Walker v. Jack Eckerd Corp.

Pope, Chief Judge,

dissenting.

I agree with the majority that, under the common law, a pharmacist has no duty to warn a patient about all possible adverse effects incident to the use of properly prescribed medications.1 Thus a pharmacist has no duty to provide patients with manufacturers’ inserts containing drug warnings or contraindications of use or to advise the patient of such warnings. Yet, in my opinion, a pharmacist is and should be more than a mere “warehouse for drugs [or] shipping clerk who must dutifully and unquestioningly obey the written orders of omniscient physicians.” Riff v. Morgan Pharmacy, 508 A2d 1247, 1251 (Pa. Super. Ct. 1986). At a minimum, a pharmacist has a duty to notify the prescribing physician of “obvious inadequacies appearing on the face of the prescription which create [ ] a substantial risk of serious harm to the plaintiff.” Id. at 1252. The Washington Supreme Court delineated this limited duty as follows: “The pharmacist . . . has a duty to accurately fill a prescription [cit.] and to be alert for clear errors or mistakes in the prescription. The pharmacist does not, however, have a duty to question a judgment made by the physician as to the propriety of a prescription or to warn customers of the hazardous side effects associated with a drug, either orally or by way of the manufacturer’s package insert.” (Emphasis supplied and omitted.) McKee v. American Home Products Corp., 782 P2d 1045, 1055-1056 (Wash. 1989). See also Kampe v. Howard Stark Professional Pharmacy, 841 SW2d 223 (Mo. Ct. App. 1992); Nichols v. Central Merchandise, 817 P2d 1131 (Kan. Ct. App. 1991); Stebbins v. Concord Wrigley Drugs, 416 NW2d 381, 387-388 (Mich. Ct. App. 1987).

*526Decided June 3, 1993 — Reconsideration denied July 15, 1993 — Walls & Corlew, Harold D. Corlew, Charles A. Cole, Jr., for Walker. Webb, Carlock, Copeland, Sender & Stair, Dennis J. Webb, Adam L. Appel, Susan Z. Lembo, for Karp. Sutherland, Asbill & Brennan, Elizabeth V. Tanis, Laura M. Shamp, for Jack Eckerd Corporation.

In my opinion this limited duty best serves the patient, the doctor and the pharmacist. Although the pharmacist owes a duty to the patient beyond just accurately filling the prescribed medication, the pharmacist is not unduly interjected into the physician-patient relationship. On the other hand, the pharmacist is required to question a prescription which is erroneous or which is irregular on its face, thereby protecting the patient and the physician from physician errors which the patient could not detect but which would be readily apparent to a properly trained pharmacist.

Applying this limited duty to the facts of this case, a material question of fact remains for jury resolution concerning whether dispensing the drug Blephamide “PRN” constitutes such a patent or obvious error that the pharmacist should have contacted the prescribing physician before repeatedly dispensing the medication. The package insert for Blephamide contains the following warning: “Prolonged use may result in glaucoma, with damage to the optic nerve, defects in visual acuity and fields of visions, and in posterior subcapsular cataract formation. Prolonged use may suppress the host response and thus increase the hazard of secondary ocular infection. ... If these products are used for 10 days or longer, intraocular pressure should be routinely monitored....” I would therefore reverse the trial court’s grant of appellee Eckerd’s motion for partial summary judgment.

I am authorized to state that Presiding Judge McMurray and Judge Blackburn join in this dissent.

As the majority notes, this case does not address the issue of the duty of a pharmacist after January 1, 1993, when new drug review and patient counseling rules adopted by the Georgia State Board of Pharmacy become effective.