Off the subject of Thanksgiving, a recent decision by the Nevada Supreme Court has caught my eye.

It has to do with a lawsuit against Walgreen's where a pharmacist filled a prescription for a sulfa drug even though the patient's information was flagged to indicate she had an allergy to sulfa drugs.

Before you decide the pharmacy was totally wrong, read on. The 86-year old patient's doctor thought the sulfa drug would be the best treatment for her urinary tract infection, and she decided that's what she wanted. She thought she might have had an adverse reaction to sulfa drugs sometime in her dim past, but didn't think it was all that bad so the doctor gave her the prescription and she took it to Walgreens to be filled.

"When Klasch's (the 86 year-old woman) caregiver picked it up, a pharmacy employee told her the prescription had been "flagged" by the computer system because Klasch's patient profile also noted her sulfa allergy.

An employee then called Klasch, who said she had taken Bactrim in the past and had no adverse reactions. The pharmacist then overrode the computer system's warning and filled the prescription with a generic form of the drug, according to court records.

Later that day, Klasch complained of feeling "itchy." She was taken to the emergency room the next day where she was diagnosed with Stevens-Johnson Syndrome/toxic epidermal necrosis -- a reaction that causes "blistering of the mucous membranes ... and patchy areas of rash, followed by the entire top layer of skin ... peeling off in sheets from large areas of the body," according to expert testimony in the case.

Klasch was taken to the burn unit at University Medical Center, where she lapsed into a coma and died with burns covering 40 percent to 50 percent of her body, according to court documents.

"In lay terms, Helen's skin was chemically cooked off of her body from the inside," her lawyers wrote in appeal documents."

Here is the Nevada Supreme Court decision:

"We conclude that when a pharmacist has knowledge of customer-specific risk with respect to a prescribed medication, the pharmacist has a duty to exercise reasonable care in warning the customer or notifying the prescribing doctor of the risk," the court said.

I really thought pharmacies were already doing that, and it sounded like Walgreens did that in this case.

There is a legal doctrine that says the pharmacist can warn the doctor and patient, but can't override the doctor's orders and thereby get between the doctor and patient. Based on that, a lower court ruled in favor of Walgreens.

"But the high court said that while pharmacists have no duty to warn of prescribed medication's generalized risks, the doctrine "does not foreclose a pharmacist's potential for liability when the pharmacist has knowledge of a customer-specific risk." "

So in other words, according to the highest court in the state of Nevada (which to me is equivalent to a decision from a bunch of circus clowns), even though your doctor in his professional wisdom has decided to prescribe a healing medication for you, and you say you want to take it because you have decided it is safe to do so, it is possible that the pharmacy will not fill it because they don't want to be found liable when sued.

Of course in this case it would have been better if they had refused to fill the prescription, but it sure sounds to me like the patient and her doctor thought they had it all figured out and would have been angry at the refusal.

Read the article for yourself

Wondering about the doctor who prescribed this? He was also sued and settled out of court with the patient's family.