Case Title: Correa v. Schoeck

Citation: 

Docket Number: SJC-12409

State: massachusetts

Court: Massachusetts Supreme Court

Date: 2018-06-07T00:00:00Z

Document:
NOTICE:  All slip opinions and orders are subject to formal 
revision and are superseded by the advance sheets and bound 
volumes of the Official Reports.  If you find a typographical 
error or other formal error, please notify the Reporter of 
Decisions, Supreme Judicial Court, John Adams Courthouse, 1 
Pemberton Square, Suite 2500, Boston, MA, 02108-1750; (617) 557-
1030; SJCReporter@sjc.state.ma.us 
 
SJC-12409 
 
CARMEN CORREA, administratrix,1  vs.  ANDREAS P. SCHOECK 
& others.2 
 
 
Middlesex.     February 6, 2018. - June 7, 2018. 
 
Present:  Gants, C.J., Lenk, Gaziano, Lowy, Budd, Cypher, & 
Kafker, JJ. 
 
 
Pharmacy.  Wrongful Death.  Negligence, Wrongful death, 
Pharmacy. Interest.  Damages, Wrongful death, 
Interest.  Judgment, Interest.  Practice, Civil, Judgment, 
Interest. 
 
 
 
 
Civil action commenced in the Superior Court Department on 
October 19, 2012. 
 
 
The case was heard by Dennis J. Curran, J., on a motion for 
summary judgment, and entry of separate and final judgment was 
ordered by him. 
 
 
The Supreme Judicial Court on its own initiative 
transferred the case from the Appeals Court. 
 
 
 
Thomas M. Greene (Michael Tabb & Simon L. Fischer also 
present) for the plaintiff. 
                     
1 Of the estate of Yarushka Rivera. 
 
2 New England Neurological Associates, P.C.; and Walgreen 
Eastern Co., Inc. 
 
2 
 
 
Bruce H. Murray for Walgreen Eastern Co., Inc. 
 
Tory A. Weigand, for Andreas P. Schoeck & another, was 
present but did not argue. 
 
The following submitted briefs for amici curiae: 
 
Mary Ellen Kleiman, of the District of Columbia, & John F. 
Brosnan for National Association of Chain Drug Stores, Inc. 
 
Kathleen L. Nastri, of Connecticut, Jeffrey R. White, of 
the District of Columbia, & Jonathan A. Karon, Thomas R. Murphy, 
Kristie A. LaSalle, & Kevin J. Powers for American Association 
of Justice & another. 
 
Wells G. Wilkinson & Victoria Pulos for Health Law 
Advocates, Inc., & others. 
 
 
 
LENK, J.  In this case, we address the novel issue whether 
a pharmacy has a legal duty to notify a prescribing physician 
when a patient's health insurer informs the pharmacy that it 
requires a "prior authorization" form3 from the physician.  
Health insurers often require prescribing physicians to submit 
prior authorization forms to establish that prescriptions for 
particular medications are medically necessary and cost-
effective.  Since it is the pharmacy that submits the claim for 
reimbursement, however, only the pharmacy, and not the physician 
or the patient, is notified when a prescribing physician must 
complete a prior authorization form and submit it to the 
insurer. 
 
Prior authorization was necessary in order for Yarushka 
Rivera to obtain insurance coverage for Topamax, a medication 
she needed to control life-threatening seizures.  Rivera was 
                     
 
3 See 130 Code Mass. Regs. §§ 406.422, 450.303 (2016). 
3 
 
diagnosed with seizure disorder, which is also known as 
epilepsy, a few months before her nineteenth birthday.  Rivera's 
insurer, MassHealth, twice paid for her Topamax prescription 
without issue.  Once Rivera reached her nineteenth birthday, 
however, the insurer refused to pay for the prescription because 
it had not received the prior authorization form required for 
Topamax patients over the age of eighteen.  Her family then made 
numerous attempts to obtain the prescribed medication from her 
pharmacy, Walgreen Eastern Co., Inc. (Walgreens), to no avail.  
Rivera was unable to afford the medication without insurance, 
and thus could not take her medication in the months before she 
suffered a fatal seizure at the age of nineteen. 
 
Carmen Correa, Rivera's mother, subsequently brought this 
action for wrongful death and punitive damages against 
Walgreens; Rivera's neurologist, Dr. Andreas P. Schoeck 
(Schoeck); and Schoeck's office, New England Neurological 
Associates, P.C. (NENA).  Correa maintains that Walgreens 
repeatedly told Rivera and members of her family that Walgreens 
would notify Schoeck of the need for prior authorization, but 
Schoeck and NENA deny ever receiving notice.  A Superior Court 
judge allowed Walgreens's motion for summary judgment, on the 
ground that Walgreens owed no legal duty to Rivera to notify 
Schoeck and NENA of the need for prior authorization.  The judge 
entered final judgment against Walgreens and stayed the claims 
4 
 
against Schoeck and NENA so that Correa could expedite her 
appeal.  He also stayed the accrual of prejudgment interest as 
to Schoeck and NENA pending resolution of the appeal. 
 
