Opinion ID: 1714104
Heading Depth: 2
Heading Rank: 1

Heading: whether grant of summary judgment to winndixie was appropriate.

Text: ¶ 18. The Moores claim that the circuit court's characterization of a pharmacist's scope of duty (that a pharmacist must only provide the right drug in the correct dosage) was so narrow that it did not permit consideration of whether the pharmacist's conduct was reasonable under circumstances where certain information which contraindicated the dispensation of the medication was known or reasonably should have been known by the pharmacist. They claim that Winn-Dixie knew or should have known, that Daisy was pregnant and that Diovan should not have been dispensed to a pregnant woman and that it should have taken steps to insure that an improper combination of medications did not result from Daisy's various prescriptions. ¶ 19. We affirm the circuit court's findings and extend the learned intermediary doctrine to pharmacists. As one court has stated, the cornerstone of the learned intermediary doctrine is the ability of the physician to intervene between the drug and the patient, and to make an informed decision as to the course of treatment based on the physician's knowledge of the drug as well as the propensities of the patient. Gather, 753 F.Supp. at 639. The physician is best situated to know the propensities of a drug and to know the needs and characteristics of his patient. ¶ 20. In a case similar to the one at bar, the United States District Court for the Eastern District of Pennsylvania found that parents of a child who was born with deformities as the result of a medication taken by its mother during pregnancy did not have a cause of action against the pharmacist who dispensed the drug because, under the learned intermediary doctrine, the pharmacist had no legal duty to warn the mother of hazards associated with taking a certain medication during pregnancy. Ramirez v. Richardson-Merrell, Inc., 628 F.Supp. 85, 87-88 (E.D.Pa. 1986). The court reasoned: Under Pennsylvania law, where the drug in issue is available only by prescription, the warning required is not to the general public or to the patient, but to the prescribing physician. The manufacturer of the drug satisfies any duty it has by providing proper warnings to the prescribing physicians. It would be illogical and unreasonable to impose a greater duty on the pharmacist or druggist who properly fills the prescription than is imposed on the manufacturer. To impose a duty to warn on the pharmacist would be to place the pharmacist between the physician, who having prescribed the drug presumably knows the patient's present condition as well as his or her complete medical history, and the patient. Such interference in the patient-physician relationship can only do more harm than good. The point that must be emphasized is that the drug sold by defendant Queen Pharmacy was a prescription drug. The weighing of benefits of medication against potential dangers that are associated with it, which is the basis of the prescription drug system, requires an individualized medical judgment which only the physician can provide. Id. at 87-88. See also Coyle v. Richardson-Merrell, Inc., 526 Pa. 208, 584 A.2d 1383, 1385-86 (1991) (The physician has the duty to be fully aware of (1) the characteristics of the drug he is prescribing, (2) the amount of the drug which can be safely administered, and (3) the different medications the patient is taking. The physician also has the duty to advise the patient of any dangers or side effects associated with the use of the drug.). ¶ 21. Other courts have held that the learned intermediary doctrine should be extended to pharmacists and that pharmacists owe no legal duty to warn in the context of prescription medication: See Mazur v. Merck & Co., 964 F.2d 1348, 1356 (3d Cir.1992) (applying Pennsylvania law) (The physician has superior knowledge and is required to balance the risks of the drug against its utility in light of the patient's medical history); Johnson v. Walgreen Co., 675 So.2d 1036, 1037 (Fla. Dist.Ct.App.1996) (affirming dismissal of complaint on the grounds that a Florida pharmacist's sole duty is to accurately and