The family’s medical experts testified it was below the standard of care for the physicians not to look at the nurses’ notes which clearly documented that the patient was on allopurinol and recorded a dosage which could be toxic to a patient in renal failure.  APPELLATE COURT OF ILLINOIS April 23, 2014

 The patient’s primary care physician referred her to a nephrology specialist for a work-up of kidney dysfunction.

  Six years later the same primary care physician started her on allopurinol for gout.

  Two months after that she began to have new symptoms of illness which she reported to the nephrologist at whose clinic by now she was receiving dialysis.

  Soon after that she had to go to an emergency room for a serious rash. 

  The rash was actually the onset of toxic epidural necrolysis, a known complication of excessive doses of allopurinol in a patient with poor renal elimination.

  That condition quickly progressed to the point she had to be hospitalized in a teaching hospital’s burn unit where she finally died from multi-organ failure.

  The Appellate Court of Illinois approved a large verdict for the patient’s family against all of the physicians involved in her care. 

  The allopurinol dose was documented by the nurses who took patient histories in the primary care clinic, the dialysis clinic and the E.R., but all the physicians simply neglected to look at the nurses’ notes.  The family’s experts testified that was medical malpractice.  Francisco v. Kozeny, 2014  WL 1673048 (Ill. App., April 23, 2014).