Dr. Peter Breggin was the medical expert in a tardive dyskinesia (TD) case that settled out of court for $700,000 in May 2014. The identity of the doctor and the plaintiff cannot be released. Large medical malpractice settlements are extremely rare in the locality of the case. Dr. Breggin has been an expert in dozens of TD cases in the US and Canada, most of which have been settled before trial, and approximately six that have been won in trial.
Tardive dyskinesia is a disorder caused mainly by antipsychotic (neuroleptic) drugs, including the newer so-called atypical drugs like Risperdal, Zyprexa, Seroquel, Abilify, and Invega. The abnormal movements can afflict any muscle group that is partially under voluntary control including the face, mouth, tongue, neck, shoulders, torso, limbs hands and feet, as well as the muscles of breathing, speech and swallowing. The variant tardive dystonia involves painful muscle spasms and the variant tardive akathisia involving inner agitation that drives the person to move his body for relief. Tardive akathisia can feel like torture.
These disorders tend to become irreversible, especially if the drug is continued after the initial symptoms appear. There is no effective treatment. For more about tardive dyskinesia see Dr. Breggin’s book Psychiatric Drug Withdrawal: A Guide for Prescribers, Therapists, Patients and their Families and elsewhere on this website.
Dr. Breggin found within a reasonable degree of medical certainty that the psychiatrist in the $700,000 settlement case had committed the following negligent acts:
(a) Prescribing antipsychotic drugs for five years when they were not indicated or needed. The drugs included Risperdal, Seroquel and Zyprexa.
(b) Failing to taper and discontinue from Risperdal during years of exposure.
(c) Failing to warn the patient and about the side effects of Risperdal, Seroquel and Zyprexa, including the dangers of tardive dyskinesia/tardive akathisia, and failing to educate the patient and family so that they could properly recognize the earliest signs of tardive dyskinesia/tardive akathisia.
(d) Failing to obtain informed consent.
(e) Continuing to prescribe the offending drugs after the patient began to show signs of tardive dyskinesia.
(f) Failing to properly re-evaluate, examine and assess the need for Risperdal periodically; and failing to record in the medical record these procedures and a plan for evaluating and discontinuing the medication.
(g) Failing to have or to display sufficient knowledge about the use of a neuroleptic such as Risperdal.
(h) Failing to conduct routine, periodic examinations for tardive dyskinesia and failing to record them in the record.
(i) Resuming neuroleptic treatment for a full year with Seroquel and Zyprexa after the recorded the diagnosis of tardive dyskinesia in the medical record.
The attorney in the case was Sidney Gorovitz. His letter confirming my role as the medical expert and his description of the case can be found here.