On Oct. 18, 2005, plaintiff Alvin Greenberg, 58, disabled, suffered from an overdose of Zyprexa. He had been administered the drug by the staff at the Green Acres Rehabilitation and Nursing Center, in Wyndmoor, where he was a resident; the order for the anti-psychotic medication had been called into the facility by his treating physician three days earlier.
Greenberg’s daughter and power-of-attorney, Alicia Greenberg, sued Green Acres, Melanio Aguirre, Greenberg’s attending physician, and Aguirre’s practice, claiming negligence, in order to recover personal injury damages. Prior to trial Greenberg settled with Green Acres for an undisclosed amount but Green Acres still remained in the action as a defendant.
Plaintiff’s counsel alleged that Greenberg was given 10 times the proper amount of Zyprexa, causing Greenberg to require an emergency room admission for Zyprexa toxicity. According to counsel, when Aguirre spoke to the nurse by telephone on Oct. 15, it wasn’t clear whether Aguirre directed the nurse to give Greenberg 25 mg or 2.5 mg of the medication. Plaintiff’s counsel asserted that both Aguirre and the nursing home were liable for the overdose because they didn’t ensure that Greenberg receive the proper dosage of the medication he required.
It was undisputed that Aguirre thought Greenberg might require the drug in response to erratic behavior and, if Greenberg’s problems persisted, Aguirre directed the nurses to call Aguirre so he could initiate the administration of the drug.
It was unclear whether a second phone conversation between the nurse and Aguirre had taken place on Oct. 16, but on that date the nurse wrote a telephone order for 25mg of Zyprexa. Thus, when Greenberg received the drug for the first time, on the morning of Oct. 17, the nurses gave him 25 mg of Zyprexa and continued to do so until Greenberg overdosed the following day.
Counsel for Green Acres maintained that the nurse who Aguirre spoke to on Oct. 15 administered the medication exactly as she was told by the physician and that the order was for 25 mg of Zyprexa, not 2.5 mg. The nurse maintained that, per procedure, Aguirre told her the order and she repeated it back to him verbatim over the phone, so Aguirre could confirm the 25 mg dosage. Aguirre later signed off on the order without correcting it.
Counsel for Aguirre asserted that there was no way he would have prescribed 25 mg, as opposed to 2.5 mg, because he knew that 2.5 mg was the recommended starting dosage for patients with dementia. Further, counsel contended that the nurse had erred because she didn’t write down the dosage amount until a day later, when the prescription had to be ordered. Aguirre admitted that he signed the order but maintained that he received stacks of them at a time from the nursing home.
Greenberg was rushed to the emergency room where he was placed on a breathing machine as he suffered through periods of unconsciousness. While Greenberg recovered from the overdose well, plaintiff’s counsel asserted that the episode caused a domino effect of subsequent injuries — Greenberg soon developed staph pneumonia which traveled outside his lung and caused empyema, a formal abscess in his chest cavity near his thoracic spine.
Counsel argued that the empyema caused an antibiotic-resistant infection which required the removal of bones in Greenberg’s middle back. That procedure necessitated the placement of a steel rod in Greenberg’s back and resulted in Greenberg being rendered wheelchair-bound for the remainder of his life.
Counsel asserted that, while Greenberg suffered from dementia, his adverse medical condition would not have deteriorated so quickly had he not overdosed. Counsel sought unspecified damages for the past and future pain and suffering that ensued as Greenburg suffered through all those ailments.
The defense maintained that Greenberg was severely diabetic and had a history of foot infections which would have rendered Greenberg wheelchair-bound regardless of whether he overdosed. Further, the defendants maintained that the empyema was not related to the overdose in any way.
They jury found Green Acres was fully liable for Greenberg’s damages and awarded Greenberg $125,000. While the jury found Aguirre was negligent, his negligence was not found to be the cause of Greenberg’s injuries.
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