Methotrexate Medication Error

Can I Sue My Doctor, Pharmacist, or Nursing Home for a Methotrexate Medication Error?

Methotrexate is a dangerous, high-alert prescription drug with a narrow therapeutic index and an extraordinarily wide range of doses and duration of treatment.[1]  This means that small differences in dosage or blood concentration outside of strict therapeutic standards can lead to severe adverse consequences; therefore, dosages must be carefully monitored for every patient.  It is widely known that the medication can cause severe side effects at any dose; however, high doses often result in drug toxicity, lengthy hospitalizations, or even death.[2]

As Michigan Methotrexate lawyers and nursing home injury attorneys, we demand justice for nursing home residents injured through abuse, neglect, or negligence, including those injured through medication errors.  Medication errors can result when a physician, pharmacist, nurse, or medical facility personnel incorrectly orders, dispenses, labels, or administers a prescription.

Unlike most medications (which are taken on a daily basis), Methotrexate is often only taken once per week.  An error in ordering, dispensing or administering may mistakenly cause this drug to be given on a daily basis, which can lead to severe injury.  When over-administration of Methotrexate occurs, or when it is otherwise prescribed incorrectly, we are there for the residents and families who are injured.

Call our offices to schedule a free consultation to learn how we can help you hold those responsible accountable and get you the full compensation you deserve for Methotrexate medication error injuries.

What is Methotrexate?

Methotrexate inhibits the growth of harmful cells that are capable of quickly reproducing, such as cancer, bone marrow, and skin cells.  While it is frequently utilized to treat advanced cancers, low-dose oral use Methotrexate prescriptions have increased tremendously, primarily as a treatment for rheumatoid arthritis or psoriasis.  For instance, within four years, the number of patients using methotrexate nearly doubled from 561,000 to 1 million patients.[3]

Methotrexate can have harmful side effects, including death, if it is administered too frequently.  Thus, it is usually only prescribed after other medications have failed in the successful treatment of symptoms.

How Often Should Methotrexate be Taken?

For non-oncologic uses, Methotrexate should only be taken weekly rather than daily, as even a single week of daily administration can result in death.  Unfortunately, the FDA reported that many elderly patients are unknowingly ingesting potentially lethal, daily doses of the drug as a result of incorrectly ordered, labeled, or dispensed methotrexate.[4]  Further, the agency found that dose frequency errors occur at an astounding rate of four per thousand patients, and this number is growing as the popularity of the medication surges.[5]

Is Methotrexate Dangerous?

Methotrexate is considered a dangerous, high-alert drug, meaning that it has a heightened risk of causing harm if it is incorrectly administered to a patient.  However, many patients suffering from severe autoimmune and inflammatory diseases (such as rheumatoid arthritis) rely on the drug for relief, despite the potential side-effects, as the therapeutic benefits of the drug can outweigh the potentially harmful side effects.

The FDA instructs both physicians and pharmacists to emphasize to patients that the drug should only be taken weekly for the treatment of rheumatoid arthritis, as daily use of the recommended dose can lead to fatal toxicity.[6]  Unfortunately, for many patients living in long-term care or nursing home facilities, they do not have direct control over the dosage or frequency at which the drug is administered, rendering them unable to guard against a potentially deadly overdose.  Consequently, hundreds of elderly patients die each year, often for the following reasons:[7]

  • Physicians prescribe high doses of Methotrexate
  • Medical personnel or nurses administer the drug incorrectly
  • Pharmacists mislabel prescriptions, inadvertently instructing patients to take daily (rather than weekly) doses
  • Pharmacists fill prescriptions despite adverse drug interactions or incorrect dosing

If you or a loved one is being administered a daily dose of Methotrexate and are experiencing side effects, it is essential to contact your physician immediately to evaluate whether a medication error has occurred.

What Are the Signs of a Methotrexate Overdose?

Signs of a Methotrexate overdose include:

  • Body aches
  • Shortness of breath
  • Flu-like symptoms
  • Vomit with blood
  • Decreased appetite
  • Black, tarry stools
  • Diarrhea
  • Nausea
  • Dizziness
  • Extreme exhaustion
  • Headaches
  • Shortness of Breath
  • Easy bruising, bleeding or reddening of the skin
  • Skin infections
  • Mouth or lip ulcers

Can I Sue My Doctor for Prescribing Methotrexate in Michigan?

From physicians and medical personnel, to pharmacists and medical facilities, anyone in the chain of distribution for a medication error can be potentially liable for any harmful injuries sustained.  As such, the doctor who prescribed your medication can be liable for the harm caused, especially if he or she failed to order the correct drug or dosage, failed to warn you about potential side effects, or failed to explain how to safely and effectively utilize the drug.

