Clicks has opposed the litigation and argued that its customer also had a duty to check that she had received, and was taking, the correct medication for her condition, as prescribed. File photo
A David-and-Goliath battle between pharmaceutical retailer Clicks and a woman who claims she almost bled to death after being dispensed the incorrect medication is being fought in the Western Cape high court, where she is seeking damages of R5.9 million.
Clicks has opposed the litigation and argued that its customer also had a duty to check that she had received, and was taking, the correct medication for her condition as prescribed.
Joy Vorster, 32, who was working as a travel agent at the time of the incident, walked into the Edgemead Shopping Centre Clicks on 14 October 2013 to collect Xatral, a medication prescribed after she underwent a routine haemorrhoidectomy.
But instead of the correct drug, her attorney Henry Shields alleged in court papers, the pharmacist handed her Xarelto, a blood-thinning medicine that prevents clotting.
Vorster’s nightmare began after she took the medication that evening, she told the Mail & Guardian this week. “My stomach made an awful sound and I went to the bathroom. I was horrified at the sight that came next. There was blood everywhere, and when I say everywhere I mean everywhere,” she said.
“It looked like a vein had burst inside of me. I tried to get hold of my surgeon, but was unable to so I contacted the emergency room [of a local hospital] who advised, if the bleeding is severe, that I needed to go in.”
Vorster, who was bleeding profusely from her rectum, was advised by a sister on duty to call her parents to say goodbye before going into surgery as her life was in danger.
“My dad was working the night shift at the time. I called him, bawling my eyes out, thinking this would be the last time I ever heard his voice.
“I was unable to get hold of my mom and this made me even more anxious. I’d never get to say goodbye to her. I could see the fear in my boyfriend’s eyes,” she said.
Vorster said she was slipping in and out of consciousness as the bleeding continued, drenching her body and the bedding in waves, before she finally passed out. She said it “felt like an organ came out of me and burst open”.
Once she was out of surgery, Vorster said her surgeon told her that he had never seen a patient bleed so profusely.
“He didn’t know what caused the bleeding. He performed a colonoscopy, but couldn’t see anything, as my insides were filled with blood.
“He said he had performed another haemorrhoidectomy, as two of the staples came loose, but that wouldn’t explain all that blood as the veins shouldn’t bleed like that after a haemorrhoidectomy,” Vorster recalled.
“The rest of the day, I was lying in fear — it kept feeling like it was going to tear loose and I was going to start bleeding again. It was terrifying.”
Vorster said the bleeding continued after she was discharged but eventually stopped. However, she developed post-traumatic stress disorder and started having nightmares.
“It’s not like I had an allergic reaction. I literally bled out and lost almost all of my blood and my life. I wish it was something like an allergic reaction.
“I’m still getting nightmares to this day about what happened,” she said.
Joy Vorster has taken Clicks to court, seeking R5.9 million for loss of income, trauma and other damages, after coming close to dying after allegedly being dispensed the wrong medication. Photo: Supplied
Vorster said her surgeon picked up the error when she took him the prescription and the medication she had been given at Clicks.
She went to the shop to complain, and the manager logged the matter, but blamed her trauma on the fact that she had disclosed she had suffered from an eating disorder as a child, claiming this predisposed her to trauma.
What followed was an uphill battle with Clicks to compensate her for the R800 cost of the various medications she bought that day and for her mounting medical bills.
Little did Vorster know that, more than 10 years later, she would still be fighting for a resolution to her R5 902 878.04 claim for loss of income, trauma and other damages.
Her attorney Shields argued in court papers that, just hours after ingesting the medication, she had begun to “bleed profusely”.
“The defendant [Clicks] had a duty of care to all members of the public who purchased pharmaceutical products … and, in particular, a duty to the plaintiff to take all reasonable steps to ensure that the products supplied would reflect the products prescribed,” Shields said.
“Such duty entails the implementation of systems which would be in accordance with professional standards, as well as common sense precautions and cross-checking methods, so as to eliminate errors.”
He said this duty was in the context where pharmaceutical products could produce “injurious fatal consequences” and that the incident was caused “solely by the negligence of the pharmacist” or other employees.
“He failed to supply the product Xatral as prescribed … and in error supplied Xarelto. He failed to implement such necessary safety and cross-checking procedures at all as might ensure that the product supplied would be in accordance with the prescription,” Shields said.
“He failed to have regard to the fact that the product supplied would have the opposite effect of the product prescribed.”
Shield said the dispenser had “failed to exercise basic and proper duties of care applicable to a pharmacist, … with particular regard to the potential dangers attached to the product he supplied, especially since it is contraindicated in numerous circumstances and should “be treated with the appropriate degree of caution”.
Vorster had suffered “a loss of the amenities of life and has experienced pain, suffering and psychological trauma” that would continue in future. Shields said Vorster had been in “significant danger” of not surviving the trauma and had been “acutely aware of her situation” that had led to her being “bedridden and unable to mobilise” for a significant time.
“The plaintiff’s emotional condition has deteriorated. She suffers from recurring nightmares related to the trauma she has experienced arising from the incident. She has lost income and will suffer future losses of income … she remains distressed and traumatised as a consequence of the trauma and near-death experience,” he added.
In the retailer’s pleading before the court, Clicks’ attorney Julia Penn argued that while it admitted the employee who handed Vorster the medication worked for it at the time, it had “no knowledge” regarding the allegation of incorrect medication being dispensed and ingested.
“It is admitted that the defendant [Clicks] has a duty of care to members of the public purchasing pharmaceutical products from the defendant to take reasonable steps to ensure that the products supplied would correctly reflect the products prescribed,” she said.
Penn admitted that products supplied in error could cause injury but denied the allegations that the pharmacist had failed in his duty of care to cross-check and ensure the correct medication was handed to Vorster.
“The defendant denies that it is liable to the plaintiff for the amounts claimed, alternatively for any other amount,” Penn said, arguing that, if the court found that Clicks was negligent as alleged, Vorster herself had also been negligent in that she “failed to take reasonable care and caution to ensure that she collected the correctly prescribed medication” and when ingesting the medication to ensure she had taken the correct medication and dose her doctor had prescribed.
“The plaintiff was accordingly contributorily [in] negligence and her damages fall to be reduced by the degree of her fault to the extent that the above honourable court deems fit,” Penn said.
She asked the court to dismiss Vorster’s claim with costs, and alternatively, that any damages awarded “be reduced by her degree of contributory fault”.
The parties are awaiting a trial date for the matter to be heard.
Asked why Clicks did not resolve the matter before it got to court, Clicks Retailers head of health care, Rachel Wigglesworth, said: “Unfortunately, we do occasionally make mistakes and when a dispensing error occurs, we take responsibility for our actions.”
“In this case, following a dispensing error, we tried to resolve the matter by presenting a reasonable offer based on the specific facts of this case and guided by legal precedent. We were however unable to reach an agreement with the customer.”