Failure to Monitor Patient on Blood Pressure Medication Leads to Kidney Failure, $2M Verdict

​A physician in Georgia was found negligent for failing to order testing to monitor a patient taking blood pressure medications that were known to potentially result in adverse effects, according to a report from Zarin's Medical Liability Alert (subscription required). On March 3, the patient visited the defendant family physician with concerns about his blood pressure and family history of diabetes. The patient's blood pressure was 180/130 mm Hg. The physician diagnosed severe hypertension and ordered "the highest possible prescriptive dose" of lisinopril. When the patient returned to the office four days later, his blood pressure was 170/110 mm Hg. The defendant added a prescription for hydrochlorothiazide (20 mg every morning), but did not order diagnostic testing. On May 20, the patient's blood pressure was recorded at 168/108 mm Hg. The defendant refilled the prescription for hydrochlorothiazide and again did not order diagnostic testing. On July 25, the defendant added another prescription, for metoprolol (Toprol XL 100 mg daily) without ordering blood or urine testing. The patient returned to the office five more times over the next three years, during which time the physician failed to order or perform any tests on the patient. The patient, who was the plaintiff in this case, contended that his blood pressure remained elevated and that he kept a diary of his blood pressure readings, which he shared with the defendant.