The court confirmed that a pharmacist owes a duty of care to discuss potential side effects when dispensing drugs that are new to a patient, and this duty exists regardless of whether the patient received the same information from another source.
However, even if a pharmacist breached this duty, it doesn’t mean that liability will be found against the pharmacist. In this recent decision, the court concluded that the pharmacist warned the plaintiff about the drowsiness side-effects of Oxazepam used to treat narcotic withdrawal, such that there was no breach of duty of care, however, even if the pharmacist did not provide this warning, the plaintiff would have lost the case in any event because there was insufficient evidence that the one pill caused the plaintiff to drive his car across the center line and into a tractor trailer.
As the court said, the evidence only reached the standard of a possibility: the plaintiff had to establish that “but for” the pill consumption, the car accident would not have occurred. Given the evidence that the plaintiff may have used Oxazepam previously and driven without incident, along with the fact that it was a very low dosage that was apt to cause only minimal impairment, coupled with the fact that the plaintiff had a history of insomnia, the court was not satisfied with the alleged direct connection between the pill usage and the subsequent accident.
For the sake of completeness, the court did provide a summary of the standard of care to be used by a community-based pharmacist such as the defendant in this case, which was as follows:
- The pharmacist must provide verbal counselling for “new” medications, to highlight the risks and side effects;
- On subsequent “renewals”, the pharmacist is to make an inquiry regarding the use of the medication, primarily to ascertain whether there has been any problems with the drug usage;
- The new medication counselling should involve the following topics, and the pharmacist should initial the hard copy of the prescription to confirm the counselling was provided, or alternatively offered and declined by the patient:
- ask the patient his/her understanding of the purpose of the medication;
- provide the reason for it and the intended results;
- review the physician’s directions as to use, such as quantity, time of day and if with meals;
- advise as to possible side effects, such as drowsiness, and to consult physician if experience problems;
- provide particular cautions regarding risks when required, including operating a motor vehicle, consuming alcohol and using other medications;
- inquire if there are questions.
- The standard of care does not require warning labels to be placed on the pill vial by the pharmacist. Nor are written information reports about the medication needed. Only verbal counselling is mandatory.
D’Aoust v. Youssef et al, 2022 ONSC 1872
https://www.canlii.org/en/on/onsc/doc/2022/2022onsc1872/2022onsc1872.html