Within the following year, the patient began to experience severe gastrointestinal pain, which was ultimately diagnosed as inflammatory bowel disease (IBD). Eventually, he underwent partial removal of his rectum and almost his entire colon.
After years of using a colostomy bag, the patient underwent surgery to connect the remains of his colon and anus, but there was not enough left of his colon to draw out excess water, and he now has permanent diarrhea.
The plaintiff claimed that the labeling for isotretinoin provided insufficient warning regarding the risk of bowel disease. The defendant manufacturer claimed that isotretinoin labeling had warned about IBD as a possible adverse effect for more than 20 years. The company also maintained that there is no significant scientific evidence to prove that the medication causes IBD.
According to a published report, a $2,619,000 verdict was returned.
Symptoms Should Have Prompted Repeat Urinalysis
In September 2002, a 62-year-old man with a 30-year history of smoking went to the defendant, his primary care physician, with a complaint of urinary symptoms. He had not undergone a general physical examination in three years.
Laboratory work was ordered. Red and white blood cells, protein, and bacteria were found in the urinalysis. The blood chemistry panel revealed elevated total cholesterol, slightly elevated glucose, and findings indicating a hereditary red blood cell abnormality.
During a subsequent phone call, the primary care physician made a diagnosis of urinary tract infection and prescribed antibiotics. The patient told the physician that he was experiencing discomfort and pain during urination. Whether the patient was advised to return for repeat laboratory studies once he had completed the prescribed antibiotics was later disputed.
In March 2003, the man presented to a gastroenterologist for a screening colonoscopy, as recommended by the defendant in September 2002. The man mentioned to the gastroenterologist that he was experiencing urinary discomfort and frequency. The gastroenterologist ordered urinalysis, and red and white blood cells, bacteria, and protein were found once again. Ten days later, the patient visited a urologist, who performed a cystoscopy and made a diagnosis of bladder cancer. Surgery revealed that the cancer had metastasized into a lymph node.
The patient underwent chemotherapy, but in early 2006 the cancer recurred in his liver and hip joint. He died in March 2006.
The plaintiff, the decedent's widow, alleged negligence by the defendant primary care physician in failing to repeat the urinalysis (she claimed to have overheard the phone conversation in question and denied hearing any such instruction) and in failing to stress the importance of returning for repeat urinalysis. The plaintiff claimed that if the cancer had been diagnosed earlier, her husband would have had a high probability of survival.
The defendant maintained that the decedent had been treated properly and that the defendant's advice to repeat the urinalysis had been ignored. The defendant also claimed that he was not required to inform the decedent of any risk for bladder cancer. Additionally, the defendant claimed that the decedent had an extremely aggressive, high-grade bladder cancer that had most likely metastasized before September 2002.
According to a published account, a defense verdict was returned.