The plaintiff's attorney produced a slew of other expert physicians, who outlined the damages already inflicted on Mrs. F, her need for further medical treatment, and her continued suffering. Several physicians testified that had they been presented with a patient with an elevated temperature, pain at the PICC site, vomiting, and dehydration, they would have examined her more carefully to rule out necrotizing fasciitis.
When the plaintiff's lawyer rested his case, the defense attorney put Ms. H on the stand. She told the judge that Mrs. F was taking at least four pain medications and had asked for refill prescriptions to replace controlled substances that she claimed had been lost.
“Considering how often patients try to con prescriptions from clinicians,” Ms. H said, she believed Mrs. F was “a drug seeker.” So she conferred with Dr. D.
But under cross-examination from Mrs. F's attorney, the PA conceded that her exam might not have been as thorough as it could have been and that she might have discounted the patient's pain as a ruse to get more medication.
Dr. D testified next. He agreed that Mrs. F appeared to be looking for drugs and didn't remember her mentioning any pain or swelling in her arm. But he also conceded that those complaints would have prompted a more thorough exam.
The judge awarded Mrs. F $8.6 million in damages. Dr. D and Ms. H may have been nobly motivated by concern that Mrs. F was becoming or was already an addict, he said, but the patient presented actual symptoms that the clinicians ignored because of their preoccupation.
Legal background
Parties in a lawsuit can opt for a “bench trial,” in which the judge hears a case without a jury. At first glance, this case looks like it should have gone the traditional route. After all, a disabled, single mom is likely to evoke plenty of sympathy. But Mrs. F's attorney chose a bench trial because jurors, like the defendants, might be distracted by the number of controlled substances Mrs. F was taking. A judge hearing the case alone would be more likely to look at the facts and apply the law without being swayed by emotions, the lawyer reasoned.
Protecting yourself
Ms. H and Dr. D had no direct liability in this particular case, because technically, the defendant was the federal government. But had they been practicing in a civilian setting, they would have been named as defendants and been held liable for the multi-million-dollar judgment.
As a clinician, you will probably encounter patients who invent or exaggerate claims of pain in order to obtain controlled substances. When you suspect such behavior, it's easy to believe the worst and give their complaints short shrift.
But sometimes, as was evidenced here, that can be a grave mistake. Before you write off a patient as a drug seeker, be sure to do a thorough exam. You may find a serious illness.
Ms. Latner, a former criminal defense attorney, is a freelance medical writer in Port Washington, N.Y.