Dental

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CASE: Clindamycin Prescription Causing C. Diff. Infection

FACTS: The 65-year-old plaintiff was on a long-term prescription of a proton pump inhibitor (PPI) for treatment of acid reflux disease. He had treated with the defendant dentist on several previous occasions, including for the extraction of teeth. On those prior occasions he had been prescribed penicillin for the prophylactic treatment of infections. On the visit in question the defendant dentist recommended the extraction of tooth #2, but rather than prescribing penicillin, the defendant prescribed Clindamycin.

Clindamycin is a high-risk antibiotic exposing patients to an increased risk of developing Clostridium difficile infections (CDI). The risk for CDI is further increased in patients who are taking PPI’s, and for patients 65 or older. The FDA has issued a “black box warning” for Clindamycin that states, in part:

Because [Clindamycin] therapy has been associated with severe colitis,which may end fatally, it should be reserved for serious infections where less toxic antimicrobial agents are inappropriate…

The defendant failed to appreciate that the prescription of Clindamycin would increase the risk that the plaintiff might develop a CDI. Consequently, the defendant failed to warn the plaintiff to seek prompt medical attention should he develop diarrhea or abdominal symptoms within 2 months of taking this prescription.

Approximately 3 weeks following the tooth extraction the plaintiff began experiencing diarrhea. Because some of his co-workers had been ill with a stomach bug, the plaintiff assumed that he had contracted the same viral illness. After approximately a week of such symptoms he saw his family physician who sent him to the ER where testing confirmed that he was suffering from a CDI.

INJURIES: Colitis, CDI, perforated sigmoid colon, contamination of the abdomen, emergent total colectomy, and ileostomy. The plaintiff underwent ileostomy reversal 6 months post-colectomy. However, he subsequently developed small bowel obstructions, wound dehiscence and incisional and ventral hernias, all requiring surgical repair. He was hospitalized for over 46 days. He was forced to wear and empty an ileostomy bag for 6 months. He required extended home nursing assistance.

He is left with significant scarring. He cannot lift more than 15 pounds. He cannot travel more than an hour. He has an extremely limited diet. He has constant diarrhea. He must wear pads. He suffers from diarrhea related rashes. His digestive system causes embarrassing sounds after eating.

SPECIAL DAMAGES: Medical expenses: $456,898; Lost wages: $59,219

SETTLEMENT: Confidential

PLAINTIFF”S COUNSEL: Randolph J. Reis and Kimberly Kirkland (Reis & Kirkland, PLLC)

CASE NAME: Anonymous vs. Anonymous