In evaluating potential physician liability, it will be important to understand:

  • Did the physician prescribe the drug after taking into account all of the patient’s medical condition and ailments?
  • Did the physician prescribe the drug after understanding all of the other medications the patient was taking?
  • Did the physician warn the patient (or the patient’s guardian) about the potential risks of taking the drug?

The key in assessing physician liability hinges upon whether the drug was properly prescribed for the conditions of a specific patient, and whether the patient was properly informed of the potential risks so that an informed decision could be made.

Can I Sue the Nursing Home, Clinic, or Hospital Where My Medication was Administered?

Medical and long-term care facilities are typically responsible for an employee’s conduct while they are working.  Thus, if the wrongful actions or mishandling of a drug by physicians, pharmacists, medical personnel, or nursing home staff caused side effects, the facility will likely be liable for the injuries sustained.

A nurse is required to properly transcribe an order for Methotrexate from a physician.  A nurse is also required to verify that transcribed orders are properly entered into the system and sent to the pharmacy.  Like physicians, nurses have the education, training and knowledge to know the conditions for which Methotrexate should be given on a weekly basis only.  A nurse should never administer Methotrexate on a daily basis to a resident who does not have a condition that warrants such a dose.  In addition, a nurse should closely monitor all residents who are taking Methotrexate for signs and symptoms of overdose and/or toxicity and should immediately notify a physician in the event of any such signs or symptoms.

Can I Sue My Pharmacist for Incorrectly Filling or Mislabeling My Methotrexate Prescription?

A pharmacist is often the last line of defense between a patient and a medication, and they can be liable if they fail to protect patients from preventable harm.  A nursing home is required to retain a consultant pharmacist, who is responsible for recognizing and notifying a physician about any drugs that are excessive in dose or duration.  The consultant pharmacist must also perform a monthly drug-regimen review for all of the nursing home residents.  Like other skilled professionals, these pharmacists have a duty to exercise a certain level of care to prevent individuals from being injured.  When a pharmacist fails to adhere to their duties, they can be sued for malpractice and held liable for their actions or inaction.

Pharmacists must use their judgment concerning drug interactions, refills, and a patient’s personal use of medication.  Additionally, they must have general knowledge about each drug that they dispense and why a patient’s physician may have prescribed it.  A pharmacist exercises poor judgment and violates the duty of care when he or she does the following:

  • Dispenses the wrong dose of a drug
  • Dispenses the wrong drug
  • Overlooks drug interactions
  • Disregards and overrides a serious potential adverse drug event alert
  • Fails to exercise care regarding dosage or duration
  • Fails to provide a patient with adequate information regarding side effects and drug interactions

In general, pharmacists should be familiar of the dangerousness of Methotrexate, as well as the fact that it is usually prescribed in weekly (or even less frequent) dosages.  Thus, if a prescription calls for a daily administration of the drug for a condition for which it should only be taken weekly, the pharmacist should not dispense the medication and should call the prescribing physician for clarification before filling the prescription.

How Long Do I Have to File a Methotrexate Lawsuit in Michigan?

Michigan Law specifies that a medical malpractice claim must be filed within two years from the date on which the alleged medical error occurred.  This is known as the statute of limitations.  If a claim is not timely filed, the lawsuit will be barred, and the victim may be unable to collect compensation for injuries.

In the case of a methotrexate error, it can be challenging to determine exactly when the injuries occurred, as a patient may not notice a problem right away.

If you would like to file a lawsuit, it is crucial to contact an attorney as soon as possible.  We can evaluate your claim, determine the applicable statute of limitations, and file a claim to ensure that you are not barred (or prevented) from recovering compensation.

How Can a Michigan Methotrexate Lawyer Help Me?

If you or a loved one has suffered an adverse health event from exposure to Methotrexate, call our office to schedule a free consultation.  We can evaluate your medical history and claim at no cost or obligation to you.  Once we learn the facts and circumstances of your case, we can explain the options you have for holding accountable those responsible.

If retained, we can fight tenaciously to get you or your loved one full and fair compensation.  We accept negligence and wrongful death cases on a contingency fee basis, meaning that we are only entitled to a fee if compensation is recovered through a settlement or trial award.   We additionally advance all litigation costs (these expenses are normally repaid to us through a settlement or award), so you will not need to pay these costs out-of-pocket while your case is proceeding.

[1] QuarterWatch, Institute for Safe Medication Practices,

[2] Methotrexate Tablets, USP, FDA,

[3] QuarterWatch, Institute for Safe Medication Practices, (from 2013 – 2017).

[4] QuarterWatch, Institute for Safe Medication Practices,

[5] QuarterWatch, Institute for Safe Medication Practices,

[6] Methotrexate Tablets, USP, FDA,

[7] Will you have Death with Methotrexate?, eHealthMe,