Walker v. Jack Eckerd Corp.
Walker v. Jack Eckerd Corp.
Opinion of the Court
Appellant/cross-appellee Wayne E. Walker (Walker) appeals from the order of the state court granting summary judgment to appellee Jack Eckerd Corporation (Eckerd’s). Cross-appellant Alan A. Karp, M.D. (Dr. Karp) cross-appeals from the order denying his motion for summary judgment.
This appeal arises from a malpractice action by Walker against Dr. Karp who prescribed a drug, Blephamide, that allegedly injured Walker, and against the pharmacy which dispensed the drug. A package insert issued to pharmacies with the drug warned that prolonged use could result in glaucoma. Dr. Karp, who was then duly licensed to practice medicine in Georgia, twice prescribed Blephamide for Walker. Walker asserts that both of Dr. Karp’s prescriptions were “PRN” prescriptions. A “PRN” prescription can be refilled as needed over a lengthy time period, usually not over one year. Dr. Karp denies that he issued either prescription as “PRN,” or otherwise refillable. Nevertheless, appellant made averments of fact in his complaint that both the first and second prescriptions, which Dr. Karp telephoned to Eckerd’s, were “PRN.” Eckerd’s dispensed this drug under one of the prescription numbers fifteen times to Walker in less than one year. Walker subsequently was diagnosed with glaucoma, which allegedly was caused by excessive Blephamide prescribed by Dr. Karp and dispensed by Eckerd’s. Held:
Case No. A93A0691 (Main Appeal)
1. The trial court, citing Reynolds v. Estate of R. J. Reynolds, 238 Ga. 1, 3 (230 SE2d 842), found that appellant’s complaint averred “that defendant Karp telephoned a ‘PRN’ prescription to defendant Eckerd’s drugstore. . . . Defendant Eckerd, in its answer, admits this allegation. As such, [appellant] is bound by the allegation contained in his complaint, which was admitted by the answer.”
Appellant’s contention that this pleading did not constitute an admission in judicio because it was merely an expression of opinion is
A question remains whether an admission in judicio results when conflicting evidence appears elsewhere in the record as to the fact allegedly admitted in the pleadings. Admissions in judicio can be considered in the disposition of summary judgment cases. See generally Reynolds, supra; Four Square Constr. Co. v. Jellico Coal &c. Co., 145 Ga. App. 650 (244 SE2d 612).
In Summerlot v. Crain-Daly Volkswagen, 238 Ga. 546, 547 (1) (233 SE2d 749), the Supreme Court observed that “[t]he Civil Practice Act provides that when issues not raised by the pleadings are tried by express or implied consent of the parties, they shall be treated ... as if they had been raised in the pleadings” and that “pleadings may be amended so as to conform to the evidence, but failure to so amend does not affect the result of the trial on the issues actually tried.” (Emphasis supplied.) Id. Then after noting that “the issue . . . was considered and determined on its merits by the trial judge,” the Supreme Court concluded that “we do not consider the alleged typographical error in the complaint to be an admission in judicio that barred the applicant from showing to the contrary.” (Emphasis supplied.) Id. at 547. This rationale was followed by this court in Stephens v. Tate, 147 Ga. App. 366, 367 (1) (249 SE2d 92), holding that an unwithdrawn admission in the complaint did not constitute a binding admission in judicio supporting grant of summary judgment where the order was hotly contested and “the issue was considered and determined on its merits by the trial court.” (Emphasis supplied.)
In Space Leasing Assoc. v. Atlantic &c. Systems, 144 Ga. App. 320 (4) (241 SE2d 438), appellants asserted that the recitation of a certain date in a complaint was a typographical error. This court, purporting to construe Summerlot, supra, held: “ ‘The Civil Practice Act provides that when issues not raised by the pleadings are tried by
It appears that merely because conflicting evidence may exist as to a given issue of fact, this will not prevent per se a party from making an admission in judicio in his pleadings as to that fact. However, if the trial court admits that conflicting evidence, and either the court (e.g., when ruling on a motion for summary judgment) or the jury (when reaching its verdict) considers the conflicting evidence on the
The case at bar is factually distinguishable from the above-cited cases; likewise, it is distinguishable from Smith v. Doe, 189 Ga. App. 264 (2) (375 SE2d 477), a case involving the pleading of inconsistent claims in a single pleading. (Green, supra at p. 423, cautions: “Inconsistent pleadings, although permitted by the Civil Practice Act for purposes of the rules of evidence, may constitute an admission or an inference beneficial to the opposite party. . . . Although the Civil Practice Act permits inconsistent pleading as a matter of procedure, the evidentiary effect of inconsistent pleading must be considered and weighed before this practice is employed.”)
