Court Rules Pharmacists Not Legally Bound To Warn Patients

Pharmacists have some legal immunity for dispensing drugs prescribed by doctors, the Mississippi Supreme Court ruled on Thursday.

The high court ruled that pharmacists fall under the so-called "learned intermediary doctrine.'' It holds doctors responsible for passing along warnings about side effects from the drug manufacturer.

Manufacturers frequently argue, in part, that they rely on a "learned intermediary'' - the doctor - to explain the products' risks and benefits to patients. The Supreme Court said pharmacists cannot be held legally responsible for making sure patients are warned of potential side effects of drugs.

"The physician is best situated to know the propensities of a drug and to know the needs and characteristics of his patient,'' Justice Bill Waller Jr. wrote Thursday.

Waller said there are some exceptions. He said pharmacists could not use the doctrine to claim immunity when prescriptions are filled in quantities inconsistent with the recommended dosage or where it is undisputed that a plaintiff had informed the pharmacy of health problems which made it inadvisable to use the drug in question.

The ruling came in a case from Harrison County. A Winn-Dixie pharmacy and Memorial Hospital of Gulfport were sued by family whose child was born with birth defects. The family claimed the hospital and its doctors were negligent in prescribing drugs dangerous to a fetus. The family alleged the pharmacy was negligent by selling a drug not advised for use by pregnant women.

A Harrison County judge ruled for Winn-Dixie in November 2000. Winn-Dixie argued its pharmacy accurately filled the prescriptions from the woman's physicians and was under no duty to advise the woman of possible side effects of the medication or to second guess the doctor.

In its appeal, the family said if the pharmacist knew the drug was dangerous to a fetus, the woman should have been told. Waller said in other states, courts have found that pharmacists have no legal duty to warn the mother of hazards associated with taking a certain medication during pregnancy. Waller said courts elsewhere have held that imposing a duty to warn on the pharmacist would be to place the pharmacist between the physician and the patient.

In the Harrison County case, Waller said the pharmacy dispensed the drug as directed by the doctors. He said there was no evidence that the pharmacist knew the woman was pregnant when the prescription was filled.

Presiding Justice Chuck McRae, in a dissenting opinion, said the "learned intermediary doctrine'' is intended to relieve a manufacturer of the duty to notify consumers of potential side effects of drugs and to protect it from liability when there is an intervening expert, such as a pharmacist or a doctor.

"In those situations, the duty is on the intervening professional'' to tell patients of possible side effects, McRae wrote. While a doctor is best suited to know the medical needs of his or her patient, McRae said the reactions and interactions of drugs are best left to pharmacists. McRae said state law provides that a pharmacist's job includes the interpretation and evaluation of prescriptions and advising and consulting on the hazards and uses of drugs.

"Although pharmacists, like other professionals, should be given some degree of autonomy in order to work effectively, they should not be given immunity under the learned intermediary doctrine. ... This blanket immunity for pharmacists opens the door for litigation involving others in the medical profession, namely doctors,'' McRae wrote.

The Supreme Court reinstated the lawsuit against Memorial Hospital. Waller said the trial judge erred in ruling that the family sued after a statute of limitations had run out. The case goes back to Harrison County for trial.