properly fill all lawful prescriptions presented); Walker v. Jack Eckerd Corp., 209 Ga.App. 517, 434 S.E.2d 63, 67 (1993) (Pharmacist has no duty to warn customer or notify physician that drug is being prescribed in dangerous amounts, that customer is being overmedicated, or that various drugs in their prescribed quantities could cause adverse reactions to customer.); Fakhouri v. K Mart Corp., 248 Ill. App.3d 328, 187 Ill.Dec. 927, 618 N.E.2d 518, 521 (1993) (Only the patient's physician can provided the individualized medical judgment to determine which medication should be utilized in any given case.); Nichols v. Central Merch., Inc., 16 Kan.App.2d 65, 817 P.2d 1131, 1133 (1991) (Under learned intermediary doctrine adopted by Kansas courts, pharmacy and its pharmacist owed no duty to warn customer of potential side effects of drug prescribed by pregnant patient's treating physician.); Kinney v. Hutchinson, 449 So.2d 696, 698 (La.Ct.App.1984) (A pharmacist has no duty to warn of adverse effects and that duty is placed on the prescribing physician as the informed intermediary between the manufacturer and the patient.); Adkins v. Mong, 168 Mich.App. 726, 425 N.W.2d 151, 152 (1988) (A pharmacist owes no duty to warn customer of potential side effects of substance dispensed in accordance with valid prescription or to monitor and intervene with customer's use of medication prescribed by licensed treating physician.); Ferguson v. Williams, 101 N.C.App. 265, 399 S.E.2d 389, 393 (1991) (Pharmacist who properly fills prescription as written by physician is under no duty to warn customer about potential risks or dangers associated with taking medication.); Griffith v. Blatt, 158 Or.App. 204, 973 P.2d 385, 390 (1999) (Learned intermediary doctrine extended to pharmacists); Morgan v. Wal-Mart Stores, Inc., 30 S.W.3d 455, 469 (Tex.Ct.App.2000) (Pharmacists are not legally obligated to warn patients of potential adverse reactions or dangerous side effects); McKee v. American Home Prods. Corp., 113 Wash.2d 701, 782 P.2d 1045, 1050 (1989) (Only the physician can relate the propensities of the drug to the idiosyncrasies of the patient). ¶ 22. An exception to the learned intermediary doctrine, as applied to pharmacists, exists where it was undisputed that a plaintiff had informed the pharmacy of health problems which contraindicated the use of the drug in question. Happel v. Wal-Mart Stores, Inc., 316 Ill.App.3d 621, 250 Ill.Dec. 28, 737 N.E.2d 650 (2000); Hand v. Krakowski, 89 A.D.2d 650, 453 N.Y.S.2d 121 (N.Y.App.Div.1982). In the case at bar, there is absolutely no evidence that Winn-Dixie's dispensing pharmacist knew of Daisy's pregnancy when the prescription for Diovan was filled. ¶ 23. Another exception exists where pharmacists fill prescriptions in quantities inconsistent with the recommended dosage guidelines. Lasley v. Shrake's Country Club Pharmacy, Inc., 179 Ariz. 583, 880 P.2d 1129 (1994); Hooks SuperX, Inc. v. McLaughlin, 642 N.E.2d 514 (Ind.1994); Horner v. Spalitto, 1 S.W.3d 519 (Mo.Ct. App.1999); Riff v. Morgan Pharmacy, 353 Pa.Super. 21, 508 A.2d 1247 (1986); Dooley v. Everett, 805 S.W.2d 380 (Tenn.Ct.App. 1990). Here, however, it is undisputed that the dosage prescribed for the Diovan was not excessive and that Winn-Dixie properly filled the prescription. ¶ 24. The Moores claim that summary judgment for Winn Dixie was inappropriate because it violated the State Board of Pharmacy's internal regulations. The State Board of Pharmacy is an administrative agency which governs the conduct of pharmacies within the State. See Miss. Code Ann. §§ 73-21-71 to -123 (2000 & Supp.2002). A violation of one of its internal regulations, which may serve as evidence of negligence, does not, however, create a separate cause of action. The regulations do not establish a legal duty of care to be applied in a civil action. See Morgan, 30 S.W.3d at 466-67 (no private right of action or independent duty of care was created by State Pharmacy Act and regulations). See also Johnson v. Walgreen Co., 675 So.2d 1036 (Fla.Dist.Ct.App. 1996). ¶ 25. We therefore extend the learned intermediary doctrine to pharmacists and affirm the grant of summary judgment to Winn-Dixie.