My apologies for not having posted here for awhile – I’ve been sidelined with either a minor flu or bad cold. Not a big deal; worse things can happen to people.
As the story behind today’s post makes very clear. This is the story of a very promising young student attending Harvard University, where he was embarking on a career toward medical school, and who showed all the promise that one could ask for. Tragically, that promise was cut short when the student, John Edwards of Wellesley, aged 19, committed suicide on November 29 2007. This past week, his parents filed a wrongful death suit against Harvard University, alleging that Edwards received substandard care from the University’s Health Services, which caused or contributed to his suicide.
Edwards originally sought help at the college’s health services office, because he reported that he was unable to study or concentrate for long periods of time. A nurse practitioner at the school’s infirmary prescribed Edwards “Adderall“, which is a drug that is designed to treat attention deficit hyperactivity disorder (“ADHD”, as it’s sometimes referred to.) In what I as a Massachusetts medical malpractice lawyer find surprising to say the least, the nurse prescribed this drug, even though Edwards had never been diagnosed with this condition. Some time afterward, when Edwards complained of anxiety and depression, the nurse practitioner also prescribed Edwards two additional medications: Prozac and Wellbutrin, which of course are powerful antidepressants. An important element in all this, is that Edwards was already taking another medication to treat acne, Accutane, and this drug is been widely linked to generating suicidal thoughts in patients who take it.
A few weeks after Edwards was taking both Prozac and Wellbutrin, he emailed this nurse practitioner that he was experiencing increased anxiety, and asked whether his medications should be changed. The nurse practitioner reportedly replied by email that she was concerned over this report, and requested that Edwards come back in to see her. Two days later, Edwards committed suicide by suffocating himself with a plastic bag, in a bathroom at Harvard Medical School. This wrongful death suit, filed by Edwards’ father John B. Edwards II of Wellesley, alleges gross negligence by the nurse practitioner, Marianne Cannon, and also alleges gross negligence on the part of Dr. Georgia Ede, who was Cannon’s supervisor at Harvard’s University Health Services Department. The suit also names Harvard University as a defendant.
A tragic outcome, anyone would say. But why sue these two individuals and Harvard University? What, if anything, did they do wrong?
Two principal legal reasons answer that question: 1) The supervising physician in this matter was responsible for overseeing all of the nurse practitioner’s professional actions – and it appears that she may not have done so. A nurse practitioner is not a physician; is not a psychiatrist, and is not a mental health professional. While nurse practitioners are talented professionals and are authorized to write prescriptions, it does not appear (from what I am aware of) that this nurse practitioner was qualified to be medically treating a patient with two powerful antidepressant, psychoactive medications – especially without requiring that the patient undergo simultaneous psychotherapy with a psychologist or qualified mental health counselor. The supervising physician in this case should have been closely, directly involved with this patient’s care, overseeing all of this nurse practitioner’s actions in the care of this patient. 2) It is well known among the medical profession that the US Food and Drug Administration (FDA) has warned that anyone taking Accutane, Prozac, or Wellbutrin should be monitored closely for suicidal thoughts. Despite these warnings, it does not presently appear that any such steps were taken to monitor Edwards.
I’ll explain the legal implications of these two allegations, in my next post.