Zuchowicz v. United States

Brief Fact Summary. Ms. Zuchowicz (Plaintiff) took an overdose of the drug, Danocrine because of the erroneous directions of a prescription. Plaintiff brought suit against the United States (Defendant) under the Federal Tort Claims Act.

Synopsis of Rule of Law. If (a) a negligent act was deemed wrong because the act increase the chances that a particular type of accident would occur; and (b) a mishap of that very sort did happen, this is enough to support a finding by a tier of fact that the negligent behavior caused the harm.

Facts. Plaintiff filed a prescription for the drug, Danocrine. The prescription erroneously instructed Plaintiff to take 1600-milligrams of Danocrine per day. This was twice the maximum recommended dosage. Plaintiff took the 1600-milligram dose each day for a month and experienced abnormal weight gain, bloating, hot flashes, night sweats, a racing heart, chest pains, dizziness, headaches, acne, and fatigue. She was told not to take the drug anymore. She was diagnosed with primary pulmonary hypertension (PPH). She was expected to live two and a half more years. She was on the waiting list for a heart lung transplant when she became pregnant. Because she was pregnant, she was ineligible for a heart lung transplant. She gave birth to her son and died a month later. Plaintiff claims that she developed PPH because of the overdose of Danocrine and brought suit against Defendant under the Federal Tort Claims Act.
* Expert testimony revealed that Danocrine was responsible for Plaintiff’s PPH. The doctor did not rule out all other possible causes of PPH, but he did exclude all other causes of secondary pulmonary hypertension. Expert testimony also ruled out all previously known drug related causes of PPH. The progression and timing of Plaintiff’s disease in relation to her overdose supported a finding of drug-induced PPH.
* Judgment for Plaintiff. Defendant appealed.

Issue. Did Plaintiff present sufficient evidence that the overdose of Danocrine caused her illness?

Held. Yes. Judgment affirmed.
* The trier of fact could have concluded that Plaintiff’s PPH was, more likely than not, caused by Danocrine. Expert testimony was presented and supported a finding of drug-induced PPH to a reasonable medical certainty. There was not a long latency period between the onset of symptoms and the patient’s exposure to the drug.
* However, in order to prove causation, it is necessary that the fact finder be able to conclude, more probably than not, that the overdose was the cause of Plaintiff’s illness and ultimate death. The mere fact that the exposure to Danocrine was likely responsible for the disease does not suffice.
* If (a) a negligent act was deemed wrong because the act increase the chances that a particular type of accident would occur; and (b) a mishap of that very sort did happen, this is enough to support a finding by a tier of fact that the negligent behavior caused the harm. When such a strong casual connection exists, the burden shifts to Defendant to show that the wrongful conduct was not a substantial cause.

Discussion. It is not enough to say that the Danocrine was the cause of Plaintiff’s PPH. If it can be proven that a standard dosage of Danocrine would have caused Plaintiff’s PPH, then it was not the overdose of Danocrine that caused Plaintiff’s PPH. Plaintiff must show that it was the overdose itself. Because this is difficult to prove, the following test was used: If (a) a negligent act was deemed wrong because the act increase the chances that a particular type of accident would occur; and (b) a mishap of that very sort did happen, this is enough to support a finding by a tier of fact that the negligent behavior caused the harm. Plaintiff satisfied her burden and the burden thus shifts to Defendant.