OTC med blamed in lawsuit against children’s hospital
A judge recently awarded the family of an 8-year-old girl from Snoqualmie, WA, $15.2 million after a University of Washington doctor at Seattle Children’s Hospital improperly recommended an over-the-counter medication that left the child with permanent brain damage.
The case, filed Oct. 28, 2011, in King County Superior Court, alleged that the University of Washington and Seattle Children’s Hospital committed medical negligence. MacKenzie Briant, who had undergone a heart transplant as an infant, was given a dose of the nasal decongestant Afrin at the direction of a cardiologist. It caused the cardiac event, which deprived her brain of oxygen and led to extensive brain damage.
According to court records, MacKenzie’s mother, Elaine Briant, called Seattle Children’s Transplant Service, where MacKenzie received care, because MacKenzie had developed a cold and stuffy nose. The mother’s call was returned by Cory Noel, MD, a cardiology fellow who was working in the Transplant Service.
Court records show that Noel then spoke to transplant cardiologist Yuk Law, MD, who provided treatment suggestions to Noel and specifically warned that MacKenzie should not be given Afrin because it could cause hypertension or other cardiac issues.
Noel misunderstood, and he instead directed MacKenzie’s mother to give the child Afrin exactly the opposite of what he was instructed. Within minutes after receiving Afrin, MacKenzie suffered a cardiac arrest, explains Ralph Brindley, JD, partner of The Luvera Law Firm in Seattle, and the attorney representing the Briant family.
Paramedics arrived and re-started her heart, but not before her brain was starved of oxygen, causing irreparable brain damage. MacKenzie spent nearly two months in Seattle Children’s Hospital before she was released. She now requires around-the-clock nursing care.
"In all my years representing families dealing with medical malpractice, this is one of the most heartbreaking medical negligence cases I have seen," Brindley says. "When we talk about medical errors, rarely is the error as elementary and vivid as failing to verify and follow a verbal order, especially as simple as something like do not use Afrin.’"
Brindley noted that had Noel repeated Law’s order back to him, Law would most certainly have corrected Noel’s error. "Tragically, Dr. Noel did not follow the procedures to deliver an acceptable standard of care, and as a result, MacKenzie will spend the rest of her life unable to speak or feed herself," he says.
MacKenzie was born in 2004 with a congenital heart defect and received a heart transplant at 110 days old. After that transplant, MacKenzie had enrolled in school, and was in good health, according to court documents.
Afrin, like many nasal decongestants, is a vasoconstrictor, which can cause increased blood pressure, which puts unnecessary stress on the heart for vulnerable pediatric heart-transplant patients. "The medical literature is clear. Giving a heart transplant patient a dose of Afrin is unacceptable," Brindley says.
Noel testified that he does not know where the miscommunication took place, but that he had directed Briant to give Afrin to MacKenzie, even though Law testified he told him not to.
"This was an incredibly hard-fought case," Brindley says. "While the University of Washington and Seattle Children’s finally admitted its doctors were negligent, they steadfastly argued that the Afrin was not the cause of MacKenzie’s cardiac event, although she coded soon after her mother administered the dose."
Briant notes that Law continues to be MacKenzie’s cardiologist.
- Ralph Brindley, JD, Partner, The Luvera Law Firm, Seattle. Telephone: (206) 467-6090. Email: firstname.lastname@example.org.