A Henry County State Court jury has awarded $16.4 million in damages to the family of a man who died by suicide after being prescribed an antidepressant without fear of the drug’s side effects, which included suicidal thoughts , to warn.
The jury assigned 51% of the blame for the man’s death to the Stockbridge doctor, who was accused of failing to inform the patient that suicidal tendencies were a known danger of the drug, particularly after consuming alcohol, and also none have regular monitoring in place.
The family’s plaintiffs’ representatives attributed the eight-figure result to their decision to be “brutally honest” with the jury about the strengths and weaknesses of their case.
‘Shot himself’
Harris Lowry Manton plaintiffs’ attorneys Andrew J. Conn and Jeffrey R. Harris told the Daily Report that John A. Pieraccini was 27 at the time of his death.
According to the plaintiff’s lawsuit, Pieraccini, when he met Dr. Jameson A. Estes of Venture Medical Associates first engaged in August 2016, complaining of work-related anxiety that culminated in an exacerbation of “panic attacks,… excessive worry,… shortness of breath…” and heart palpitations.”
The plaintiff’s attorney said it was what Estes failed to do during and after the first visit that led Pieraccini’s family to later sue the doctor, setting off a six-year legal battle.
“During the assessment of the deceased, Dr. Estes to conduct a mental status examination, which was consistent with the level of care and skill normally exercised by physicians in the same or similar circumstances,” the complaint states. “DR. Estes diagnosed the decedent with an “unspecified” anxiety disorder and prescribed him psychotropic medications (citalopram and Xanax) in amounts and for a period of time that represented significant deviations from the standard of care.”
After completing his evaluation of Pieraccini, the plaintiff’s attorney said Estes failed to set a specific follow-up date. Instead, according to the complaint, the doctor suggested that the patient return for a checkup within three months.
“The failure to schedule a specific follow-up appointment and establish a plan to evaluate the decedent significantly sooner than three months after the initial examination constituted significant deviations from the standard of care,” the complaint states. “On September 17, 2016, less than four weeks after he went to Dr. Estes introduced, the deceased shot himself in the head with a pistol. The deceased was declared dead due to his injuries sustained from the gunshot wound.”
‘DR. “Estes conducted an appropriate assessment”
Hours before his death, the plaintiff’s attorney said Pieraccini and his fiancée had dined at a restaurant and enjoyed cocktails. When Pierarccini returned home, he killed himself, leaving behind a shocked and grieving family.
“The Pieraccini family was determined to make amends,” Conn said in a strong statement. “The family would like to warn the public that some of these doctors, often general practitioners who are not psychiatrists, may prescribe these medications without fully informing their patients of the dangers.”
Pieraccini’s parents filed a lawsuit against Estes and Venture Medical Associates in 2018.
(L-R) Jonathan C. Peters and Jeffrey A. Peters of Peters & Monyak in Atlanta. (Photo: John Disney/ALM)
Jonat, trial attorney from AtlantaHan C. Peters and Jeffrey A. Peters of Peters & Monyak defended the doctor and his practice but did not respond to a Daily Report request for comment.
A preliminary defense decision states: The duo claimed their client, “a board-certified family physician,” did not violate medical standards of care or commit medical malpractice.
“DR. Estes conducted an appropriate assessment of Mr. Pieraccini, including taking an appropriate medical history and conducting an appropriate examination,” the statement of defense states. “Mr. Pieraccini’s evaluation revealed no concerns for depression, and he exhibited no signs or symptoms that suggested he might harm himself or others. Dr. Estes appropriately prescribed Mr. Pieraccini citalopram and alprazolam at appropriate dosages to treat the panic attacks.”
According to the defense report, Pieraccini’s suicide followed “several hours of group drinking.” [a] bar “from which he and his fiancée “had to be driven home by the manager.”
“DR. Estes is not liable to the plaintiffs and the judgment should be in his favor,” the statement of defense states.
