Sommers Schwartz attorneys Matthew Curtis [verify link] and Micaela Dalrymple filed a medical malpractice and wrongful death lawsuit on behalf of the estate of a 71-year-old Detroit woman who died after a kidney specialist prescribed a COVID-19 medication known to cause a dangerous, potentially fatal drug interaction in kidney transplant patients.
The decedent had received a kidney transplant in 2018 and, like all transplant recipients, depended on a daily anti-rejection medication called Tacrolimus to prevent her immune system from attacking the transplanted organ. Tacrolimus is highly sensitive to drug interactions, and it is well established that Paxlovid, an oral COVID-19 antiviral, can cause Tacrolimus levels to build to dangerously high concentrations by blocking the enzyme the body uses to metabolize it. For this reason, Paxlovid is contraindicated in transplant patients on Tacrolimus. When COVID-19 treatment is needed in this patient population, Remdesivir, an intravenous antiviral that does not interact significantly with Tacrolimus, is the appropriate alternative.
On July 7, 2024, the decedent went to the emergency room and tested positive for COVID-19. The ER physician consulted the on-call kidney specialist specifically to discuss the decedent’s anti-rejection medications and Paxlovid use. The specialist advised that no adjustments to the decedent’s Tacrolimus were needed and that Paxlovid would not interfere with her regimen. Relying on that advice, the ER physician sent a Paxlovid prescription to her pharmacy and discharged her home. No arrangements were made to monitor her Tacrolimus blood levels while she was taking both drugs together.
The decedent’s condition worsened over the days that followed. On the evening of July 11, she returned to the ER with worsening COVID symptoms, gastrointestinal distress, increasing weakness, a rapid heart rate, and confusion. She was admitted on July 12 under a second kidney specialist from the same practice. Upon admission, the treating physician restarted the decedent’s Tacrolimus without first obtaining a blood level and without holding the medication pending results, even though the patient had spent five days taking it alongside Paxlovid, a known interaction. She continued receiving Tacrolimus for two more days.
On July 14, a blood test finally confirmed what the prior days of worsening symptoms had been signaling: Tacrolimus levels were dangerously high, a clear sign of toxicity. The drug was discontinued immediately, but the damage had already been done.
Also on July 14, the decedent was found pulseless and unresponsive in her hospital room. CPR was initiated, and after four rounds of resuscitation, the code team restored a heartbeat. She was transferred to the intensive care unit on a ventilator.
Brain imaging and neurological evaluation in the days that followed revealed severe hypoxic ischemic encephalopathy (brain damage caused by oxygen deprivation during the cardiac arrest), along with seizure activity and severely impaired brainstem function. Neurologists described her chances of meaningful recovery as very poor. Her family elected comfort measures, and she was removed from the ventilator on July 27, 2024. The death certificate listed Tacrolimus toxicity and COVID-19 as the causes of death.
Brought under Michigan’s Wrongful Death Act, the lawsuit names both treating kidney specialists and their shared nephrology practice as defendants. It seeks compensation for the pain and suffering the decedent endured from the time of the defendants’ negligence through her death, as well as hospital, medical, funeral, and burial expenses.
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