Cottam v. CVS Pharmacy

Supreme Judicial Court of Massachusetts · Torts

TortsNegligenceDuty to WarnPharmacist LiabilityVoluntary Assumption of DutyEvidencepharmacy duty to warnprescription drugs

Facts

CVS had a computer system that generated written drug warnings in a short form and a long form, and CVS policy required pharmacists to give new prescription customers the long form and review the information with them. Cottam filled a new prescription for Trazodone at CVS and testified that he received only the short form, which warned of drowsiness and a few other conditions but not priapism; the pharmacist also orally warned only about drowsiness. After taking the drug, Cottam developed priapism, delayed seeking treatment for about thirty hours, and became permanently impotent; he claimed he would have sought prompt medical care had he been warned that priapism was a serious side effect. The prescribing physician testified that he had warned Cottam about priapism, and the physician had settled with Cottam before trial.

Issue

Does a pharmacy have a general duty to warn customers of the side effects of prescription drugs it dispenses? If not, can a pharmacy voluntarily assume such a duty by providing warnings or information, and did CVS do so here? The case also presented whether expert testimony was required and whether certain evidentiary rulings were erroneous.

Rule

Generally, a pharmacy has no duty to warn customers of the side effects of prescription drugs where the pharmacist has no specific knowledge of an increased danger to a particular customer. However, a pharmacy may voluntarily assume a duty to warn or provide information, and once assumed, that duty must be performed with due care; the scope of the assumed duty is determined fact-specifically from the totality of the pharmacy's communications and the patient's reasonable understanding of what the pharmacy undertook to provide. Expert testimony is not required when the issue is the adequacy and comprehensibility of the warning as understood by an ordinary reasonable person rather than the technical performance of the pharmacist.

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One of 10 multiple-choice questions for this case. Pick an answer to see why.

In Columbus, Ohio, Elena Park filled a new prescription at Riverbend Pharmacy, a local drugstore. The pharmacist correctly dispensed the medication but gave no warning about a rare side effect, and nothing indicated the pharmacist knew Elena faced any unusual danger beyond that of ordinary patients.

If Elena sues the pharmacy for negligence solely because it failed to warn her about the drug's side effects, which is the strongest argument for the pharmacy?

Explanation. The majority held that, as a general rule, a pharmacy has no duty to warn customers of prescription-drug side effects when the pharmacist lacks specific knowledge of increased danger to that particular customer. The court extended the learned intermediary doctrine to pharmacies because physicians are better positioned to tailor warnings to a patient's history and condition. That rule defeats a claim based solely on a failure to warn in these facts. (Derived from Cottam v. CVS Pharmacy (n.d.).)