A Boy Received An Overdose Of High-Blood-Pressure Drug. A Suffolk County jury yesterday awarded $7.1 million in damages to the family of Joey Rice, a 4-year-old Newton boy who, as a premature infant, received a massive overdose of a high-blood-pressure drug after pharmacists at Children’s Hospital in Boston failed to dilute an adult medication.
The boy’s parents, Christopher and Kathleen Rice, argued in court that the overdose triggered brain damage that left their son mentally retarded and suffering from cerebral palsy and seizures. The defendants, three former employees of the hospital pharmacy, contended that Joey’s brain damage resulted from complications of his premature birth, not from their mistake.
Hospital Was Not Sued
Children’s Hospital, which was not sued but whose insurers aided in the defense, issued a statement yesterday saying it was ”disappointed” in the verdict. ”Joseph Rice was an extraordinarily sick child from birth. We believe the medical evidence clearly showed that the child’s neurological damage preexisted the administration of the medication,” the statement said.
The Rices, reached at home yesterday, declined comment. But in the past, they have expressed frustration over a different aspect of their son’s care. In 2000, three years after the birth of Joey and his healthy twin, Angelo, they won a noisy public battle with their insurer, Blue Choice, over funding for a respirator so Joey could go home from Franciscan Children’s Hospital and Rehabilitation Center in Brighton, where he was moved from Children’s.
”My husband and I fooled ourselves into thinking that because we are well-educated, middle-class, and pay taxes and health insurance premiums, we could make the system work for Joey,” Kathleen Rice told the Globe in 1999, after the insurer initially declined funding.
The defendants, pharmacy technician Margarita Pagan, pharmacist Phu Duthinh, and pharmacy supervisor Francesco Federico, could not be reached yesterday, nor could their lawyers.
In a 1997 investigation, the state Department of Public Health blamed the prescription mistake on ”lack of attentiveness” by Pagan, who told officials she did not know the medication had to be diluted, and Duthinh, who mistakenly initialed a document saying the dose was correct.
”That kind of error scared me to death,” Duthinh told investigators. ”I let the error slip out of the pharmacy; I accept the blame.”
Public health officials did not fault the hospital, which responded by changing the labels on the medication involved to better alert staff that it must be diluted for children.
The mistake occurred on March 15, 1997. According to state records, doctors prescribed a drug called Enalaprilat for Joey’s high blood pressure. Pagan prepared the dose, and Duthinh initialed it without noticing that the medication had not been diluted. A nurse administered it, believing she had given the 6-microgram dose required for the 3-month old baby. In fact, the dose had 750 micrograms, more than 100 times the proper amount.
An hour later, staff noticed a drop in the baby’s blood pressure and tried to stabilize it.
The Rices’ lawyers, Kenneth Margolin and Charles Capace, argued that Federico failed to properly train and supervise Pagan and Duthinh. They did not name the hospital as a defendant, but that may partially reflect legal limits on the damages they could win. Under Massachusetts law, nonprofit institutions such as Children’s cannot be held liable for more than $20,000 per case.