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$2.7M Verdict against Doctor Who Prescribed Toxic Drug Combination

x-ray view of a person with lung disease
Interstitial lung disease causes scarring of the lung tissue.

An Ohio jury ordered a doctor to pay a $2.7 million verdict for prescribing a toxic mix of arthritis medications and then failing to notify her about the resulting terminal lung disease.

The jury in Cleveland has returned the verdict in favor of Debbie Neifer – a wife, mother and waitress at a Cleveland-area Friendly’s restaurant. “The jury sent a strong message about a patient’s right to be informed and a physician’s duty of care,” says medical malpractice attorney Peter H. Weinberger of Spangenberg Shibley & Liber in Cleveland, OH. “The horrific injuries suffered by Mrs. Neifer that ultimately led to her death a month after the verdict could have been avoided had her doctor exercised the appropriate standard of care. This close, loving family has been irreparably harmed by this tragedy.” Weinberger is a member of The National Trial Lawyers.

Debbie Neifer sought treatment in March 2006 with Dr. Carlos Zevallos for her rheumatoid arthritis. He increased her dosage of Methotrexate, a commonly-prescribed anti-rheumatic drug known as Rheumatrex or Trexall, which her primary care physician had prescribed. He also ordered a chest X-ray, which was clear, showing no pulmonary disease.

She returned to Dr. Zevallos in 2010, when he decided to supplement the Methotrexate she was taking with the drug Leflunomide, commonly known as Arava.  When taken together, the drugs have the potential to cause severe lung disease, especially in patients like Mrs. Neifer.  Notwithstanding that risk, Dr. Zevallos added the Leflunomide and did not order tests to evaluate her lungs.

A crackling sound in her lungs

Just seven months later, at a regularly-scheduled appointment, Dr. Zevallos heard crackling in Mrs. Neifer’s lungs during a routine office visit.  Dr. Zevallos sent her for a chest X-ray. The following day, Dr. Zevallos received the X-ray results with comments from the radiologist indicating possible lung disease. In fact, had further testing been done at that time, it would have been discovered that Mrs. Neifer was now suffering from interstitial lung disease, which causes progressive scarring of lung tissue. The condition is a known risk of combing Methotrexate and Leflunomide.

However, Dr. Zevallos did nothing to follow up on the X-ray and further and failed to inform Mrs. Neifer of the abnormal X-ray result, preventing her from appropriately participating in decisions regarding any future course of treatment.  Dr. Zevallos merely filed the X-ray report in her chart and continue to prescribe Methotrexate and Leflunomide.

In June 2011 -- nine months after the abnormal chest X-ray – Mrs. Neifer was having trouble breathing and was rushed to the emergency room. She learned then that she had developed terminal lung disease, caused by the drug combination. She spent months in the hospital, away from her family, unable to work. She moved to a nursing home, where she was confined to a wheelchair, requiring an increasing supply of external oxygen in order to breath. A month after the verdict, on January 18, 2014, Mrs. Neifer passed away from her injuries, leaving behind her husband Mark and son Michael.

Mrs. Neifer incurred medical bills in excess of $650,000.   She was totally and permanently disabled and required around-the-clock care and oxygen treatment before she died.   The jury awarded her $1,000,000 for her economic losses, $1,000,000 for her non-economic losses, and her husband $700,000 for his losses.

The case is No. CV 12 787443 in Cuyahoga County Court of Common Pleas.

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