In its Order dated March 28, 2019, the New York Supreme Court, Appellate Division, First Department (“New York Appellate Court”) affirmed summary judgment granted to the defendant bariatric surgeon in a New York medical malpractice case in which the plaintiff sought to hold the defendant responsible for the injuries the plaintiff suffered as a result of his medication not being resumed in the ICU after surgery.
The New York medical malpractice plaintiff claimed that the defendant, a private attending bariatric surgeon with privileges at Holy Name Hospital in New Jersey, performed a gastric bypass on him after which the defendant failed to timely resume the plaintiff’s Lexapro prescription while he was recovering from complications in the intensive care unit (ICU). The plaintiff had a medical history of using Lexapro, a selective serotonin reuptake inhibitor, to manage his anxiety. As a result of this failure, the plaintiff alleged that while he was in a medically induced coma, he developed severe agitation caused by Lexapro withdrawal, which led to the use of wrist restraints, and, eventually, permanent bilateral wrist drop.
The New York Appellate Court stated that although physicians owe a general duty of care to their patients, that duty may be limited to those medical functions undertaken by the physician and relied upon by the patient. Under the particular circumstances in this case, the defendant, as the patient’s surgeon, did not owe the patient a duty to manage his medication in the ICU. Rather, in this emergent setting, the defendant bariatric surgeon properly relied on the ICU staff and other specialists to treat and manage the plaintiff’s nonsurgical issues.
The New York Appellate Court held: “To reach any discussion about deviation from accepted medical practice, it is necessary first to establish the existence of a duty … Thus, in light of our determination, we need not address the parties’ remaining contentions.”
Marianne O’Toole, etc., et al. v. Elliot Goodman, MD, Defendant-Respondent, Holy Name Hospital, et al., Defendants. No. 8489.
The package insert for Lexapro warns: During marketing of Lexapro and other SSRIs and SNRIs (serotonin and norepinephrine reuptake inhibitors), there have been spontaneous reports of adverse events occurring upon discontinuation of these drugs, particularly when abrupt, including the following: dysphoric mood, irritability, agitation, dizziness, sensory disturbances (e.g., paresthesias such as electric shock sensations), anxiety, confusion, headache, lethargy, emotional lability, insomnia, and hypomania. While these events are generally self-limiting, there have been reports of serious discontinuation symptoms. Patients should be monitored for these symptoms when discontinuing treatment with Lexapro. A gradual reduction in the dose rather than abrupt cessation is recommended whenever possible. If intolerable symptoms occur following a decrease in the dose or upon discontinuation of treatment, then resuming the previously prescribed dose may be considered.
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