Cafarelle v. Brockton Oaks CVS, Inc.

5 Mass. L. Rptr. 257
CourtMassachusetts Superior Court
DecidedApril 15, 1996
DocketNo. 940414A
StatusPublished

This text of 5 Mass. L. Rptr. 257 (Cafarelle v. Brockton Oaks CVS, Inc.) is published on Counsel Stack Legal Research, covering Massachusetts Superior Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Cafarelle v. Brockton Oaks CVS, Inc., 5 Mass. L. Rptr. 257 (Mass. Ct. App. 1996).

Opinion

Brady, J.

Plaintiffs brought this action against defendant, Brockton Oaks CVS, Inc. (“CVS”), alleging that it negligently filled prescriptions by supplying medication to the deceased plaintiff, Jennifer Lynne Cafarelle (“Jennifer”), at a rate faster than that prescribed. Plaintiffs argue that defendant should have refused to refill the prescriptions before the normal time and should have warned Jennifer, her parents, and/or her physician that Jennifer was overusing the prescribed medication and that such overuse was potentially dangerous. Plaintiffs further allege that defendant’s conduct caused Jennifer’s death. Plaintiffs bring claims for wrongful death, conscious pain and suffering, emotional distress, and violations of G.L.c. 93A.

Defendant moved for summary judgment pursuant to Mass.R.Civ.P. 56 claiming that, as a matter of law, it only had a duty accurately to fill the subject prescriptions and it had no affirmative duly to warn plaintiffs of the dangers associated with overusing the subject prescription drug medication. Defendant also argued that plaintiffs have not put forth sufficient facts showing that its conduct caused Jennifer’s death. On February 29, 1996, I denied defendant’s motion, with memorandum to follow.

BACKGROUND

On July 3, 1991, Jennifer died from acute respiratory failure associated with a severe asthma condition from which she suffered since infancy. At the time of her death, Jennifer was thirteen years old. On July 2, 1991, Jennifer and a few friends went to the Brockton Fair under the supervision of a family friend, Mary Sullivan. Jennifer began having breathing problems sometime in the late afternoon or early evening on that day. Jennifer experienced an asthma attack, used her Proventil inhaler, and eventually emptied it in an attempt to stabilize her breathing. At approximately 10:30 p.m., Jennifer was transported by ambulance to the Goddard Memorial Hospital in Stoughton suffering from respiratory distress. Jennifer was taken to the hospital Emergency Department and eventually died in the early morning of July 3, 1991. The clinical diagnosis at the time of her death was asthma with acute exacerbation and severe acute respiratory distress.

Jennifer began treatment for asthma with Dr. Michael Lawrence, an allergist, when she was three and one half years old. Lawrence and the other doctors with whom he was associated at Goddard Memorial Hospital treated Jennifer until her death in July 1991. Jennifer had moderate asthma with occasional severe exacerbations which required aggressive therapy with corticosteroids, environmental control, and allergy shots. Jennifer was admitted several times to the hospital suffering from status asthmaticus, which is a severe and prolonged asthma attack. Jennifer also had frequent office visits for acute asthma.

In the year before her death, Dr. Lawrence and his associates treated Jennifer approximately once per month. During that period, Dr. Lawrence prescribed a Proventil Inhaler to Jennifer to be used on an “as needed” basis. At the time of her death, Jennifer was also taking Theodur tablets, Intal/Alupent (administered through an electrical nebulizer), Alupent tablets, and Azmacort. Proventil and Azmacort are beta-ago-nists and are used to treat the symptoms of asthma by opening up the lung passages; they do not affect the inflammation in the lungs.

The Proventil inhaler prescribed by Dr. Lawrence contained two hundred metered doses. At eight puffs per day, the inhaler would last about one month. Dr. Lawrence testified at his deposition that when he first issued the inhaler to Jennifer, he instructed her on the proper breathing technique and he advised her not to use the inhaler more than two puffs up to four times a day, at a maximum. Dr. Lawrence stated that he discussed with Jennifer and her mother the consequences of exceeding the recommended maximum dosage. Dr. Lawrence also stated that he told them that overuse of the inhaler could result in possible accelerated heart rate or cardiac arrhythmia and the masking of worsening symptoms of asthma. In the seven month period before Jennifer’s death, Dr. Lawrence and his associates issued her a number of prescriptions for Proventil inhalers, all of which were filled at the defendant pharmacy.

During the relevant time period, CVS had an in-store computer used by the pharmacists when filling and refilling customer prescriptions. This computer system allowed the pharmacist to access a customer’s prescription profile showing the customer’s entire prescription history at that store. When a prescription was initially filled the pharmacist would type into the computer the number of days the prescription should last based on the quantity and dosage prescribed by the physician. If a customer requested a refill too soon, the computer alerted the pharmacist with a warning prompt. The purpose of the warning prompt was for insurance payment purposes and also to alert the [258]*258pharmacist that the customer may be overusing the medication. The pharmacist must manually override the warning prompt if he makes the decision to dispense the prescription in spite of the warning. According to plaintiffs’ expert, Dr. Thomas M. Golbert (“Dr. Golbert”), CVS pharmacists filled Jennifer’s prescriptions for Proventil inhalers approximately three times more frequently than is standard practice or recommended use of these medications.

