Certified Legal Nurse Consultant Alert: FDA Warns of Dangers of Dietary Supplements
One of the largest over-the-counter (and often over-the-Internet) markets in the world is for dietary supplements. Every day, consumers turn to dietary supplements to improve their lives. Body-builders seek to increase muscle-mass, the elderly (and some spouses) seek to improve memory and cognitive function and others seek to improve digestion or battle depression with supplements such as creatine, ginkgo biloba, probiotics, St. John’s Wort and Vitamin E.
There are far too many dietary supplements to list in this blog, but they all have one thing in common. Supplements can be potentially dangerous to a plaintiff’s case and beneficial to a defendant’s case if mixed with the wrong prescription medication.
In October the FDA issued a warning against mixing dietary supplements with medication. They warned that some dietary supplements (even “natural” and “herbal”) can adversely alter absorption, metabolism or excretion of a medication. The side-effects can be an increased or decreased effect of a medication, resulting in life-threatening outcomes – especially in children, pregnant or breast-feeding women or anyone about to undergo surgery.
All Certified Legal Nurse Consultants (plaintiff and defense) should educate attorney-clients about the importance of obtaining the plaintiff’s history of supplement ingestion along with history of prescription and over-the-counter medications. A defense legal nurse consultant can potentially use a plaintiff’s supplement history to defend a medical malpractice case. Comparative negligence can apply if a plaintiff fails to disclose a history of supplement ingestion to his physician. The defense may also be able to defend the causation element.
Alternatively, it’s arguable that a physician should review a patient’s supplement history before prescribing medications and warn of any adverse effects. After all, what consumer reads the little, tiny warnings that come with a prescription?
All Certified Legal Nurse Consultants should consider a plaintiff’s medication history to be incomplete if it doesn’t include a full disclosure of supplement ingestion.
I’m Just Sayin’
P.S. Comment and share whether or not you’ve seen patients experience side effects from supplements.
4 thoughts on “Certified Legal Nurse Consultant Alert: FDA Warns of Dangers of Dietary Supplements”
While comparative negligence is potentially a real “thorn in the flesh” for the patient who may be classified as a poor historian, medication reconciliation is an absolute “toll order” for the admitting physician. It also calls for the duty of the nurse to fully relay to the doctor all the medication history obtained from the patient and patient’s family during that initial admission nursing assessment so that sensored and retrospective treatment regimes can be recommended by the MD.
I saw a 40-year-old patient die on the OR table during a D&C/hysteroscopy. It turns out she was taking St. John’s Wort and didn’t mention it during the pre-anesthesia visit. After that incident, the anesthesia department changed their policy and asked every patient about nutritional supplements or herbal products. Prior to this, they had only asked about prescription medications. St. John’s Wort interacts with one of the agents they use during anesthesia.
Some of that is about to change. At the breast cancer conference in Atlanta last weekend, herbals were discussed. Curcumin was determined to be the safest and most beneficial of all, to cancer patients – as an adjunct treatment with conventional medicine. The take-home was that oncologists should look into adding that one to certain cancer treatments for beneficial enhancement. Our oncologist friend said he thinks at some point that Curcumin will be treated as a medication, and that more doctors will use it. NIH has already had a couple studies published on that spice, and they look very promising.
Regarding other herbals, the interviewing nurse in an office or at a surgery center or hospital should always ask about such herbals and spices and OTC drugs well- before any procedure date. We were doing that much: interviewing pre-surgical patients 20 years ago, back when taking large amounts of Vitamin E was big. I called the orthopedic surgeon and he took the patient off the Vitamin E and rescheduled her procedure for a month later. He also thanked us. Otherwise, you bet, there could have been a bleeding problem – and a legal case.
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*The opinions and statements made by Vickie Milazzo, the founder of Medical-Legal Consulting Institute, Inc. are based on her experiences and expertise, should not be applied beyond the specific context provided, and do not guaranty or project actual results. Vickie Milazzo is no longer involved in the operations or management of the business, but is involved as an independent education consultant.
While comparative negligence is potentially a real “thorn in the flesh” for the patient who may be classified as a poor historian, medication reconciliation is an absolute “toll order” for the admitting physician. It also calls for the duty of the nurse to fully relay to the doctor all the medication history obtained from the patient and patient’s family during that initial admission nursing assessment so that sensored and retrospective treatment regimes can be recommended by the MD.
I saw a 40-year-old patient die on the OR table during a D&C/hysteroscopy. It turns out she was taking St. John’s Wort and didn’t mention it during the pre-anesthesia visit. After that incident, the anesthesia department changed their policy and asked every patient about nutritional supplements or herbal products. Prior to this, they had only asked about prescription medications. St. John’s Wort interacts with one of the agents they use during anesthesia.
Thank you for sharing this Vickie.
Some of that is about to change. At the breast cancer conference in Atlanta last weekend, herbals were discussed. Curcumin was determined to be the safest and most beneficial of all, to cancer patients – as an adjunct treatment with conventional medicine. The take-home was that oncologists should look into adding that one to certain cancer treatments for beneficial enhancement. Our oncologist friend said he thinks at some point that Curcumin will be treated as a medication, and that more doctors will use it. NIH has already had a couple studies published on that spice, and they look very promising.
Regarding other herbals, the interviewing nurse in an office or at a surgery center or hospital should always ask about such herbals and spices and OTC drugs well- before any procedure date. We were doing that much: interviewing pre-surgical patients 20 years ago, back when taking large amounts of Vitamin E was big. I called the orthopedic surgeon and he took the patient off the Vitamin E and rescheduled her procedure for a month later. He also thanked us. Otherwise, you bet, there could have been a bleeding problem – and a legal case.