Background
Isaac Crow, Jr., suffered a lawn mower accident resulting in finger amputation and subsequent complications including gangrene, bacterial infection, pneumonia, and cervical abscess. He received intravenous antibiotic treatment, including Daptomycin prescribed initially at 500 mg daily by Dr. Brunet on June 6, 2024. On June 20, 2024, infectious disease physician Dr. Malek ordered the dosage increased to 750 mg, the recommended dosage for Mr. Crow’s body weight. Option Care pharmacy, which dispensed the medications, communicated the increase to both the physician and Mrs. Crow, explaining they would receive a supplemental 250 mg syringe to be combined with the existing 500 mg dosage, followed by a full 750 mg syringe the following week.
Mr. Crow experienced adverse reactions to the increased dosage, including weakness, muscle deterioration, and soreness. Mrs. Crow reported elevated creatine phosphokinase levels on June 24, and Mr. Crow was evaluated at emergency rooms on June 29 and July 2, where blood cultures revealed candida growth and elevated bilirubin levels. He was hospitalized, his PICC line was removed, and he eventually refused further antibiotic treatment. Mrs. Crow filed suit on May 12, 2025, alleging unauthorized dosage increase by Option Care’s pharmacist causing harm to her husband.
Option Care filed an exception of prematurity on July 15, 2025, asserting the claims sounded in medical malpractice and therefore required submission to a medical review panel under the Louisiana Medical Malpractice Act (LMMA) before proceeding with litigation. The trial court sustained the exception and dismissed the case without prejudice.
The Court’s Holding
The Second Circuit affirmed the trial court’s dismissal, holding that Option Care’s exception of prematurity was timely and substantively sound. The court rejected Mrs. Crow’s arguments that the claim sounded in fraud or intentional tort rather than medical malpractice. Applying the Coleman v. Deno factors, the court concluded the Crows’ allegations, when examined against the actual evidence in the record, clearly sounded in medical malpractice requiring LMMA compliance.
The court determined there was no evidence supporting key allegations in the complaint. The record clearly established that Dr. Malek, not the pharmacist, prescribed the dosage increase. The only error identified—the pharmacy’s misidentification of the prescribing physician—was found by the Louisiana Board of Pharmacy to be simple human error. The court examined photographs of syringes and packaging in the record and found they were consistent with the pharmacy correctly preparing supplemental and full-dose syringes as discussed with the Crows.
The court held that because the claims involved questions of medical judgment and standard of care—the core of medical malpractice—they fell squarely within the LMMA. The court rejected the notion that pharmacy conduct automatically escapes LMMA requirements, emphasizing that pharmacists, like physicians, are healthcare providers whose conduct may be reviewed through the statutory panel process when questions of professional judgment are at issue.
Key Takeaways
- Medical malpractice claims in Louisiana require submission to a medical review panel before litigation, even when plaintiffs characterize the conduct as fraud or an intentional tort.
- Courts will examine the actual evidence in the record—not merely the allegations in pleadings—to determine whether a claim sounds in medical malpractice or intentional conduct.
- A pharmacy’s human error in identifying a prescriber, without more, does not transform a medical malpractice claim into an intentional tort or establish fraud when the underlying prescription and dosage were lawful.
- LMMA gating requirements apply to healthcare provider conduct involving questions of professional judgment or standard of care, including pharmacy services.
Why It Matters
This decision reinforces that Louisiana’s LMMA operates as a mandatory procedural gating mechanism for medical malpractice claims, preventing plaintiffs from circumventing the medical review panel requirement by recharacterizing malpractice allegations as fraud or intentional tort. The court’s careful examination of the evidence demonstrates that trial courts and appellate courts will look behind conclusory pleadings to the facts to determine the true nature of the dispute.
For healthcare providers and pharmacies, the decision confirms that even allegations of unauthorized changes to medication regimens require LMMA compliance when the underlying facts show physician authorization and proper pharmacy procedures. The decision also clarifies that human error in administrative matters—such as physician identification—does not establish fraud or intentional misconduct absent evidence of deliberate misrepresentation and reliance. For plaintiffs and their attorneys, the ruling underscores the critical importance of pleading with specificity and supporting allegations with admissible evidence, as vague allegations unsupported by medical records will not survive a prematurity exception.