In this case, the trial court expressly held in its order that “plaintiff [was] bound by the allegation contained in his complaint, which was admitted by the answer.” Inherent in this ruling, as further evidenced by the accompanying citation to Reynolds, supra, is the trial court’s election not to allow appellant to withdraw the admission in judicio made in his complaint of the fact that Karp twice telephoned a “PRN” prescription to Eckerd’s drugstore, as averred in the complaint. Clearly, the trial court did not dispose of the issue of “PRN” prescriptions on the merits. Accordingly, the trial court did not abuse its discretion in entering this finding and treating the admission in judicio as conclusive. Reynolds, supra.
2. Appellant asserts the trial court erred in holding that there was no breach of a legally recognized duty on the part of Eckerd’s either in failing to warn or in failing to refuse to refill the prescriptions. (By virtue of the admission in judicio in appellant’s pleadings it has been conclusively established that the prescriptions were tele
Neither party has cited and we are not aware of any Georgia statutory authority expressly imposing a duty to warn or to refuse to fill prescriptions upon pharmacists who are provided with manufacturers’ literature warning of potential adverse effects if certain drug dosages are exceeded. Compare OCGA § 16-13-73. In fact, OCGA § 26-3-8 (b) specifically excepts certain prescription drugs from various statutory labeling and warning requirements. However, both parties have well-identified the two conflicting lines of authority pertaining to the common-law duty of pharmacists regarding the warning of patients and the refusal to fill prescriptions; the strengths and weaknesses of each position have been ably argued by counsel for both sides. It appears to be a matter of first impression for this court as to the scope of a pharmacist’s duty, at the present time in this state, in the dispensing of prescriptions.
Appellant, citing Docken v. CIBA-GEIGY, 790 P2d 45, 47 (CA Or.) (pharmacist owes duty to perform compatible to standard of care in the community) and Dooley, supra (whether pharmacist owed duty to warn customer was fact question precluding summary judgment), advances what we perceive currently to be a minority view. Appellant has asserted that, assuming arguendo Eckerd’s was following the prescription instructions issued by a physician licensed to practice medicine in Georgia, there existed an independent duty on the part of Eckerd’s either to warn appellant or his prescribing physician of the dangerous properties of the drug or to refuse to refill and dispense the prescription, and that a jury issue arose as to the breach of such duty. Docken, supra; Dooley, supra; compare Riff v. Morgan Pharmacy, 508 A2d 1247 (SC Pa.).
However, in view of OCGA Title 26, Chapters 3 and 4, the need for preserving, without interference of third parties, a trusted physician-patient relationship, the fact that patients have different reactions to and tolerances for drugs coupled with the fact that the severity of a patient’s condition may warrant a different level of risk acceptance, which factors are best monitored and evaluated by doc
In adopting this view, we are aware that effective January 1, 1993, the Georgia State Board of Pharmacy imposed certain new drug review and patient counseling rules on pharmacists. Rules of Ga. State Board of Pharmacy, § 480-31-.01. However, this does not alter the legislature’s intent prior to these rules to except certain prescription drugs from various labeling and warning requirements. OCGA § 26-3-8 (b). Nor will we here decide whether these rules of the State Board of Pharmacy are mandated by federal law or are in conflict with OCGA § 26-3-8 (b). Suffice it to say that this case is not intended to serve as controlling precedent for cases involving pharmacists’ duties arising after January 1, 1993.