Because we conclude that Walgreens had a limited duty to 
take reasonable steps to notify both the patient and her 
prescribing physician of the need for prior authorization each 
time Rivera tried to fill her prescription, we reverse the 
allowance of summary judgment for Walgreens.  Walgreens's duty 
extends no further, however -- the pharmacy was not required to 
follow up on its own or ensure that the prescribing physician in 
fact received the notice or completed the prior authorization 
form.  We conclude also that the judge erred in staying the 
accrual of prejudgment interest.4 
 
1.  Background.  a.  Facts.  On May 13, 2009, Rivera 
suffered a seizure; it appears to have been her first.  Rivera 
was eighteen at the time and living under the care of her 
mother, Correa, and her stepfather, Julio Escobar.  Rivera was 
taken to a hospital, where she was treated for seizure disorder.  
Upon discharge three days later, a physician at the hospital 
prescribed her Topamax, an antiepileptic medication.  Later that 
                     
 
4 We acknowledge the amicus briefs submitted by the National 
Association of Chain Drug Stores, Inc.; the American Association 
of Justice and the Massachusetts Academy of Trial Attorneys; and 
Health Law Advocates, Inc., the Massachusetts Law Reform 
Institute, the Center for Health Policy and Law of Northeastern 
University, and the Public Health Advocacy Institute. 
5 
 
month, Rivera began seeing a neurologist, Schoeck, who agreed 
that she should continue taking Topamax. 
 
In June, 2009, Rivera filled the Topamax prescription 
written by the hospital physician at her local Walgreens 
pharmacy.  MassHealth covered payment for the prescription 
without incident.  Later that month, Rivera and her family tried 
to refill the Topamax using Schoeck's prescription, but a 
Walgreens pharmacist explained that it was too early to do so 
because Rivera had not finished the previous prescription.  The 
pharmacist also informed them that, in the future, MassHealth 
would require a prior authorization form, to be completed by 
Rivera's prescribing physician, in order for the insurer to 
cover the cost of the medication.  According to Correa, the 
pharmacist said that it was Walgreens's policy to notify the 
prescriber by facsimile or telephone of the need for prior 
authorization, and that Walgreens would contact Schoeck, but 
there is no evidence that Schoeck was so notified. 
 
At that time, MassHealth required a prior authorization 
form to cover the cost of Topamax for individuals over eighteen 
years of age.  Rivera was eighteen when she began taking 
Topamax, but would turn nineteen shortly thereafter, on August 
3, 2009.  The prior authorization form is predominantly intended 
to establish the medical necessity and effectiveness of the 
prescribed medication, and to ensure that there are not "more 
6 
 
cost-effective alternatives," as MassHealth "strongly advocates 
the use of generic drugs."  Executive Office of Health and Human 
Services, Introduction to MassHealth Drug List, 
https://masshealthdruglist.ehs.state.ma.us/MHDL/pubintro.do 
[https://perma.cc/5H6U-U6UX].  During the relevant time period, 
the form used was two pages long and took ten minutes or less to 
complete; it required entry of information about the patient's 
MassHealth membership, diagnosis, prescribed medication, basic 
history, prescriber information, and the prescriber's signature. 
 
A patient's prescribing physician must submit the prior 
authorization form to MassHealth; pharmacies and patients are 
unable to complete the form.  MassHealth notifies only the 
pharmacy of the need for prior authorization, however, because 
it is the pharmacy that submits the claim for coverage; 
MassHealth does not notify the patient or the physician when 
prior authorization is required.  Although they are not required 
to do so by law or regulation, pharmacists at Walgreens and 
other pharmacies routinely send a facsimile transmission to the 
prescribing physician with the relevant patient information to 
alert the physician to the need for prior authorization, and 
sometimes place telephone calls to follow up on the required 
forms. 
 
When prescription coverage is denied by an insurer due a 
need for prior authorization, Walgreens's computer system 
7 
 
immediately notifies the pharmacist.  Upon issuing the alert, 
the computer system also allows its employees, with a single 
"click" of a computer "mouse," to send a facsimile message to 
the prescribing physician, with the necessary patient and 
medication information, notifying the physician of the need for 
prior authorization.  Walgreens pharmacists sometimes also 
follow up with prescribing physicians regarding prior 
authorization via telephone, particularly when a patient 
requests that they do so.  During the relevant time period, 
however, Walgreens did not have a practice of creating or 
maintaining records of any communications or attempted 
communications with physicians regarding the need for prior 
authorization. 
 
NENA, in turn, receives notices that prior authorization is 
needed from pharmacies via facsimile on a daily basis.  NENA 
first learns that a patient requires prior authorization when it 
receives a facsimile transmission from a pharmacy, not from any 
other sources; it is rare for patients to contact NENA directly 
regarding the need for prior authorization.  Upon receipt of a 
facsimile transmission concerning the need for prior 
authorization, Schoeck's assistant fills out as much of the 
prior authorization form as she can and gives the form to 
Schoeck to complete.  The assistant then submits the form via 
8 
 
facsimile to the insurer on the same day that she receives the 
notice. 
 
Rivera's family was again able to fill Schoeck's 
prescription without prior authorization on July 26, 2009, as 
she was not yet over the age of eighteen.  At that visit, a 
Walgreens pharmacist stated that any future prescriptions would 
not be covered by MassHealth without the prior authorization 
form, since she would turn nineteen before the prescription 
could be refilled.  The pharmacist told Rivera's family to 
inform Schoeck of the need for the form.  According to Correa, 
that pharmacist also assured them that Walgreens would notify 
Schoeck by telephone or facsimile of the need for prior 
authorization, as was customary policy.  There is no evidence in 
the record that the pharmacist so notified Schoeck. 
 
Rivera ran out of her Topamax supply in August, 2009.  
Between July and October, 2009, Escobar spoke with Schoeck's 
office approximately seven times via telephone concerning the 
required prior authorization form.  Escobar attests that he made 
these calls to assist Walgreens's efforts, as he and his family 
relied on Walgreens to obtain the appropriate paperwork from 
Schoeck's office.  He explained that he, Rivera, and Correa 
would not have known how to obtain the necessary paperwork 
without Walgreens's assistance.  Sometime in August, 2009, 
Escobar also telephoned a Walgreens employee, who again 
9 
 
recommended that Rivera's family contact Schoeck about the need 
for prior authorization. 
 
