Can Medical Malpractice Cause Stevens-Johnson Syndrome?

Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are a continuum of severe skin conditions. Most cases are caused by prescription drugs like the anti-gout medication, Allopurinol, or anticonvulsants such as Lamictal.

There is no doubt – SJS and TEN are painful, and if not treated properly, there are long-lasting effects, including vision problems, acute respiratory failure, and in severe cases can be fatal. It is critical to seek immediate medical attention if you show SJS symptoms. It is equally important for victims suffering from SJS/TEN to ensure they receive compensation if medical negligence caused the condition.

Stevens-Johnson Syndrome is diagnosed when up to ten percent of the skin is affected. Toxic Epidermal Necrolysis is when 30 percent or more of the skin is involved. Most patients are initially diagnosed with SJS, and then, as the disease progresses, they are diagnosed as having TEN.  

Signs You Are Suffering From Stevens-Johnson Syndrome

The first symptoms of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis may be flu-like symptoms, including fever, sore throat, or fatigue. The symptoms can be followed within a few days by a rash, lesions, blisters, and/or ulcers in the mucus membranes – eyes, mouth, and genitalia. These symptoms do not always occur in this order and may occur in different areas of the body. 

SJS/TEN is evaluated by:

• A physical exam, including a review of clinical presentation and potentially causative medications.
• A skin biopsy can be used to rule out other possible causes (as well as confirm SJS).
• A skin or oral culture can determine whether or not there is an infection.

What Causes Stevens-Johnson Syndrome?

SJS/TEN is most commonly a reaction to a medication. Other causes are possible but much less likely, according to the current medical consensus. Some health factors can increase a person’s risk of SJS/TEN, such as a weakened immune system and viral or bacterial infections, including HIV, pneumonia, hepatitis, influenza, herpes, mumps, Epstein-Barr, strep, diphtheria, brucellosis, mycobacteria, and mycoplasma pneumoniae. Those with cancer, a family history of SJS/TEN, and someone with the HLA-B gene also have a higher risk. 

Medications cause approximately 75% of SJS and TEN cases, and while there are reports of many medications causing SJS, the prominent medications linked to SJS/TEN through the medical literature include:

• Allopurinol (Zyloprim), used to treat kidney stones and gout.
• Lamictal (lamotrigine), used to treat epilepsy and bipolar disorder.
• Nevirapine (Viramune), used to treat HIV infection.
• Antibiotics including macrolide, penicillin, quinolone, and sulfa

The Role of Medical Malpractice in SJS/TEN Cases

Unfortunately, medical errors can play a role in SJS/TEN cases. The errors resulting in medical negligence can occur at various levels. For instance, misinformation or lack of information could arise in a pharmacy dispensing a drug causing SJS/TEN. In most states, there are special laws applicable to pharmacists that require them to provide counseling to the consumer when purchasing prescriptions. Because SJS/TEN is a progressive disease, proper counseling is necessary to provide vital information to the patient to prevent further injury. If this is not done, the pharmacy could be held accountable.

There also could be negligence by a drug manufacturer. The U.S. Food and Drug Administration (FDA) serves as a safety net between drug companies and consumers. In many cases, drug manufacturers have been told of associations between a particular drug they sell and SJS/TEN reactions. Yet, they have failed to apply warnings to their products or have chosen to decline an update of the drug’s warnings. In either case, the failure to properly alert the consumer is a legal issue, and the drug manufacturer could be responsible for your injuries.

Medical malpractice by your medical provider could also play a part. The prescribing physician’s responsibility is to keep up-to-date on warnings, appropriate uses, and adverse effects of all drugs they prescribe. If a physician erroneously prescribes a medication for improper use or at the wrong dose, or if the physician fails to provide you adequate counseling regarding the drug’s potential to cause SJS/TEN, they are negligent in their duties. Also, at the onset of Stevens-Johnson Syndrome, a patient will show critical signs of the illness, which may not be apparent to the patient but should be apparent to a reasonable physician. If a physician is not thorough enough in their examination, he could misdiagnose the condition sending the patient home where the disease could worsen. 

Stevens-Johnson Syndrome & Toxic Epidermal Necrolysis Treatments

SJS/TEN can be life-threatening, and early intervention is critical. All non-essential medications should be halted, and the patient should be taken immediately to an intensive care unit or burn center to receive specialty treatment. The time between the ingestion of a medication and an SJS/TEN reaction varies widely depending upon patient-specific and medication-specific factors but generally occurs within a few weeks of taking the medication. 

If your physician did not instruct you to stop taking the causative drug after your reaction had begun, or you were not promptly treated by an SJS specialist after your symptoms began, you could be the victim of medical malpractice.

Treatment options for SJS/TEN may include:

• Fluid replacement and nutrition. For proper healing to occur and for new skin to grow, fluids in the body must be replaced. The patient may receive fluids and nutrients through a tube inserted in the nose and guided to the stomach (nasogastric tube).
• Wound care. The health care team typically uses cool, wet compresses to soothe blisters while they heal and gently remove dead skin to promote new skin to grow. It is also routine for affected areas also are dressed with either petroleum jelly (Vaseline) or a medicated dressing.
• Oral and Eye care. An eye specialist or an ENT specialist may be required for specialized treatment of the mouth and eyes. 
• Medication: Medications used in the treatment of Stevens-Johnson Syndrome include pain medication, topical steroids to reduce inflammation of the eyes and mucous membranes and antibiotics. 

How an Attorney Can Help with SJS/TEN Cases

SJS and TEN not only cause severe skin reactions and horrific pain but expensive, lengthy hospitalizations and a healing process that could take years to complete and result in permanent injuries. If your SJS/TEN was potentially caused due to medical negligence, a dangerous drug, or an inadequate warning, you should seek compensation for your injuries and suffering.

To determine if your case was due to medical malpractice or product-related negligence, you need a law firm well-versed in SJS/TEN claims. Some questions you should ask any lawyer who you may be considering to handle your SJS/TEN case include:

• How many SJS/TEN claims have you handled in the last five years?
• Do you stay current on the medical issues related to SJS and TEN? If so, how?
• What is the standard of care for medical professionals treating SJS and TEN?
• What types of drugs are most likely to cause SJS and TEN?
• How will you prove in court that the drug I took caused my SJS or TEN injuries? 

Since 2016, Childers, Schlueter & Smith of Atlanta has been a national leader in SJS/TEN medical malpractice cases, resolving or obtaining jury verdicts with total settlements of over Thirty Million Dollars ($30,000,000.00). If you or someone you know is suffering from SJS/TEN and needs legal guidance, our firm can help you through the complex process of determining who is responsible for your SJS/TEN injuries. Call us at 1-800-641-0098 or contact us online for more information on how we can help.