Happel v. Wal-Mart Stores, Inc.
262 Ill. Dec. 815, 199 Ill. 2d 179, 766 N.E.2d 1118 (2002)
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Rule of Law:
A pharmacy has a narrow duty to warn either the prescribing physician or the patient when it possesses patient-specific information about drug allergies and knows that the drug being prescribed is contraindicated for that individual patient.
Facts:
- Heidi Happel was allergic to aspirin, ibuprofen, and acetaminophen.
- Wal-Mart pharmacy maintained a computer system containing Heidi Happel's allergy information, gathered through its policy of asking customers about their allergies.
- On August 4, 1993, Dr. Zbigniew Lorenc, who was aware of Happel's allergies but unaware of the drug's contraindication, prescribed the pain reliever Toradol for her.
- Toradol is a nonsteroidal anti-inflammatory drug (NSAID) and is contraindicated for individuals with aspirin allergies.
- When Happel's husband picked up the prescription, a Wal-Mart employee asked for and was again informed of Happel's allergies.
- Wal-Mart's pharmacy filled and dispensed the Toradol prescription without warning either Happel or Dr. Lorenc about the contraindication.
- After taking the Toradol, Happel suffered a severe allergic reaction, experiencing anaphylactic shock and subsequent long-term health problems.
Procedural Posture:
- Heidi and Kent Happel filed a negligence action against Dr. Lorenc and Wal-Mart Stores, Inc. in an Illinois trial court.
- The Happels settled with Dr. Lorenc, who was then dismissed from the lawsuit.
- Wal-Mart moved for summary judgment, arguing it had no legal duty to warn the Happels.
- The trial court granted summary judgment in favor of Wal-Mart.
- The Happels, as appellants, appealed to the Illinois Appellate Court.
- The appellate court reversed the trial court's grant of summary judgment, finding that Wal-Mart did owe the Happels a narrow duty to warn.
- Wal-Mart, as appellant, was granted leave to appeal to the Supreme Court of Illinois.
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Issue:
Does a pharmacy have a duty to warn a customer or their prescribing physician of a potential adverse reaction when the pharmacy knows both of the customer's specific drug allergies and that the prescribed drug is contraindicated for a person with those allergies?
Opinions:
Majority - Justice McMorrow
Yes. A pharmacy has a narrow duty to warn a customer or their physician when it possesses specific knowledge of a patient's allergies and knows that a prescribed drug is contraindicated for that patient. The court determined that the general 'learned intermediary doctrine,' which places the duty to warn on the prescribing physician, does not apply in these specific circumstances. The court applied a four-factor test for duty, finding that the injury to Happel was highly foreseeable and likely, the burden on Wal-Mart to warn was minimal (a simple phone call), and the consequences of imposing this duty were acceptable. The duty arises from the 'special circumstances' where the pharmacy possesses superior knowledge of both the patient's condition (allergies) and the specific danger of the drug (contraindication), meaning a warning does not require the pharmacist to exercise medical judgment or improperly intrude into the doctor-patient relationship.
Analysis:
This decision establishes a significant, albeit narrow, exception to the learned intermediary doctrine for pharmacists in Illinois. It moves beyond the traditional view that a pharmacist's duty is limited to accurately dispensing medication, imposing an affirmative duty to act on specific knowledge of a clear contraindication. The ruling holds that when a pharmacy solicits and records patient-specific information like allergies, it cannot ignore that information when it creates a life-threatening risk. This precedent increases potential liability for pharmacies and shapes the professional standard of care, encouraging them to use the patient data they collect to prevent foreseeable harm.
