On The Docket
David B. Brushwood, BSPharm, JD
Patients who have difficulty obtaining their medications can become fearful, distressed, and disrespectful of pharmacy personnel. The actions and the words said by patients may lead to reactions by pharmacy personnel. A recent legal case from Louisiana reviewed a patient’s claim that her pharmacy should be held liable for intentional infliction of emotional distress (IIED) following alleged “extreme and outrageous” conduct by the pharmacy’s employees.
Background
The patient was using tirzepatide to treat T2D. She was aware that the drug was not consistently in stock at her pharmacy. She contacted the pharmacy requesting a refill. She received a text 3 days later telling her that the order had been processed and was ready for pickup but that the prescriber had electronically transmitted a new prescription with an increased strength. The patient called the pharmacy and was advised by a pharmacist that the refill would be cancelled and that the new strength of medication would be obtained for her.
Six days later, the patient called the pharmacy to determine the status of her prescription, but she was allegedly “left on hold and was unable to reach an employee.” Later that day she arrived at the pharmacy to check the prescription status. She admitted that her “tone of voice expressed aggravation, irritation, and frustration for what she had suffered.”
According to the patient, a pharmacy employee “rolled her eyes at her and physically and audibly expressed derision toward her.” The patient and the employee “engaged in heated verbal barbs and the employee made an offensive hand signal toward her.” The employee left the counter. Nobody assisted the patient, despite her insistence that she needed the medication by the next day to avoid “blood sugar fluctuations.”
On the following day, the patient was able to obtain her medication at a different pharmacy.
The patient filed an IIED lawsuit against her pharmacy. The pharmacy moved for dismissal, and this motion was denied. The pharmacy appealed.
Rationale
The appellate court reviewed the elements of a claim for the tort of IIED. These elements require that the defendant has committed extreme and outrageous conduct, that caused the plaintiff to suffer severe emotional distress, and was intended by the defendant.
After listing these elements, the court noted that the pharmacy’s service to the plaintiff “may well have involved conduct that was inconsiderate and discourteous.” The court also noted that “persons must necessarily be expected to be hardened to a certain amount of rough language, and to occasional acts that are definitely inconsiderate and unkind.” The court concluded that “not every verbal encounter may be converted into a tort.”
The court ruled that the alleged actions by the defendant pharmacy could not meet the criteria for IIED. The patient’s lawsuit was dismissed.
Takeaways
There is an expectation of civility in professional relationships. This expectation extends to patients and to pharmacy team members. It is unfortunate that some patients who experience what they view as unnecessary hassles at their pharmacy will engage in aggressive confrontations with pharmacy team members. It is important for pharmacy personnel to defy Newton’s third law of motion (for every action there is an equal but opposite reaction). Incivility must be treated with civility. Up to a point.
There are limits on the acceptability of behaviors and statements by both patients and pharmacy team members. Mutual respect is the standard for professional interactions.
When the relationship between a patient and a pharmacy can no longer be respectful, it may be necessary to discontinue the relationship. Pharmacies should adopt and enforce a policy of patient’s rights and responsibilities that reflects mutual expectations for civility.
Unusual or strange patient behaviors should be tolerated by pharmacy staff. Threats and abuse need not be tolerated. As this case illustrates, there are no effective legal remedies for incivility. Civility is an essential aspect of professionalism and not of law. ■