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Torts Keyed to Franklin
Zuchowicz v. United States
Citation:140 F.3d 381 (2d Cir. 1998)
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Doctors and pharmacists at a naval hospital prescribed Mrs. Zuchowicz a drug called Danocrine to treat her endometriosis (a disease found in the uterus). The doctors prescribed Mrs. Zuchowicz double the maximum authorized dosage of Danocrine for one month and then the maximum authorized dosage for two months after that. They then directed her to stop taking Danocrine.
Four months later, Mrs. Zuchowicz—a healthy, active woman with no history of cardiovascular problems—was diagnosed with a fatal heart disease called primary pulmonary hypertension, resulting in weight gain, swelling of hands and feet, fatigue, and shortness of breath. The disease is extremely rare, occurs predominantly in young women, and can be caused by select other exogenous agents, such as birth control pills or appetite suppressants.
The disease was worsened by her new pregnancy, and it also made her ineligible for a lung transplant. One month after Ms. Zuchowicz gave birth, she died. Her husband sued on behalf of her estate.
At trial, Dr. D’Mowski, one of Mrs. Zuchowicz’s expert witnesses, testified that Danocrine was safe and effective when properly used but that very few women had received doses in this high of a setting. Because no formal studies of excess doses had been conducted, Mrs. Zuchowicz was unable to provide epidemiological or anecdotal evidence linking the disease to Danocrine overdoses. Therefore, her case rested primarily on the testimony of two expert witnesses in pulmonary diseases and pharmacology respectively.
Dr. Matthay, the pulmonary disease expert witness, considered a detailed history of the progression of Mrs. Zuchowicz’s disease, her medical history, and the timing of the Danocrine overdose and her symptoms. He testified that he was confident to a reasonable medical certainty that the Danocrine caused Mrs. Zuchowicz’s disease. While he could not rule out all other possible causes of pulmonary hypertension generally, he did rule out causes of secondary pulmonary hypertension, as well as drug-related causes of primary pulmonary hypertension.
Dr. Tackett, the pharmacology expert witness, testified that, to a reasonable degree of scientific certainty, he believed that the overdose of Danocrine more likely than not produced hormonal factors to cause Mrs. Zuchowicz’s disease.
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