We do not here address a situation where a druggist has improperly compounded a drug, filled a legitimate prescription with a different drug than prescribed, or allowed a drug to become infected with some adulterating foreign substance during the course of preparing and filling the prescription. Compare Pysz, supra at 562 (2) and Gar-side, supra at IV; Ramirez, supra at 88 (4) with Ullman, supra at 956
3. In view of the above, the trial court did not err in granting appellee’s motion for partial summary judgment. See generally Lau’s Corp. v. Haskins, 261 Ga. 491, 495 (405 SE2d 474). At best there existed but a shadowy semblance of an issue as to appellee Eckerd’s liability. “Summary judgment law does not require the movant to show that no issue of fact remains but only that no genuine issue of material fact remains; and while there may be some shadowy semblance of an issue, the case may nevertheless be decided as a matter of law where [, as in this case,] the evidence shows clearly and palpably that the jury could reasonably draw but one conclusion.” (Citations and punctuation omitted.) Peterson v. Liberty Mut. Ins. Co., 188 Ga. App. 420, 424 (373 SE2d 515).
Case No. A93A0692
Cross-appellant Karp asserts the trial court erred in denying his motion for summary judgment as there is no genuine issue of fact whether a physician-patient relationship exists between him and appellant. Cross-appellant argues that both of the prescriptions were placed by phone merely as an “accommodation” to cross-appellee, who initially was married to Karp’s mother-in-law, and not as a result of an existing physician-patient relationship. Karp did not bill crossappellee for his services.
In this state “there can be no liability for malpractice in the absence of physician-patient relationship.” Peace v. Weisman, 186 Ga. App. 697, 698 (1) (368 SE2d 319); see Rogers v. Coronet Ins. Co., 206 Ga. App. 46, 49 (3) (424 SE2d 338).
Generally, it is a question of fact for the jury whether there exists a physician-patient relationship; however, a case may be disposed of by summary judgment where the facts are shown by such clear, palpable, and undisputed evidence that the jury could reasonably draw but one conclusion. Cf. Southern Trust Ins. Co. v. Braner, 169 Ga. App. 567, 569 (1) (314 SE2d 241). A physician-patient relationship can be established by circumstantial evidence. See OCGA §§ 24-1-1 (4); 24-4-9. In ruling on a motion for summary judgment, the opposing party should be given the benefit of all reasonable doubt, and the court should construe the evidence and all inferences and conclusions arising therefrom most favorably toward the party opposing the motion. Moore v. Goldome Credit Corp., 187 Ga. App. 594, 595-596 (370
Judgment affirmed.
Dissenting Opinion
dissenting.
I agree with the majority that, under the common law, a pharmacist has no duty to warn a patient about all possible adverse effects incident to the use of properly prescribed medications.
In my opinion this limited duty best serves the patient, the doctor and the pharmacist. Although the pharmacist owes a duty to the patient beyond just accurately filling the prescribed medication, the pharmacist is not unduly interjected into the physician-patient relationship. On the other hand, the pharmacist is required to question a prescription which is erroneous or which is irregular on its face, thereby protecting the patient and the physician from physician errors which the patient could not detect but which would be readily apparent to a properly trained pharmacist.
Applying this limited duty to the facts of this case, a material question of fact remains for jury resolution concerning whether dispensing the drug Blephamide “PRN” constitutes such a patent or obvious error that the pharmacist should have contacted the prescribing physician before repeatedly dispensing the medication. The package insert for Blephamide contains the following warning: “Prolonged use may result in glaucoma, with damage to the optic nerve, defects in visual acuity and fields of visions, and in posterior subcapsular cataract formation. Prolonged use may suppress the host response and thus increase the hazard of secondary ocular infection. ... If these products are used for 10 days or longer, intraocular pressure should be routinely monitored....” I would therefore reverse the trial court’s grant of appellee Eckerd’s motion for partial summary judgment.
I am authorized to state that Presiding Judge McMurray and Judge Blackburn join in this dissent.
As the majority notes, this case does not address the issue of the duty of a pharmacist after January 1, 1993, when new drug review and patient counseling rules adopted by the Georgia State Board of Pharmacy become effective.
Reference
- Full Case Name
- Walker v. Jack Eckerd Corporation; Karp v. Walker
- Cited By
- 55 cases
- Status
- Published