September 27, 2012
Tracy Prewitt successfully defended a Cannelton, Indiana internist against allegations of medical malpractice in Perry Circuit Court. Plaintiff alleged that the defendant internist inappropriately prescribed quinine sulfate for the treatment of nocturnal leg cramps or restless leg syndrome in early December 2006. She maintained that quinine sulfate was FDA-approved only for the treatment of a specific strand of malaria and had never been shown via double-blind controlled studies to be an effective treatment for nocturnal leg symptoms. Plaintiff alleged that the internist should have known that the risks associated with the drug outweighed the benefits. Plaintiff claimed that after ingesting two pills of quinine sulfate, she developed thrombotic thrombocytopenic purpura and hemolytic uremic syndrome (TTP-HUS), requiring her to undergo four months of dialysis and resulting in the development of stage three kidney disease. Prewitt countered by establishing that the internist’s decision to prescribe quinine sulfate was reasonable. Internists throughout Indiana were treating nocturnal leg symptoms with quinine sulfate in 2006, and numerous case reports suggested that the drug was beneficial in treating those symptoms. In fact, Plaintiff herself had been taking over-the-counter quinine sulfate for over a decade, and had experienced good results with no untoward side effects. An FDA bulletin recommending against the use of quinine sulfate for the treatment of nocturnal leg symptoms was issued after the prescription in question. The defense further questioned whether quinine sulfate had actually resulted in Plaintiff’s development of TTP-HUS and stage three kidney disease. Prewitt presented expert testimony establishing that the majority of cases of TTP-HUS are idiopathic in nature. Further, Plaintiff had vascular disease and stage two kidney disease prior to the prescription in question. The jury unanimously agreed with the defense that the internist acted appropriately and entered a defense verdict finding no fault against her.