This is a rather rare breed: a psychiatric medical malpractice case. Plaintiff claims she was negligently prescribed Ziprasidone even after it was clear the drug was causing her harm. This case was filed on February 8, 2016. This is the 58th medical malpractice case filed in Maryland in 2016 and the first psychiatric malpractice claim of the year.Summary of Plaintiff's Allegations
A woman, a resident of Laurel, Maryland, comes under the care of the Defendant doctor. She is treated for bipolar disorder. The Defendant doctor prescribes medications to treat the woman's bipolar disorder, including Ziprasidone (often sold as Geodon). This drug carries a high risk of a ton of bad outcomes, including tardive dyskinesia, which is a movement disorder. A common side effect of antipsychotic medications are movement disorders like tardive dyskinesia.
The woman remains under the Defendant doctor's care and on the medication regimen that he prescribed her for more than 12 years. The package insert on this drug clearly says that the risk of tardive dyskinesia increase with prolonged use.
After that period, the woman develops early signs and symptoms of tardive dyskinesia. Despite these signs and symptoms, the Defendant doctor continues to prescribe the woman the same medication regimen.
Approximately a year after first showing signs and symptoms of tardive dyskinesia, the woman is evaluated at the University of Maryland Medical Center. It is there, for the first time, that the woman is diagnosed with tardive dyskinesia. She has tardive dyskinesia in, among other areas of her body, her mouth and jaw.
The woman returns to the Defendant doctor. She shares the results of her diagnosis from the University of Maryland Medical Center with the Defendant doctor. Still, the Defendant doctor continues to prescribe the same medication regimen for approximately two more years. As a result, the woman develops permanent tardive dyskinesia, including to her mouth and jaw.
The woman files a medical negligence against the Defendant Doctor, alleging that he violated the standard of care by failing to (1) appropriately treat her bipolar disorder by prescribing medications, such as Ziprasidone, known to cause tardive dyskinesia rather than prescribing safer alternatives, (2) appropriately recognize and treat her early signs and symptoms of tardive dyskinesia, (3) refer her to other healthcare providers for appropriate diagnosis, treatment and management, and (4) discontinue in a timely manner the medication regimen. The woman claims that had the Defendant doctor not acted in a negligent manner, she would not have developed tardive dyskinesia and it would not have progressed in the manner in which it did.
The woman also files a lack of informed consent claim. She alleges that the Defendant doctor failed to properly inform her about the material risks, benefits, and alternatives of using medications such as Ziprasidone.Additional Comments
- Arguing that is it negligence to prescribe Ziprasidone is a dead end. When someone is bipolar, the pharmacological treatment is always going to involve risks. But arguing that she should have been taken off the medication once she was diagnosed with tardive dyskinesia is a tougher sell.
- On the other hand, there is evidence to support that argument that it can be appropriate to keep patients on this drug even after they have tardive dyskinesia. In fact, the Physicians' Desk Reference says that "… some patients may require treatment with Ziprasidone despite the presence of the syndrome"
- Howard County is a tough jurisdiction for plaintiffs in any malpractice case but particularly in a malpractice case like this.
- Howard County
- An adult psychiatrist
- Joshi & Merchant, M.D., P.A.
- University of Maryland Medical Center
- Failed to appropriately treat her bipolar disorder by prescribing medications, such as Ziprasidone, known to cause tardive dyskinesia rather than prescribing safer alternatives
- Failed to appropriately recognize and treat her early signs and symptoms of tardive dyskinesia
- Failed to refer her to other healthcare providers for appropriate diagnosis, treatment and management
- Failed to discontinue the medication regimen in a timely manner
- Medical Negligence
- Lack of informed consent
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