Antibiotic Reaction Lawsuit Claims Medical Malpractice Resulted in Woman’s Death

Lawsuit alleges the woman received eight times the recommended dose of cefepime, which should have been limited due to her level of kidney function.

The son of an Ohio woman has filed a wrongful death lawsuit against a hospital that allegedly gave her high doses of an antibiotic that they should have known was toxic for her, resulting in a fatal cardiac arrest.

The complaint (PDF) was brought on July 6 in the Court of Common Pleas in Hamilton County, Ohio, by Brad Howington, representing himself and the estate of his mother, Dixie McDonald. The lawsuit names Mercy Health – West Hospital LLC, as the defendant.

Howington claims his mother was repeatedly given doses of cefepime that exceeded recommendations by the U.S. Food and Drug Administration (FDA). He argues this medical malpractice contributed to McDonald’s death at the hospital on July 6, 2024.

Cefepime Health Concerns

Cefepime, also known by the brand name Maxipime, is a cephalosporin antibiotic given intravenously for the treatment of severe infections, including infections of the skin, lungs, stomach and blood. First approved in 1996, the brand name version has been discontinued in the U.S. However, the drug is still regularly used in its generic cefepime form.

In 2012, the U.S. Food and Drug Administration (FDA) warned that Maxipime poses an increased risk of seizures. This risk was linked to a particular type of seizure known as nonconvulsive status epilepticus.

A 2023 study also linked the antibiotic to an increased risk of neurological disruption, including convulsions, agitation and delirium. Researchers suggested the neurological dysfunction risks may be a result of Maxipime crossing the blood-brain barrier, which could lead to neurotoxicity and increase the risk of outcomes such as delirium, coma and seizures.

Cefepime Death Allegations

According to Howington’s lawsuit, McDonald was first admitted to Mercy West on June 11, 2024, where she was diagnosed with bilateral pulmonary emboli. Doctors performed a thrombectomy and discharged her on June 14.

Three days later she was back in the hospital due to shortness of breath. She was diagnosed with a heart attack and multifocal pneumonia and was given 2,000 mg of cefepime every 12 hours.

The medical malpractice lawsuit argues that this was a mistake. McDonald’s medical chart indicated that she has stage 3b chronic kidney disease. According to the drug’s label, her kidney function levels required a reduced dose of 1,000 mg every 24 hours, meaning McDonald was being given eight times the FDA-recommended dose.

Howington indicates that multiple safeguards were triggered which the healthcare providers ignored. This included warnings from the hospital’s electronic records system, which issued a Best Practice Advisory, specifically warning that the dose was inappropriate for McDonald’s liver function. The lawsuit alleges a healthcare provider, whose identity is currently unknown, overrode the advisory.

On June 21, healthcare providers were given three separate warnings about the potential for a cefepime overdose, including a nurse, a pharmacist and a nephrologist.

“The nephrology consulting service documented that Decedent was exhibiting myoclonus (involuntary muscle jerking), a known sign of cefepime neurotoxicity, and recommended switching to a different antibiotic.”

– Brad Howington v. Mercy Health – West Hospital LLC

Hospital staff continued to give McDonald high doses of cefepime for three more days, which the lawsuit indicates led to progressive encephalopathy, a sign of cefepime neurotoxicity. McDonald was unable to follow commands or speak, showed signs of rigidity, dorsiflexion of the feet, moaning and crying. This led to a percutaneous coronary intervention (PCI) procedure being canceled due to her inability to communicate.

By June 24, the consulting service identified cefepime as the cause of McDonald’s encephalopathy and she was discontinued from the drug. The lawsuit states that her mental status then improved.

Infectious disease experts indicated that McDonald had completed her antibiotic course by July 5. However, that afternoon an unidentified worker gave her a 2,000 mg dose of cefepime, followed by 1,000 mg every 12 hours.

On July 6, McDonald was found unresponsive, having died of cardiac arrest. The lawsuit notes that the drug was infusing into her at the time of death.

Howington presents claims of wrongful death, fraudulent concealment and survival action. He seeks compensatory and punitive damages for his mother’s death.

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