Because liability is disputed, the plaintiff’s attorney said the litigation continued for six years before moving to a jury trial on Oct. 2.
“The defendant doctor, Stockbridge family physician Jameson Estes, and his insurer MAG Mutual never offered a dime to settle the case,” Harris said in a strong statement. “We had no offers until the verdict.”
“The Doctor’s Duty”
Judge Stephen N. Knights Jr., Henry County State Court. (Courtesy photo)
Before Henry County State Court Judge Stephen Knights Jr., the plaintiffs’ attorneys said they focused their trial strategy on explaining to jurors why the defendant shared responsibility for his patient’s death.
“The biggest obstacle was educating the jury about the reasons why someone might want to commit suicide and the impact that a doctor and prescription antidepressants can have on that risk,” Conn told the Daily Report. “While suicide obviously means that someone has taken their own life, that does not mean that they bear full responsibility for that decision, especially if they are taking prescription medications that alter brain chemistry and cause someone to think differently.”
To make their point, the plaintiff’s attorney used the testimony of a medical expert to explain to the jury both the effects of the prescribed medication and the prescriber’s duties.
“One thing that made a big difference was the fact that we used medical literature that the defendant doctor himself had stated was reliable and that he regularly updated him on the standard of care,” Conn said. “All these medical journals [and] The articles outlined that doctors need to closely monitor their patients when prescribing new antidepressants within the first two to four weeks. Here the doctor scheduled a follow-up examination only three months later, even though there was clear evidence from the sources that even he could be confident that it should have been much shorter.”
To further establish the defendant’s alleged guilt, the plaintiff’s attorney chose to remain candid with the jury about “the strengths and weaknesses” of the plaintiff’s case before presenting additional evidence that called Estes’ credibility into question.
“We were completely honest about the fact that John took his own life on a night of drinking quite heavily. But we also helped the jury understand that John did not have the information necessary to avoid drinking citalopram or to understand the subtle signs that citalopram might cause him to become more suicidal,” Conn said. “This was the doctor’s duty and he made no effort to do so.”
The plaintiff duo also presented the jury with an affidavit filed by Estes in which he claimed that “one-third to one-half of his practice involves treating psychiatric patients.” The plaintiff’s attorney said they then submitted a subsequent deposition in which Estes “revealed that such patients represented only 22 percent of his practice, most of whom were prescribed medication for attention deficit disorder (ADD).” After the ADD cases were removed, the plaintiffs’ attorney emphasized to jurors that only 12 to 14 percent of Estes’ practice “focused on patients with depression and anxiety.”
“Hold doctors to standards”
After five days of trial and more than four hours of deliberations, the jury reached a verdict of $16.4 million. The plaintiff’s attorney said the jury awarded their clients $8.36 million, with 51% of the fault attributable to the doctor and his practice.
However, due to pre-trial demands for liquidated damages and an unaccepted settlement offer, Conn expected the damages to increase to $12 million.
“We are very pleased that the jury understood the importance of holding doctors to the standards set by the rules that are easily accessible and accessible to them. “They understood that suicide is due in part to the actions of the person taking their own life, but that there are many other factors that contribute to a person’s decision to do so,” Conn told the Daily Report. “In this case, they assumed that John did not receive a thorough examination when he visited the defendant, was not educated by the defendant, and was not monitored by the defendant about these dangerous new drugs.”
Read the verdict and verdict
Plaintiffs’ attorneys praised the efforts of paralegals Kerri Daly and Zuzana Dubois and Hoffspiegel law partner Alexander Hoffspiegel for their contributions to the case, including “an incredible Zoom focus group” that helped prepare the plaintiff duo for trial.
“We hope that uncovering this case will help bring about change. While it is true that antidepressants are intended to help people and often do, there is a 2 to 4 percent risk that a patient will become more severe or become suicidal for the first time in the first four weeks after being prescribed these medications. said Conn. “We hope this will change the industry practice of prescribing antidepressants without thorough investigations, detailed education and close monitoring of patients.”
