctrine when it comes to findings of liability by a doctor. Our team of experienced professionals is prepared to launch a thorough investigation as to the circumstances of your case, and to help explore all of your rights and legal options.

If you have been injured, contact the Hollander Law Firm at (561) 347-7770 for a free and confidential consultation. There is no fee unless we win.

Additional Resources:

Crider v. Cattie, March 17, 2015, North Carolina Court of Appeals

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