Rivera suffered a second seizure on September 2, 2009, 
while she was visiting Rhode Island.  She was hospitalized and 
discharged with a small supply of Topamax and a prescription for 
more of the medication.  On September 8, 2009, Rivera, Correa, 
and Escobar attempted to fill the prescription for Topamax 
obtained in Rhode Island at the same local Walgreens, but a 
Walgreens pharmacist stated that MassHealth had again denied 
coverage due to lack of prior authorization.  Correa maintains 
that this pharmacist also promised to contact Schoeck regarding 
the necessary form.  There is no evidence that Walgreens 
followed up with Schoeck.  At that visit, Rivera and her family 
were told that they could get the prescription filled if they 
paid the full $399.99 cost of the medication out of pocket, but 
they were unable to afford that amount.  They told the Walgreens 
employee that they would contact Schoeck's office again. 
 
Rivera and her family unsuccessfully tried to fill 
Schoeck's prescription for Topamax four more times, on 
September 18, September 28, October 12, and October 13, 2009.  
Correa maintains, and Walgreen denies, that a pharmacist assured 
Rivera and her family on each occasion that Walgreens would 
notify Schoeck about the necessary form.  Correa and Escobar 
claim that if Walgreens had not made such assurances, they would 
10 
 
have gone to a different pharmacy to assist them in obtaining 
prior authorization.  None of Walgreens's employees has any 
memory of communicating or attempting to communicate with 
Schoeck or with NENA concerning Rivera's Topamax prescription.  
Walgreens, along with some of the pharmacists who directly 
interacted with Rivera's family, conceded knowledge, however, 
that if a customer suffering from epilepsy suddenly stopped 
taking Topamax, that customer could suffer a seizure. 
 
According to Correa, at an appointment on October 19, 2009, 
Rivera told Schoeck that she had not been able to take her 
Topamax since the end of August, because his office had not 
completed the necessary paperwork, and he told her that he would 
have his assistant look into it.  Schoeck and NENA maintain that 
they were never notified by pharmacists or family members about 
the need for prior authorization in this case. 
 
Rivera died after suffering a third seizure, on October 29, 
2009.5 
                     
 
5 In June, 2009, after she suffered her first seizure, 
Rivera also began seeing a psychiatrist who diagnosed her with 
bipolar disorder and depression.  The psychiatrist prescribed 
her Lamictal and Celexa for her mood disorders.  Rivera was able 
to fill these prescriptions at her local Walgreens without 
incident.  Two weeks before Rivera's death, the psychiatrist 
lowered the dosage of Lamictal.  According to Correa, in 
September, 2009, while Rivera was hospitalized in Rhode Island, 
Schoeck's assistant told Escobar that Lamictal also was an 
effective treatment for seizures, so even if Rivera could not 
 
11 
 
 
b.  Prior proceedings.  Acting on behalf of Rivera's 
estate, Correa brought this action for wrongful death and 
punitive damages against the defendants, alleging that the 
defendants' negligence caused her daughter's death.  See G. L. 
c. 229, §§ 2, 6.  Walgreens moved for summary judgment on the 
ground that it owed no legal duty to Rivera.  The motion judge 
allowed Walgreens's motion for summary judgment without a 
written decision, and invited Walgreens to file a motion for 
entry of a separate and final judgment. 
 
Correa moved for reconsideration, or, alternatively, for 
entry of a separate and final judgment against Walgreens, and a 
stay of trial, so that she could appeal from the decision.  In 
their opposition to Correa's motion, Schoeck and NENA also 
sought a stay of any accrual of prejudgment interest pending 
Correa's appeal of the allowance of Walgreens's motion for 
summary judgment. 
 
The motion judge issued a written opinion denying the 
request for reconsideration.  In order to facilitate Correa's 
appeal and to prevent duplicative trials, he entered a separate 
and final judgment against Walgreens and stayed the claims 
against Schoeck and NENA.  In addition, the judge stayed the 
accrual of prejudgment interest, opining that, because Schoeck 
                                                                  
obtain Topamax, she would be "fine" if she continued to take 
Lamictal. 
12 
 
and NENA were not responsible for the delay that the stay of 
claims would cause, allowing prejudgment interest to accrue 
during the appeal would result in a windfall to Correa.  Correa 
unsuccessfully moved to alter or amend the judgment.6 
 
On appeal, Correa maintains that Walgreens had a legal duty 
to notify Schoeck of the need for prior authorization or, 
alternatively, that Walgreens voluntarily assumed such a duty.  
She also argues that the motion judge erred in staying the 
accrual of prejudgment interest as to Schoeck and NENA. 
 
2.  Discussion.  a.  Standard of review.  "The standard of 
review of a grant of summary judgment is whether, viewing the 
evidence in the light most favorable to the nonmoving party, all 
material facts have been established and the moving party is 
entitled to a judgment as a matter of law."  Augat, Inc. 
v. Liberty Mut. Ins. Co., 410 Mass. 117, 120 (1991).  We review 
such decisions de novo, and therefore accord no deference to the 
decision of the motion judge.  Chambers v. RDI Logistics, Inc., 
476 Mass. 95, 99 (2016). 
                     
