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Zuchowicz v. United States

Citation. 140 F.3d 381 (2nd Cir. 1998)
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Brief Fact Summary.

The plaintiff was erroneously prescribed a drug by the defendant in twice the recommended maximum dose. She then developed a rare and fatal condition that ultimately led to her death.

Synopsis of Rule of Law.

Where a strong causal link exists, it is up to the negligent party to bring evidence denying but for cause and suggesting that the in the actual case, the wrongful conduct had not been substantial factor.


Plaintiff filled a prescription for the drug Danocrine at the Naval Hospital pharmacy in Groton, Connecticut. The prescription wrongly told her to take 1600mg of the medicine per day, which is twice the maximum recommended dosage. Plaintiff took 1600mg each day for the next month and then dropped to 800mg for about a week. She experienced a myriad of side effects, from weight gain and edema to chest pain, dizziness, and headaches. She was then examined by a OB/GYN who instructed her to stop taking the Danocrine. A few months later, she was still experiencing symptoms and was subsequently diagnosed with primary pulmonary hypertension, a rare and fatal condition with a life expectancy of 2.5 years. Plaintiff was on the waiting list for a lung transplant when she became pregnant, which made her ineligible for a transplant. She gave birth to a son soon thereafter and died one month later.

The plaintiff’s expert testified that he was confident to a reasonable certainty that the high dose of Danocrine caused the condition that killed the plaintiff.


Is the defendant liable for the condition that ultimately led to the plaintiff’s death?Is the defendant liable for the condition that ultimately led to the plaintiff’s death?


Yes. The Danocrine overdose was more likely than not the cause of the fatal condition. The judgement of the district court is affirmed.


Based on the plaintiff’s expert testimony, the court determined that the Danocrine more likely than not caused the fatal condition. While all other possible causes could not be eliminated, the evidence showed that experts had ruled out many other causes of the condition, and it seemed as though the timing of the overdose supported the finding to a reasonable medical certainty.

To meet the causation requirement, the court must also determine that, more likely than not, the negligent overdose caused the condition. If the negligent act was deemed wrongful because it increased the changes that the accident would occur and a mishap of that sort did happen, the evidence supports a finding that the negligent behavior caused the harm. Where this strong causal link exists, the negligent party must bring evidence against but for cause, suggesting that the wrongful act was not a substantial factor. The plaintiff here had strong evidence of causation due to the timing of the condition’s onset and the overdose, as evidenced in the expert’s testimony.

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