Sterling Drug, Inc. v. Yarrow

Irene Yarrow (plaintiff) began using the prescription drug Aralen (chloroquine phosphate) in 1958 to treat her rheumatoid arthritis. Yarrow’s physician, Dr. Olson, had learned about the drug from a traveling salesman or “detail man” who worked for Sterling Drug, Inc. (Sterling) (defendant), the drug’s manufacturer. Yarrow used the drug on a daily basis until 1964, when Dr. Olson recommended that she discontinue its use because Yarrow’s ophthalmologist had noticed that Yarrow’s vision had deteriorated and suspected that it might be the result of her medication. Up until that time, Dr. Olson was unaware that Aralen could cause a type of irreversible vision loss known as chloroquine retinopathy. Beginning in 1957, reports in medical journals showed that the drug could be causing side effects of the type Yarrow was experiencing, and by 1961 it was apparent that the retinal changes associated with the drug were irreversible. The evidence showed that Sterling was aware of the reports that the drug caused irreversible retinal damage in a substantial percentage of patients using the drug to treat rheumatoid arthritis for an extended period. Yarrow brought an action against Sterling, claiming that Sterling had been negligent in testing, manufacturing, and marketing the drug and in failing to warn her, her physician, the public, and retail pharmacists of the potential danger of using the drug. The trial court found that Sterling communicated its product information to prescribing doctors by means of its detail men, the Physicians’ Desk Reference, product cards, and Dear Doctor letters. In January 1963, Sterling sent a Dear Doctor letter to all physicians and hospital personnel in the United States, explaining the dangers associated with the drug. There was evidence that Dr. Olson was inundated with literature about various drugs and could not possibly read it all and that he relied on detail men, conversations with other doctors, medical journals, and medical conventions for information on the drugs he prescribed. The trial court found that Sterling had negligently failed to warn Dr. Olson, Yarrow’s prescribing physician, and awarded Yarrow $180,000. Sterling appealed, claiming that the trial court erred in requiring Sterling to warn of Aralen’s dangers by the most effective method (personal notification of all physicians by detail men), which was an erroneous legal standard and a higher one than the duty to make reasonable efforts to warn.