 
6 NENA also sought summary judgment as to the punitive 
damages claim against it on the ground that it could not be 
vicariously liable for punitive damages.  A different motion 
judge denied the motion.  That judge noted that the complaint 
alleged gross negligence, and the record presented a genuine 
issue of material fact whether Schoeck's conduct amounted to 
gross negligence. 
13 
 
 
b.  Duty of care.  To prevail in her wrongful death suit, 
Correa must prove that the defendants were negligent.  Afarian 
v. Massachusetts Elec. Co., 449 Mass. 257, 261 (2007).  The 
elements of a negligence claim are that "the defendant owed the 
plaintiff a duty of reasonable care, that the defendant breached 
this duty, that damage resulted, and that there was a causal 
relation between the breach of the duty and the 
damage."  Jupin v. Kask, 447 Mass. 141, 146 (2006).  At issue 
here is whether Correa can establish a legal duty of care on 
Walgreens's part.  "[T]he existence or nonexistence of a duty is 
a question of law, and is thus an appropriate subject of summary 
judgment."  Id. 
"The concept of 'duty' . . . 'is not sacrosanct in itself, 
but is only an expression of the sum total of . . . 
considerations of policy which lead the law to say that the 
plaintiff is entitled to protection. . . .  No better general 
statement can be made than that the courts will find a duty 
where, in general, reasonable persons would recognize it and 
agree that it exists'" (alterations omitted).  Id., 
quoting Luoni v. Berube, 431 Mass. 729, 735 (2000).  The duty of 
care is derived from "existing social values and customs and 
appropriate social policy."  Jupin, supra at 143, 
quoting Cremins v. Clancy, 415 Mass. 289, 292 (1993).  
14 
 
Accordingly, "imposition of a duty generally responds to changed 
social conditions" (citation omitted).  Jupin, supra at 147. 
In light of the evolving nature of the pharmacist-patient 
relationship, Walgreens's specific knowledge regarding the need 
for prior authorization, the industry-wide customs and practices 
of pharmacies handling prior authorization requests, and the 
foreseeability of the harm to Rivera, we conclude that Walgreens 
owed a limited duty to take reasonable steps to notify both 
Rivera and Schoeck of the need for prior authorization each time 
Rivera tried to fill her prescription. 
i.  Pharmacist-patient relationship.  The pharmacist-
patient relationship is unlike that of a typical store vendor 
and customer.  Pharmacists are no longer "confined to standing 
behind a counter and distributing prescription medications to 
patients," and "now also do many other things.'"  Van Beek, The 
Future for Pharmacists:  Does Physician-Pharmacist Collaborative 
Practice Mean Collaborative Liability?, 36 J. Legal Med. 442, 
444 (2015).  Pharmacists also are particularly well suited to 
"relay critical information back to prescribers" (citation 
omitted).  Id.  See Baker, The OBRA 90 Mandate and Its 
Developing Impact on the Pharmacist's Standard of Care, 44 Drake 
L. Rev. 503, 504 (1996) ("During the 1970s, pharmacists began 
searching for a new role -- one more compatible with their 
education and knowledge.  [They were] [u]nwilling to be 
15 
 
relegated to the simple functions of 'count, pour, lick and 
stick' . . ."). 
In Massachusetts, pharmacists are statutorily obligated to 
take certain steps to identify and prevent medical risks to a 
patient.  General Laws c. 94C, § 21A, requires pharmacists to 
"conduct a prospective drug review before each new prescription 
is dispensed or delivered to a patient or a person acting on 
behalf of such patient."  The corresponding regulations of the 
Board of Registration in Pharmacy specify that the required 
"prospective drug utilization review" includes a "reasonable 
effort" to identify, inter alia, instances of "drug-disease 
contraindication," "incorrect drug dosage or duration of drug 
treatment," and "drug-allergy interactions."  247 Code Mass. 
Regs. § 9.07(2)(a) (2013).  Upon learning of such dangers, "the 
pharmacist shall take appropriate measures to ensure the proper 
care of the patient."  247 Code Mass. Regs. § 9.07(2)(b) (2013).  
The regulations specifically contemplate that this "may include 
consultation with the prescribing practitioner and/or direct 
consultation with the patient."  Id. 
General Laws c. 94C, § 21A, further requires pharmacists to 
"offer to counsel" any patient when the pharmacist fills a new 
prescription, either face-to-face or by telephone, "except when 
the patient's needs or availability require an alternative 
method of counseling."  "For the purposes of medical assistance 
16 
 
and other third party reimbursements or payment programs, any of 
the [aforementioned] methods, or a combination thereof, shall 
constitute an acceptable offer to provide counseling."  Id.  
That these statutes and regulations refer to those obtaining 
prescriptions as "patients" rather than "customers" also 
indicates that the relationship between pharmacist and patient 
goes beyond that of a typical commercial relationship. 
Thus, while pharmacists are not required by law or 
regulation to facilitate prior authorization processes for 
patients, it is evident that they have some role in furthering 
the well-being of their patients, and are well situated to 
assist patients with certain issues regarding their medications. 
ii.  Specific knowledge.7  This court has long recognized 
that pharmacies have a duty to fill prescriptions 
correctly.  Cottam v. CVS Pharmacy, 436 Mass. 316, 320 (2002), 
citing Andreottala v. Gaeta, 260 Mass. 105, 109 (1927), 
and Nesci v. Angelo, 249 Mass. 508, 511 (1924).  See G. L. c. 
94C, § 19 (a) ("The responsibility for the proper prescribing 
                     
