Partner Catherine Nietzel Notches Defense Verdict for Psychiatrist

August 6, 2013

Plaintiff is a woman then in her 30’s who had been taking Xanax for panic attacks and anxiety disorder, prescribed by her internist.  She discovered she was pregnant and the doctor advised her to stop taking the Xanax without tapering her off the medication because she was already 5 weeks pregnant at the time she advised her internist. She saw her internist four days later complaining of symptoms she attributed to withdrawal but the internist thought the symptoms were more consistent with rebound anxiety. The next day, she came to co-defendant Hospital’s emergency room complaining of withdrawal symptoms and indicating she thought she should have been tapered off the medication.  She was evaluated by an emergency room physician who did not report her as having symptoms of withdrawal but referred her for a psychiatric consultation.  Our client, a psychiatrist, was then called by the psychiatric nurse who did an initial evaluation and the nurse and doctor discussed the possibility of whether she was, in fact, experiencing withdrawal.  However, our client determined her symptoms were not consistent with that diagnosis and agreed with the emergency room physician who had evaluated her. The psychiatrist further weighed the risks that she was in true withdrawal, which typically occurs within the first day or two after stopping the medication and at doses higher than the plaintiff was taking against the known risks of taking such drugs while pregnant.  Xanax is a Category D medication, the second highest category used by the FDA to characterize the risk to a fetus.  The risk of seizures when stopping such medications, even when tapered, is extremely low. The doctor directed the nurse to contact her internist to learn whether he was willing to see her within a 24 hour period to evaluate her symptoms, which he was.  Our client also referred the patient to a community psychiatrist. 

About an hour after the patient left the emergency room, she suffered an apparent seizure and broke her ankle.  The patient went on to develop reflex sympathetic dystrophy and has a significant impairment of her leg as a result. 

The plaintiff’s last demand prior to suit was $750,000 and no offers by the defendants were made, although the defendants signaled they would be willing to make some offer if the plaintiff reduced her demand.  The plaintiff never further reduced her demand.  All three defendants received defense verdicts.