A CVS pharmacist, James Grobman (“Grobman”), testified that a pharmacist has a duty to alert the doctor when the pharmacy computer alert warns that the customer may be overusing the prescribed medication and that the pharmacist also has a duty to warn the patient that she may be overusing the medication. CVS has produced no documentation that any of its pharmacists ever warned the prescribing physician that Jennifer was overusing any of her medications. However, Grobman stated in his deposition that he called Dr. Lawrence’s office and told the secretary that he had concerns about Jennifer’s overuse of the Pro-ventil inhalers. Grobman also stated that he told Mrs. Cafarelle that Jennifer was overusing the inhalers. Conversely, Jennifer’s parents contend in their answers to interrogatories that CVS did not inform them of the dangers associated with overusing the asthma medication. Whether Mr. Grobman provided these warnings is a disputed factual issue which cannot be resolved on summary judgment.

Sometime in April 1991, and apparently for insurance purposes, Grobman entered a new prescription for Jennifer’s inhaler into the pharmacy computer as a fifteen-day supply, as opposed to the previous twenty-five day supply. However, Jennifer was given the usual seventeen-gram inhaler canister which should have lasted her for at least twenty-five days if used as recommended. CVS treated another prescription on May 13, 1991 as a fifteen-day supply. Grobman stated that he informed Dr. Lawrence’s office that this change was needed to provide the medication to Jennifer at a faster rate and to ensure that the insurance company would pay for the medication. Grobman testified that he received approval of this change from a staff member at Dr. Lawrence’s office. However, the prescriptions that CVS has presented allegedly authorizing these changes do not indicate a reduction in the amount of medicine Jennifer received or a change in the rate at which the inhaler was supposed to be used. Again, these are simply disputed factual issues.

DISCUSSION

CVS argues that it had no duty to warn plaintiffs or Jennifer’s physicians that she was overusing her prescribed medication and that such overuse may pose a danger to her health.

Free access — add to your briefcase to read the full text and ask questions with AI

Related

Pysz v. Henry's Drug Store
457 So. 2d 561 (District Court of Appeal of Florida, 1984)
McKee v. American Home Products Corp.
782 P.2d 1045 (Washington Supreme Court, 1989)
Nevada State Board of Pharmacy v. Garrigus
496 P.2d 748 (Nevada Supreme Court, 1972)
Walker v. Jack Eckerd Corp.
434 S.E.2d 63 (Court of Appeals of Georgia, 1993)
State v. Perry
231 S.E.2d 262 (Supreme Court of North Carolina, 1977)
Batiste v. American Home Products Corp.
231 S.E.2d 269 (Court of Appeals of North Carolina, 1977)
Ferguson v. Williams
399 S.E.2d 389 (Court of Appeals of North Carolina, 1991)
Georgia Osteopathic Hospital, Inc. v. O'Neal
403 S.E.2d 235 (Court of Appeals of Georgia, 1991)
Ferguson v. Williams
374 S.E.2d 438 (Court of Appeals of North Carolina, 1988)
Perkins v. Windsor Hospital Corp.
455 A.2d 810 (Supreme Court of Vermont, 1982)
Jones v. Irvin
602 F. Supp. 399 (S.D. Illinois, 1985)
Gassen v. East Jefferson General Hosp.
628 So. 2d 256 (Louisiana Court of Appeal, 1993)
McLeod v. WS Merrell Co., Div. of Richardson-Merrell
174 So. 2d 736 (Supreme Court of Florida, 1965)
Stebbins v. Concord Wrigley Drugs, Inc
416 N.W.2d 381 (Michigan Court of Appeals, 1987)
Adkins v. Mong
425 N.W.2d 151 (Michigan Court of Appeals, 1988)
Raynor v. Richardson-Merrell, Inc.
643 F. Supp. 238 (District of Columbia, 1986)
Makripodis v. Merrell-Dow Pharmaceuticals, Inc.
523 A.2d 374 (Supreme Court of Pennsylvania, 1987)
Riff v. Morgan Pharmacy
508 A.2d 1247 (Supreme Court of Pennsylvania, 1986)
Eldridge v. Eli Lilly & Co.
485 N.E.2d 551 (Appellate Court of Illinois, 1985)
Ingram v. Hook's Drugs, Inc.
476 N.E.2d 881 (Indiana Court of Appeals, 1985)

Cite This Page — Counsel Stack

Bluebook (online)
5 Mass. L. Rptr. 257, Counsel Stack Legal Research, https://law.counselstack.com/opinion/cafarelle-v-brockton-oaks-cvs-inc-masssuperct-1996.