 
7 The record before us makes no meaningful distinction 
between "pharmacists" and "pharmacies," and the parties use the 
terms interchangeably.  We conclude that, in the context of 
notifying patients and physicians of the need for prior 
authorization, the duties of pharmacists and pharmacies are 
coextensive.  See generally Cottam v. CVS Pharmacy, 436 Mass. 
316, 320-323 (2002) (using "pharmacist" and "pharmacy" 
interchangeably in finding no duty to warn patients of general 
side effects of medications). 
17 
 
and dispensing of controlled substances shall be upon the 
prescribing practitioner, but a corresponding responsibility 
shall rest with the pharmacist who fills the prescription").  
In Cottam, supra at 320-321, this court held that pharmacists do 
not, however, have a duty to warn patients of general side 
effects of prescription drugs.  The court reasoned that under 
the "learned intermediary doctrine," which traditionally has 
been applied to drug manufacturers, "a prescription drug 
manufacturer's duty to warn of dangers associated with its 
product runs only to the physician; it is the physician's duty 
to warn the ultimate consumer."  Id. at 321, quoting McKee 
v. American Home Prods. Corp., 113 Wash. 2d 701, 709 (1989).  
Thus, "[r]equiring the manufacturer to provide warnings directly 
to the consumer would interfere with the doctor-patient 
relationship."  Cottam, supra.  The court in Cottam extended the 
learned intermediary doctrine to pharmacies, as the reasons 
behind the doctrine applied "with equal force" to 
pharmacies.  Id. at 321-322, citing McKee, supra at 711. 
 
Nonetheless, Cottam left open the possibility that a legal 
duty exists in circumstances where a "pharmacist failed to act 
on specific knowledge that he or she possessed regarding danger 
to a particular customer."  Cottam, supra at 322-323 
(acknowledging that courts in other jurisdictions have imposed 
duties on pharmacies in cases that involve "more than a simple 
18 
 
failure to warn," such as "filling a prescription for what the 
pharmacist knew to be a lethal dose, . . . failing to warn the 
customer when filling two prescriptions that adversely interact 
with one another, . . . and . . . failing to warn the customer 
of the drug's adverse interaction with alcohol where the 
customer was known by the pharmacist to be an alcoholic").8  The 
"modern trend of case law" is that "the learned-intermediary 
doctrine does not insulate a pharmacist from liability when he 
or she has knowledge of a customer-specific risk.  Instead, when 
a pharmacist has such knowledge, the pharmacist has a duty to 
warn the customer or to notify the prescribing doctor of the 
customer-specific risk."  (Footnote omitted.)  See Klasch 
v. Walgreen Co., 127 Nev. 832, 840 (2011).  See also Happel 
v. Wal–Mart Stores, Inc., 199 Ill. 2d 179, 197 (2002) ("we hold 
that a narrow duty to warn exists where, as in the instant case, 
a pharmacy has patient-specific information about drug 
allergies, and knows that the drug being prescribed is 
contraindicated for the individual patient"). 
We consider this "modern trend" instructive.  Given their 
role in patient care, pharmacists are trained and well situated 
to notify patients and physicians when pharmacists have specific 
                     
8 See, e.g., Lasley v. Shrake's Country Club Pharmacy, Inc., 
179 Ariz. 583 (Ct. App. 1994); Horner v. Spalitto, 1 S.W.3d 519 
(Mo. Ct. App. 1999); Hand v. Krakowski, 89 A.D.2d 650 (N.Y. 
1982). 
19 
 
knowledge regarding a risk of harm to a particular customer 
filling a prescription.  Contrary to Walgreens's argument, this 
case is readily distinguishable from the circumstances 
in Cottam, 436 Mass. at 321, where imposing a duty on 
pharmacists to warn patients of general medication side effects 
would have interfered with the doctor-patient relationship.  
Because MassHealth does not notify prescribing physicians of the 
need for prior authorization, pharmacies actually facilitate the 
doctor-patient relationship by notifying the physician of this 
need, and thus helping to ensure that the patient obtains 
insurance coverage for the medication that the doctor wants the 
patient to take.  See Horner v. Spalitto, 1 S.W.3d 519, 523 (Mo. 
Ct. App. 1999) (Pharmacists "are in the best position to contact 
the prescribing physician, to alert the physician about the dose 
and any contraindications relating to other prescriptions the 
customer may be taking as identified by the pharmacy records, 
and to verify that the physician intended such a dose for a 
particular patient.  We do not perceive that this type of risk 
management unduly interferes with the physician-patient 
relationship.  Instead, it should increase the overall quality 
of health care" [footnote omitted]). 
To determine whether the duty to act on specific knowledge 
regarding potential harm to a particular patient extends to 
situations where prior authorization is needed, we turn to the 
20 
 
relevant industry practices, which tend to indicate the expected 
standard of care in the industry. 
iii.  Industry practices.  The Restatement (Second) of 
Torts § 299A (1965) (Restatement) provides that, "[u]nless he 
represents that he has greater or less skill or knowledge, one 
who undertakes to render services in the practice of a 
profession or trade is required to exercise the skill and 
knowledge normally possessed by members of that profession or 
trade in good standing in similar communities."  This principle 
"applies to any person who undertakes to render services to 
another in the practice of a profession, such as that of 
physician or surgeon, dentist, [or] pharmacist . . . ."  Id. at 
§ 299A comment b. 
Walgreens conceded at oral argument that it has a duty to 
notify the patient of the need for prior authorization, but 
maintains that it has no duty to notify the prescribing 
physician.  Correa submitted undisputed evidence in her motion 
for summary judgment, however, that Walgreens pharmacists 
routinely notify patients and prescribers' offices directly of 
the need for prior authorization, and that, according to her 
proffered expert, this practice is typical of the industry.9  
                     
9 Walgreens contends that notifying physicians of the need 
for prior authorization is not part of its practice, and that it 
merely requires employees to notify the customer of the need for 
 
