Although not an Indigo case, a recent medical malpractice verdict in GA illustrates the importance of documentation and closer patient follow up around new medication regimens in the family practice clinic, particularly in the treatment of depression and anxiety.
I’m no clinician but 25 years managing thousands of medical malpractice claims has taught me a thing or two about evaluating these kinds of risks. A recent trial involving a family practice physician got my hackles up!
A 27 year old single male visits a family practice clinic having just moved in from out of state. He has started a new job and is struggling with being stressed out to the point of having panic attacks. After taking a comprehensive history and ruling out any other risk factors for anxiety and depression, the physician prescribed Xanax & Citalopram at the suggested starting doses. He advised the patient of potential side effects and asked him to return to the clinic if any of those side effects manifested. He then made a follow-up appointment for 90 days.
A month later, after an evening date with his girlfriend where he became intoxicated, the young man took his own life.
The malpractice claims alleged that the physician failed to properly advise the patient of potential side effects of the medication, failed to warn him that alcohol was contraindicated and failed to schedule closer follow up at two weeks, or even a month. The physician disputed the claim on the first two grounds and testified that 90-day follow-up was reasonable and within the SOC for the patient. The jury returned a verdict in favor of the patient, finding that closer monitoring was required. The jury also found the patient shared responsibility because he became intoxicated and took his own life.
Although I have my own doubts about the appropriateness of the jury verdict, there is always a lesson to take away from an outcome like this one. Regardless of whether follow up at 90 days met the standard of care, if the physician had monitored the patient more closely and scheduled him in at two weeks or 30 days, rather than 90 days, the chances are the jury would have returned verdict for the defense. Of course, this also assumes that even despite closer follow up, the patient would still have taken his own life, a point that was no doubt disputed in the trial.
Family practice tends to be a lower frequency, lower severity specialty in the world of medical malpractice but according to ten years of data from one large malpractice insurer, the management and monitoring of medication is the top driver of claims in this specialty. According to the study, from 2012-2021, 78% of cases against family practice physicians arose from allegations of improper management and monitoring of medication. 20% of those cases involved anti-depressants.
The take-away then, particularly when it comes to new cases of anxiety and depression presenting in clinic, is that if you want to not only be able to defend your care but also win your case, set up tighter, more timely follow up protocols around new medication regimens and follow them!
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May you enjoy all the success and fulfillment you deserve in this ever-changing landscape of healthcare litigation and remember... the devil is in the details and the documentation!
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Photo by Drazen Zigic from iStock.