Is death an inevitable side effect? I read an article recently by Dr. Mrazek at the Mayo Clinic entitled “How Many Deaths Will it Take.” The article pointed out the number of deaths from adverse drug reactions and that widespread adoption of pharmacogenetic testing would reduce this number. Yesterday, Dr. Mrazek’s statement came closer to home. I received an e-mail from Roman Finnegan. Roman and has family have not only endured the death of their young daughter by warfarin overdose, but have been battling CPS and the courts to drop false charges of child abuse because of the bruising and bleeding the overdose lead to. The case was finally dismissed earlier this month. You can view the statements that lead to the dismissal at the links below.

Affidavit of Edith Nutescu  - Director of the Antithrombosis Center, a member of the Affiliate Faculty at the Center for Pharmacoeconomic Research, and a Clinical Associate Professor in the Department of Pharmacy Practice at the College of Pharmacy, University of Illinois at Chicago.   Declaration of Bruce Lambert  – Department of Pharmacy Administrator and Clinical Professor, Department of Pharmacy Practice, University of Illinois at Chicago. Roman closed his e-mail by stating "I think your company should use this case as an example. It's one thing to say your product can save lives. It's another to demonstrate how it can help to avoid a tragedy like the one we have endured.”

Granted warfarin protocols were not adhered to as they should have been in this case, but a simple DNA test could have determined a more accurate dose from the beginning of therapy. Without the CYP 2C9 and VKORC1 genotypes, physician’s are prescribing with huge gaps in the information available to them, as shown in the pie chart below.

Would you prescribe without knowing the age, weight and gender of your patient?
Why proceed without the genetic component?