21 
 
Indeed, Schoeck and NENA regularly receive notices of the need 
for prior authorization from pharmacies, and it is rare for them 
to receive notice from a patient.  Walgreens pharmacists are 
even trained to provide such notice, and the computer system 
they use has built-in mechanisms to assist them in doing so. 
The skill and knowledge of pharmacists today involve more 
than the dispensing of pills.  A pharmacist exercising the skill 
and knowledge normally possessed by members of the professional 
community ordinarily would notify a patient and the prescribing 
physician that prior authorization is needed.10 
                                                                  
prior authorization and advise the customer to notify his or her 
physician.  In their depositions, Walgreens employees, in turn, 
characterized their facsimile transmissions and telephone calls 
to prescribing physicians as a mere "courtesy" to their 
customers.  These characterizations are not dispositive.  While 
a duty may be created by a company's internal policies, a legal 
duty also may rest on industry practices and policy 
considerations for an industry as a whole.  See Jupin, 447 Mass. 
at 143, 146-147. 
10 The American Pharmacists Association (APhA) contemplates 
greater pharmacist involvement in the prior authorization 
process, in order to help patients overcome what it considers a 
"barrier[] to patient care."  American Pharmacists Association 
Policy Manual (2017), http://www.pharmacist.com/policy-manual 
[https://perma.cc/JM8Y-8259] (select "Patient/pharmacist 
Relationships" and then "Prior Authorization").  Consistent with 
industry practices, APhA "supports prior authorization programs 
that allow pharmacists to provide the necessary information to 
determine appropriate patient care."  Id.  Indeed, APhA's policy 
manual asserts that "[p]rescription drug benefit plan sponsors 
and administrators should actively seek and integrate the input 
of network pharmacists in the design and operation of prior 
authorization programs."  Id. 
22 
 
 
iv.  Foreseeability.  "[A]s a general principle of tort 
law, every actor has a duty to exercise reasonable care to avoid 
physical harm to others" (footnote omitted).  Jupin, 447 Mass. 
at 147, quoting Remy v. MacDonald, 440 Mass. 675, 677 (2004).  
"A precondition to this duty is, of course, that the risk of 
harm to another be recognizable or foreseeable to the 
actor."  Jupin, supra.  "To the extent that a legal standard 
does exist for determining the existence of a tort duty . . . , 
it is a test of the 'reasonable foreseeability' of the 
harm."  Id., quoting McClurg, Armed and Dangerous:  Tort 
Liability for the Negligent Storage of Firearms, 32 Conn. L. 
Rev. 1189, 1230 (2000). 
If the pharmacist does nothing with the knowledge that 
prior authorization is needed, the patient will not be able to 
obtain insurance coverage for the medication.  This could cause 
foreseeable harm to the patient, who might not otherwise be able 
to pay for potentially life-saving medications, as was the case 
here.  See G. L. c. 118E, § 9 (MassHealth covers persons "whose 
income and resources are insufficient to meet the costs of their 
medical care").  To prevent this harm, the patient must be made 
aware that there is a barrier to obtaining the prescription, and 
that the physician's input is necessary to overcome this 
barrier. 
23 
 
Notice to the patient, however, is insufficient to 
discharge the pharmacy's duty.  It is particularly important in 
these circumstances that the pharmacy also notify the physician 
directly to avoid foreseeable harm.  Correa submitted undisputed 
interrogatory responses that, according to her proffered expert, 
requests that a physician complete a prior authorization form 
are more effective when they come from pharmacies, as opposed to 
patients, in part because much of the information needed, and 
the proper forms and procedures, are known only to pharmacies.  
The expert also asserts that the urgency of requests from a 
patient might be discounted as the patient's unnecessary anxiety 
or oversensitivity, whereas the pharmacy could be viewed as a 
more objective source of information. 
 
Given present pharmacy practices, recognition of this 
limited duty does not place an onerous burden on pharmacies.11  
                     
 
11 This duty will not unduly burden smaller, independent 
pharmacies.  In most instances, those pharmacies, just as 
national chain pharmacies, likely use computers to run their 
businesses.  According to amicus curiae National Association of 
Chain Drug Stores, Inc., ninety-seven per cent of prescriptions 
filled in Massachusetts are paid for by insurance.  Pharmacies 
regularly employ specialized computer systems to navigate the 
numerous health plans available to patients.  See P.D. Fox, AARP 
Public Policy Institute, Prescription Drug Benefits:  Cost 
Management Issues for Medicare, at 22 (Aug. 2000), https:// 
assets.aarp.org/rgcenter/health/2000_09_cost.pdf [https://perma 
.cc/KZ6R-5DBA].  See also ModernMedicine Network, Health 
Information Technology in the Community Pharmacy, Drug Topics 
(Aug. 10, 2016), available at http://drugtopics.modernmedicine 
.com/drug-topics/news/health-information-technology-community-
 
24 
 
Nor does it require pharmacies to monitor or supervise 
prescribing physicians.  As to the latter, Walgreens argues that 
Massachusetts common law does not recognize a duty to control a 
third party's conduct to prevent that person from causing harm 
to another, absent a "special relationship."12  The duty we 
                                                                  
pharmacy [https://perma.cc/RZ4W-GTC4] ("Software programs that 
receive prescriptions and aid in dispensing medications are 
already in wide use in community pharmacies").  To the extent 
that small pharmacies operate without computers, they may use 
telephone or facsimile transmissions to notify prescribing 
physicians that prior authorization is needed. 
 
12 Walgreens's reliance on the Restatement is unavailing.  
The Restatement identifies two main types of special 
relationships that may give rise to legal duties, neither of 
which is applicable here.  First, the Restatement provides that 
 
"[t]here is no duty so to control the conduct of a third 
person as to prevent him from causing physical harm to 
another unless (a) a special relation exists between the 
actor and the third person which imposes a duty upon the 
actor to control the third person's conduct, or (b) a 
special relation exists between the actor and the other 
which gives to the other a right to protection." 
 
