Learned intermediary doctrine protects pharmacy from having to alert customer of dangerous drug interaction

While some jurisdictions are adopting the learned intermediary doctrine (here) and others are abandoning it (here), the Illinois Court of Appeals has just issued a short but interesting case on the issue of whether the learned intermediary doctrine relieves a pharmacy from a duty to warn a customer of a potential drug interaction.

As you probably know, the learned intermediary doctrine provides that manufacturers of prescription drugs do not have duty to warn consumers directly of the risks involved in using prescription drugs because they can rely on the physicians who prescribe them to do so. In Illinois, the doctrine has for a long time, and with only one exception, been applied to exempt pharmacies and pharmacists from liability for failing to give warnings to patients. Part of the reasoning for extending the use of the doctrine in this manner is to prevent the pharmacist from second guessing the physician -- who the doctrine assumes is the best qualified and best positioned person to determine what is best for the patient -- and thus to prevent having the pharmacist interfere with the doctor-patient relationship.

The new case decided by the Illinois Court of Appeals is called DiGiovanni v. Albertson's Inc and it is availble here. In it, the court follows the long standing rule in the state that recognizes the protection provided by the learned intermediary doctrine for pharmacists. Given the long standing approach on the issue in the state and given the specific facts of the case, the case is correctly decided, but I have some mixed feelings about it.

As I have commented before (here), it may be time to revisit the whole LID doctrine to begin with. And, I believe it is unnecessary to apply it to pharmacists. I do not see a problem in holding pharmacists to the same standard of care that we hold everyone else. They should act like reasonable people under the circumstances. If they do, there will be no liability. The result in this case would have been the same had we applied that simple rule.

 The facts were clear that the pharmacist acted reasonably. The record indicates that the pharmacist called the physician prior to filling the prescription regarding the potential interaction, and the physician indicated that he would monitor the patient. Under those circumstances, the pharmacist was reasonable in relying on the expertise of the doctor. Perhaps the pharmacist could have told the patient to check with his doctor about the possible drug interaction too, but I am not sure that we can say that - under the circumstances - failing to do so should result in liability.

I guess my point is that the main concern here should be to develop a doctrine that seeks to provide the consumer with more protection. If it requires that pharmacists use their expertise by double checking with the doctor or telling the patient do double check with the doctor before exposing the patient to a known risk, so be it. The burden on the pharmacist to make a phone call or give a word of warning to a customer seems well worth it to me.