In September 2019, the Plaintiff, a 67-year-old retired farmer, was seen by the defendant gastroenterologist for evaluation of his then-asymptomatic Crohn’s colitis. The Plaintiff had a historical allergy to sulfa drugs based on a childhood reaction to a sulfanomide antibiotic, which was noted in his medical records.
The defendant gastroenterologist made the decision to prescribe sulfasalazine, a sulfa drug, to the Plaintiff without viewing the allergies section of the Plaintiff’s chart. When the defendant gastroenterologist’s nurse attempted to enter the sulfasalazine order, a “med warning” appeared, alerting the nurse and defendant gastroenterologist to the Plaintiff’s sulfa drug allergy. The defendant gastroenterologist testified that he then returned to the exam room and discussed the sulfa allergy with the Plaintiff, who allegedly reported that his childhood reaction had been mild. The defendant gastroenterologist chose to proceed with the sulfasalazine prescription, overriding the med warning and prescribing enough sulfasalazine to last six months. The Plaintiff testified that the defendant gastroenterologist advised him that any reaction to the drug would be mild.
Approximately 4 weeks after initiation of sulfasalazine, the Plaintiff suffered Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS), a severe, multi-system drug reaction, characterized by morbilliform cutaneous skin eruption, multi-organ injury, and a long latency period (typically 2-6 weeks). He suffered burn-like lesions to 80% of his body surface, acute hepatitis, leukopenia, neutropenia, and hyponatremia secondary to the sulfa drug reaction. After a nine-day hospitalization, he was discharged home, where his skin continued to peel and slough off his body for several months. During Plaintiff’s recovery period, he developed sepsis due to a skin infection secondary to the drug reaction and was again hospitalized.
Plaintiff alleged that the defendant gastroenterologist breached the standard of care in prescribing sulfasalazine, failing to advise the Plaintiff of the possibility of a severe, delayed reaction, and failing to offer alternative options like mesalamine, a biologic, or a “wait-and-see” approach based on the Plaintiff’s asymptomatic presentation. Plaintiff alleged the defendant gastroenterologist failed to consider the likelihood that the childhood reaction was t-cell mediated, which would result in a more severe reaction if re-exposed to the same allergen.
Defendants argued that it was reasonable to prescribe the Plaintiff sulfasalazine, as many childhood allergies dissipate over time, and that the DRESS was not related to the Plaintiff’s childhood drug reaction. Defendants further argued that sulfasalazine was the only available treatment for the Plaintiff, because the Plaintiff was averse to immunosuppression and other treatments were less effective.
The parties settled for $400,000.00 prior to trial. The Plaintiff was represented by Alexandra Humphreys, Esq. and Frank Hilton, Esq. of Wharton Aldhizer & Weaver, PLC in Harrisonburg, Virginia.