Restatement (Second) of Torts § 315 (1965).  This has no 
relevance to the situation here.  Second, "[a]n actor in a 
special relationship with another owes the other a duty of 
reasonable care with regard to risks that arise within the scope 
of the relationship."  Restatement (Third) of Torts:  Liability 
for Physical and Emotional Harm § 40(a) (2012).  These "special 
relationships" include 
 
"(1) a common carrier with its passengers, (2) an innkeeper 
with its guests, (3) a business or other possessor of land 
that holds its premises open to the public with those who 
are lawfully on the premises, (4) an employer with its 
employees who, while at work, are:  (a) in imminent danger; 
or (b) injured or ill and thereby rendered helpless, (5) a 
school with its students, (6) a landlord with its tenants, 
and (7) a custodian with those in its custody, if:  (a) the 
 
25 
 
recognize in this case, however, does not require pharmacies to 
control the actions of prescribing physicians by, for example, 
imposing enforcement mechanisms should a physician fail to 
complete a prior authorization form.  Rather, pharmacies simply 
must take reasonable steps to notify patients and prescribing 
physicians that, if the physician wants a patient to receive 
insurance coverage for the prescribed medication, the physician 
must complete a form.  Additionally, Walgreens's concern that 
recognizing a duty here will expose pharmacies to liability 
every time payment is denied by a health insurer is unfounded.  
Our decision only covers situations where insurance coverage is 
denied specifically because a prior authorization form is 
required.  Pharmacies can protect themselves from liability in 
these instances simply by notifying the patient and prescribing 
physician by any reasonable means, and making a contemporaneous 
record of having done so. 
 
We decline to hold, as Correa requests, that pharmacies are 
obliged to follow up with the prescribing physician until they 
are certain that the physician received and will act upon the 
request for prior authorization.  A patient may decide at any 
                                                                  
custodian is required by law to take custody or voluntarily 
takes custody of the other; and (b) the custodian has a 
superior ability to protect the other." 
 
Id. at § 40(b).  This provision is also inapplicable. 
26 
 
point to take the prescription to a different pharmacy, so the 
first pharmacy cannot assume that silence on the part of the 
prescribing physician means that the physician has not received 
the notice.  To require the pharmacist to make repeated 
inquiries could also run afoul of the court's holding in Cottam, 
436 Mass. at 321-322; a physician may decline to provide the 
prior authorization form for numerous reasons not known to the 
pharmacy. 
 
In sum, Walgreens owed a legal duty of care to take 
reasonable steps to notify both Rivera and her prescribing 
physician of the need for prior authorization each time Rivera 
tried to fill her prescription, but its duty extends no 
further.13 
 
c.  Accrual of prejudgment interest.  General Laws c. 229, 
§ 11, provides that "[i]n any civil action in which a verdict is 
given or a finding made for pecuniary damages for the death, 
with or without conscious suffering, of any person, whether or 
not such person was in the employment of the defendant against 
                     
 
13 Correa argues, in the alternative, that Walgreens 
voluntarily assumed a duty to notify Schoeck by assuring Rivera 
and her family that Walgreens's pharmacists would contact 
him.  Voluntary assumption of a duty is a fact-specific inquiry, 
based on "the totality of the pharmacy's communications with the 
patient and the patient's reasonable understanding, based on 
those communications, of what the pharmacy has undertaken to 
provide."  Cottam, 436 Mass. at 326.  In light of our holding, 
we do not consider Correa's alternative argument. 
27 
 
whom the verdict is rendered or finding made, there shall be 
added by the clerk of the court to the amount of the damages 
interest thereon."  This court previously has instructed that 
G. L. c. 229, § 11, must guide decisions with respect to 
prejudgment interest for wrongful death suits.  Turcotte 
v. DeWitt, 333 Mass. 389, 392 (1955).  As Correa points out, the 
statutory language indicates that accrual of interest is 
mandatory, rather than discretionary.  See G. L. c. 229, § 11 
(interest "shall be added"); Retirement Bd. of Stoneham 
v. Contributory Retirement Appeal Bd., 476 Mass. 130, 138 
(2016), quoting Hashimi v. Kalil, 388 Mass. 607, 609 (1983) 
("The word 'shall' is ordinarily interpreted as having a 
mandatory or imperative obligation"). 
 
Notwithstanding this language, Schoeck and NENA point to 
cases from other contexts in which this court has explained that 
the decision to award or limit prejudgment interest requires 
"balancing equities."  USM Corp. v. Marson Festener Corp., 392 
Mass. 334, 350 (1984).  Such balancing, however, was intended to 
prevent a plaintiff from obtaining an undeserved windfall.  See, 
e.g., St. Paul Surplus Lines Ins. Co. v. Feingold & Feingold 
Ins. Agency, Inc., 427 Mass. 372, 377 (1998) (prejudgment 
interest should not run from commencement of action because "the 
fact that no loss was incurred until after an action was 
commenced should be recognized, as a matter of fairness, in 
28 
 
order to avoid giving a party an undeserved windfall"); USM 
Corp., supra at 348 (prejudgment interest not appropriate in 
trade secret misappropriation action because, unlike typical 
tort action, "monetary award based on the defendants' profits is 
not designed to make the plaintiff whole and because . . . the 
defendants' monetary gain accrued after the commencement of 
[the] action").  Similarly, an award of prejudgment interest has 
been denied where the plaintiff unjustifiably delayed the 
progression of a case.  See Peters v. Wallach, 366 Mass. 622, 
629 (1975) (delay caused by plaintiffs' repudiation of 
settlement agreement they had previously accepted); Currier 
v. Malden Redev. Auth., 16 Mass. App. Ct. 906, 907 (1983) ("a 
judge has the discretion to adjust an award of interest where a 
litigant has been responsible for an unnecessary delay"); Whaler 
Motor Inn, Inc. v. Freedman, 9 Mass. App. Ct. 884, 885 (1980) 
(delay resulted from "plaintiff's pursuit of [an] untenable 
position"). 
 
