MDLinxA Jury Awards Over $8 Million After a Man Died by Suicide Less than a Month After Being Prescribed Citalopram

Unforeseen Consequences: The Delicate Balance in Psychiatric Care and the Tragic Case of Misdiagnosis

In a case that underscores the intricate complexities of psychiatric care, a Georgia physician was found liable for the suicide of a patient. The case highlights the critical importance of thorough patient evaluation, appropriate prescription practices, and the potential risks of misdiagnosis in mental health care.

Key Points:

• Dr. Jameson Estes was found liable for the 2016 suicide of his patient, John Pieraccini.
• Pieraccini was diagnosed with an unspecified anxiety disorder and prescribed Xanax and citalopram.
• The prescriptions were deemed significant departures from the standard of care.
• Pieraccini committed suicide a month after starting the medications.
• The defense argued that Pieraccini showed no signs of depression or self-harm.
• The plaintiff’s attorneys argued that Pieraccini was not adequately informed about the risks of his medication.
• The jury found Dr. Estes and Venture Associates 51% responsible for Pieraccini’s death, awarding the family around $8.36 million in damages.
• Patient suicide is a common reason for malpractice suits against psychiatrists.
• Guidelines from the American Psychiatric Association provide screening tools for patient evaluation.
• Thorough patient evaluation and appropriate response to treatment steps are crucial in preventing patient suicide.

We often think of patients with depression as the ones to watch and worry about as at-risk for suicide. And they certainly can be. But you’ve also got these patients who are impulsive or who something has happened to. And you don’t know by their history. You don’t know by looking at them. That’s where these screening tools can really catch people. They’re quick; some of them are five, six questions, and they can spot things you might not otherwise.

Jean Gaggino, MD

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