Argus v. Scheppegrell

472 So. 2d 573
Supreme Court of Louisiana·Decided June 28, 1985·No. 85-C-0100·Published·Cited by 18 cases

Opinion

472 So.2d 573 (1985)

Billie J. Argus, Wife of/and Herbert ARGUS
v.
William C. SCHEPPEGRELL, Jr., M.D.

No. 85-C-0100.

Supreme Court of Louisiana.

June 28, 1985.
Rehearing Denied September 9, 1985.

Douglas A. Kewley, Bruce A. North, Malony, Nolan, North & Reiss, Metairie, *574 William J. Scheffler, III, Gretna, for plaintiff-applicant.

Dominic J. Gianna, John D. Person, Hammett, Leake & Hammett, New Orleans, for defendant-respondent.

LEMMON, Justice.

We granted certiorari in this pre-comparative fault case to determine whether a physician who wrongfully supplied prescriptions for controlled dangerous substances in excessive amounts to a teenaged patient who was a known drug addict, even after promising the patient's mother that he would not supply the patient any more prescriptions for drugs, should be relieved of liability for the patient's death on the basis that the patient was contributorily negligent by taking a lethal overdose of drugs. We hold that because of the disparity of positions in the relationship between a trained and licensed physician and a nineteen-year old uneducated patient whose drug addiction was known to the physician, and because of the vastly different duty required of each party under the circumstances, the patient's reasonably expected conduct did not constitute an absolute bar to her parents recovery for her wrongful death. The patient's conduct cannot be, at the same time, both the foreseen risk which imposes the duty on the physician and the defense which totally excuses the physician's breach of that very duty. Under such circumstances, the physician can only avoid liability completely (even in a pre-comparative fault case) by refusing to supply prescriptions at all.[1]

Plaintiffs' daughter, Cindy Argus, consulted Dr. William Scheppegrell in December, 1975. She was a few months beyond her eighteenth birthday, and he had been in private practice for nineteen years. In January, 1976, Cindy requested diet medication as a method of controlling her weight while pursuing a modeling career. Although Cindy was five feet, six inches tall and weighed only ninety-seven pounds, Dr. Scheppegrell prescribed forty preludin tablets in 75-milligram dosage and forty tuinol tablets in 200-milligram dosage. Dr. Scheppegrell continued to supply prescriptions for these and other drugs at close intervals over a period of nineteen months.

In early August, 1977, Cindy's mother called Dr. Scheppegrell and told him that Cindy was addicted to drugs and might be suicidal. She obtained his promise not to furnish the child with any further prescriptions. Nevertheless, on August 15, 1977, Dr. Scheppegrell gave Cindy a prescription for fifty tablets each of preludin and tuinol, along with valium. Two days later, she took three-fourths of the bottle of tuinol and became comatose. She died one month later from the overdose.

A medical review panel determined that Dr. Scheppegrell failed to comply with the appropriate standard of care in that he prescribed drugs over a prolonged period of time when he knew or should have known the drugs would cause addiction and also prescribed the drugs in quantities that were deleterious to human life and health. After a trial on the merits, the jury found that both Cindy and Dr. Scheppegrell were negligent, and the district court rendered a judgment in favor of defendant. The court of appeal affirmed. 459 So.2d 238. We granted certiorari to review the decision of the lower courts. 464 So.2d 304.

The disparity in the positions between the doctor and this particular patient could not have been greater. Cindy was one of seven children. Her father at one time held two jobs, and he and Mrs. Argus assisted in managing the apartment complex where they lived.

Cindy was far from a model child. Her mother caught her smoking marijuana when she was fourteen years old. She dropped out of school in the ninth grade at age 16. Although it is not clear when her drug addiction started, and although the defense attempted to show that she and *575 her friends obtained prescriptions from several doctors for the purpose of selling drugs to satisfy their own addiction, the record plainly established that the amount and combination of drugs prescribed by Dr. Scheppegrell alone could have caused addiction.

Both preludin and tuinol are controlled dangerous substances under federal and state law. An expert in medicine and pharmacology testified that there was no valid medical reason for prescribing the two drugs in combination with each other. Preludin is an amphetamine which may be used as an appetite suppressant.[2] Preludin can create a psychological craving for euphoria which leaves its victim in a depressed, confused and anxious state when the use of the drug ceases. Tuinol is a combination of barbiturates which may be used to treat insomnia. Tuinol can create a psychological and physical addiction, rendering its victim physically ill and suspectible to seizure and other serious physiological symptoms when the drug is discontinued. Ingestion of eight to fifteen pills can be fatal.

The combination of drugs in the present case created a cycle which ultimately resulted in Cindy's death.[3] As the psychological craving for amphetamines increases, the victim needs more and more of the drug to induce euphoria because of the system's increased tolerance. At the same time, as the physical craving for barbiturates increases, the victim needs higher and higher dosages to induce sleep, but does not build up a tolerance to the drug's potential lethal effects.

Over the course of nineteen months, Dr. Scheppegrell prescribed this combination of drugs at least seventeen times. Of the seventeen prescriptions, the doctor recorded only four on the patient's chart, a failure he attributed to oversight. Although the instructions on the preludin prescription were to take one pill (of the forty pills) daily in the morning, the doctor issued new prescriptions several times within fourteen days. He once prescribed two full bottles of preludin on the same day, putting the second one in the mother's name. Although the doctor several times noted that no refills were to be given, he consistently provided new prescriptions.

On October 1, 1976, Cindy was picked up by the police and treated at the hospital for a possible overdose of barbiturates. Mrs. Argus frequently found pills in Cindy's purse and noticed "track marks" on her arms about six months before the fatal overdose. The autopsy report also listed numerous scars, the size, shape and number of which indicated, according to medical testimony, that Cindy may have been self-injecting preludin for some time prior to her death. Nevertheless, Dr. Scheppegrell testified that Cindy appeared happy and well-adjusted and displayed no evidence of drug addiction. He denied seeing any "track marks", although he claimed that he checked her blood pressure on every visit.

Approximately two weeks before the fatal overdose, Mrs. Argus called Dr. Scheppegrell about refraining from providing further prescriptions. The substance of that conversation is contested. Mrs. Argus testified that she told the doctor that Cindy was having seizures and asked if they could be caused by the drugs he had prescribed. When the doctor answered affirmatively, she asked him to stop the prescriptions, and he agreed. Dr. Scheppegrell, in a television news interview following the overdose, admitted that the mother had called and that he had agreed to discontinue the prescriptions. He stated, however, that the mother only told him

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