Such concerns are not present here.  While Schoeck and NENA 
are not responsible for the delay in this case, Correa's desire 
to pursue an immediate appeal from the judgment in favor of 
Walgreens did not afford her a tactical advantage.  Indeed, the 
motion judge decided to stay the claims against Schoeck and NENA 
in the interests of "judicial economy," realizing that, if 
Schoeck and NENA proceeded to trial, and Correa then succeeded 
29 
 
in her appeal concerning the claims against Walgreens, the 
matter would be remanded for trial against Walgreens, resulting 
in considerable duplication of effort.  If Correa were to 
prevail against Schoeck and NENA, interest accrued during the 
appeal simply would compensate her for the loss of the use of 
the money awarded during the course of the proceedings.  
See Conway v. Electro Switch Corp., 402 Mass. 385, 390 (1988) 
(prejudgment interest intended to "compensate a damaged party 
for the loss of use or the unlawful detention of money" 
[emphasis added]).  Accordingly, it was error to stay the 
accrual of prejudgment interest in this case. 
 
3.  Conclusion.  The allowance of Walgreens's motion for 
summary judgment is reversed, and the stay of the accrual of 
prejudgment interest is vacated.  The matter is remanded to the 
Superior Court for further proceedings consistent with this 
opinion. 
 
 
 
 
 
 
 
So ordered. 
 
 
LOWY, J. (dissenting).  A systemic flaw contributed to the 
tragic death of a young woman who was deprived of vital 
medication because her pharmacy was unable to obtain a prior 
authorization form from her prescribing physician as required by 
her insurer.  In an understandable attempt to address this flaw, 
the court now imposes a nebulous duty on pharmacies to inform 
physicians that a prior authorization is required for certain 
medications in order to secure insurance coverage.  This duty 
requires pharmacies to take "reasonable steps" to notify both 
the patient and the prescribing physician that a prior 
authorization is required each time the patient tries to fill 
the prescription, with no real guidance concerning what 
constitutes reasonable steps. 
 
I agree with the court that pharmacists have a duty to take 
reasonable steps to notify patients of the need for prior 
authorization every time the patient tries to fill a 
prescription.  I disagree, however, with the court's conclusion 
that pharmacists have a duty to notify the prescribing physician 
of the need for prior authorization every time the patient 
attempts to fill a prescription.  Imposing such a duty is 
neither implied by contract, mandated by statute, nor -- until 
today -- recognized by common law. 
 
The court's desire to improve patient safety and avoid the 
tragic results that occurred in this case is beyond question, 
2 
 
but I am troubled that imposing a tepid duty on pharmacies that 
have no ability to control the system while simultaneously 
dissipating the personal responsibility of health insurers, 
physicians, and patients within the existing system will have an 
adverse effect on patient safety. 
 
The pharmacy is not the entity that requires the prior 
authorization, nor does it have the legal authority to provide 
it.  The pharmacy is a conduit because the pharmacy submits 
insurance claims for coverage.  Nonetheless, the court's 
decision saddles pharmacies with the legal duty to inform 
physicians' offices that prior authorization is required.  The 
rule announced today dissipates the legal accountability and 
personal responsibility of health insurers and physicians and 
gives patients a false sense of security, all while imposing a 
legal duty on an entity that may not actually be in the best 
position to help avoid the harms that occurred in this case.1 
 
It appears that many pharmacies have attempted to fill this 
disconnect between the providers prescribing the medications and 
                     
 
1 The prescribing physician also has a duty to provide the 
prior authorization when doing so is required by the standard of 
care.  The duty imposed by the court may, in certain 
circumstances, blur that duty.  Indeed, Carmen Correa argues 
that in addition to the negligence of Walgreen Eastern Co., 
Inc., and Dr. Andreas P. Schoeck, their combined negligence 
resulted in the prior authorization never being submitted to 
MassHealth. 
3 
 
the insurance companies requiring the prior authorizations.  I 
expect that this is good business practice and the right thing 
to do.  The court's opinion, however, runs contrary to well-
established principles of tort law because it imposes a legal 
duty on a party without the control or means to avoid the risk 
and resulting harm.  A system that allows health insurers to 
detach themselves from both the patient and the provider, while 
fostering a false sense of security among patients, cannot be 
salvaged by requiring pharmacists to send a single facsimile 
message or leave a lone telephone message in potentially 
unmonitored voicemail at a health care provider's office. 
Is leaving a voicemail message in the physician's answering 
service enough?  How many telephone calls are enough?  Will this 
duty evolve to require the pharmacy to confirm receipt of the 
message?  Will the pharmacist also have to inform the health 
insurer that the physician has yet to provide the prior 
authorization form?  What must the pharmacist say to the patient 
who is without medication and awaiting the prior authorization?  
Will patients be lulled into a false sense of security and 
potentially dissuaded from following up with their physician to 
demand that the prior authorization be completed?  Will every 
pharmacy in the Commonwealth, regardless of the resources 
available to them, need to create a document retention system to 
memorialize each attempt to notify a health care provider and to 
4 
 
memorialize the nature of the health care provider's office's 
response?  Will independent pharmacies be able to create such 
systems and remain in business?  Will those pharmacies that 
implement the most thorough process and train their pharmacists 
to be assiduous and conscientious in seeking to obtain prior 
authorization expose themselves to enhanced liability when they 
fail to obtain prior authorization?  Will the court's opinion 
enable physicians and health insurers to delegate a portion of 
their responsibilities to pharmacies to the detriment of 
patients?  I respectfully dissent.