5/22/2018 3:28 PM

Velva L. Price
District Clerk
Travis County
CAUSE NO. D-1-GN-18-001885 D-1-GN-18-001885
Nancy Ramirez

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LORENA LOPEZ-GONZALEZ § IN THE DISTRICT COURT

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and BRYAN HAVEL §

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V. § TRAVIS COUNTY, TEXAS

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STONEGATE PHARMACY, LP. and §
201ST JUDICIAL DISTRICT

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KYLE R. GRIMSLID, PHARM.D. §

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PLAINTIFFS’ FIRST AMENDED PETITION

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CONTAINING REQUESTS FOR DISCLOSURE

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TO THE HONORABLE JUDGE OF SAID COURT:

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COME NOW, LORENA LOPEZ-GONZALEZ, and BRYAN HAVEL, Plaintiffs,

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complaining of STONEGATE PHARMACY, LP and KYLE R. GRIMSLID, PHARM.D.,

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Defendants, and for cause of action would respectfully show the Court and jury the following:
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I.
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DISCOVERY CONTROL PLAN

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Plaintiffs request that this case be governed by a Level 3 Discovery Control Plan pursuant

to Texas Rules of Civil Procedure 190 and 190.4.

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II.
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PARTIES, JURISDICTION AND VENUE

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Plaintiffs LORENA LOPEZ-GONZALEZ and BRYAN HAVEL are individuals residing

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in Austin, Travis County, Texas.

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Defendant, STONEGATE PHARMACY, LP, is a Texas limited partnership with a

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principal place of business in Travis County, Austin, Texas and has answered and appeared.
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Defendant KYLE R. GRIMSLID, PHARM.D., is an individual and was a Texas

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pharmacist at the time of the events in question. He now resides in the State of Ohio and may be

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 served via the Texas Secretary of State, James E. Rudder Building, 1019 Brazos, Room 105,

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Austin, Texas 78701. Mr. Grimslid resides at 8203 Bent Tree Drive, West Chester, OH 45069.

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At times, Plaintiffs refer to Stonegate and Kyle Grimslid collectively as Defendants or as

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Stonegate.

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The District Courts of Travis County, Texas have jurisdiction over this case. The amount

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in controversy exceeds the minimal jurisdictional limits of this Court, and the exercise of this

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Court’s jurisdiction over the Defendants is proper.

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Venue is appropriate in the District Courts of Travis County, Texas pursuant to Texas

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Civil Practices & Remedies Code §§ 15.002(a)(1) and 15.001(a)(2) in as much as a substantial

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part of the events or omissions giving rise to the claim occurred in Travis County.
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III.
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Plaintiffs would show that Defendants have been notified of Plaintiffs’ claim at least
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sixty (60) days prior to the filing of this lawsuit in accordance with the Texas Medical Liability
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and Improvement Insurance Act, Tex. Civ. Prac. & Rem. Code § 74.051.
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IV.
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FACTS
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This case arises from the negligence and gross negligence of Stonegate Pharmacy and
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Kyle Grimslid in compounding and delivering to Plaintiff a prescription medication in a dose

over 50,000% greater than it should have been, almost killing the Plaintiff when she took it.
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Making matters worse, Stonegate and/or Kyle Grimslid knew or should have known it put
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Plaintiff in harm’s way because Stonegate and/or Kyle Grimslid caught itself mis-compounding
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and overdosing at least two other patients with the same drug at basically the same time.
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Although Stonegate and/or Kyle Grimslid reached out to those patients to warn them and try and

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 stop them from taking potentially lethal doses, Stonegate and/or Kyle Grimslid did nothing to

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investigate the dosage it compounded and gave Plaintiff, did nothing to alert or warn her and did

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nothing to stop her from taking it and continuing to take it.

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Plaintiff Dr. Lorena Lopez-Gonzalez suffered from a thyroid condition for which her

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physician prescribed Levothyroxine, a thyroid hormone used to treat hypothyroidism, a condition

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where the thyroid gland does not produce enough thyroid hormone. On or about February 26,

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2016, Dr. Lopez-Gonzalez submitted a prescription to Stonegate Pharmacy for compounding and

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preparation of Levothyroxine. Instead of compounding the prescription safely and as indicated

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by the physician, Stonegate and/or Kyle Grimslid compounded a dosage that was over 50,000

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percent greater than it should have been. Dr. Lopez-Gonzalez took the medication as directed,
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not knowing that she was ingesting a potentially lethal dose each time she took it.
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As Dr. Lopez-Gonzalez took the improperly compounded medication, each overdose

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began causing damage to her body, ultimately sending her into a life threatening thyroid storm
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and to intensive care where she almost died. After ingesting what she didn’t know was the
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improperly compounded medication, Dr. Lopez-Gonzalez became ill and went to the hospital
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multiple times and finally returned to the Seton Northwest Hospital emergency room on March
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13, 2016 and was admitted that same day. Because of the poison pills Stonegate and/or Kyle
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Grimslid gave her, Dr. Lopez-Gonzalez was suffering from thyrotoxicosis. Technically,

thyrotoxicosis refers to the presence of too much thyroid hormone in the body. The excess of
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thyroid hormone in her body was due to the compounding error and overdose given to her by
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Stonegate, but her doctors did not know that yet. Over the next few days, the thyrotoxicosis
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developed into a full Thyroid Storm and required admittance into the Intensive Care Unit. A
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Thyroid Storm is a life-threatening health condition that is associated with untreated or

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 undertreated hyperthyroidism. During a Thyroid Storm, an individual's heart rate, blood pressure,

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and body temperature can soar to dangerously high levels. This was a terrifying time as the

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doctors were puzzled and could not figure out the cause of her physical or mental condition. At

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that time, they had no idea of Stonegate’s error or that Lorena was essentially being poisoned by

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the medication Stonegate had mis-compounded. Between Sunday and Wednesday, Lorena’s

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symptoms worsened to the point she had not eaten solid food for almost a week, and was

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extremely fatigued with continued vomiting and stomach nausea. On top of these physical

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ailments, Lorena experienced severe cognitive and memory lapses, worsening to outright

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psychosis. In addition, Lorena’s behavior and mental state were so concerning that she had to be

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restrained to her bed and she had to be protected from hurting the nurses and herself. She needed
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to be stopped from attempting to remove the medical equipment on her body. She was being
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pumped with extensive drugs to combat all of this, and was increasingly unstable in her physical
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and mental condition.

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On Wednesday and due to her dangerous combination of tachycardia and psychosis,

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Lorena was diagnosed and admitted into the ICU as is the standard practice for Thyroid Storm
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incidents. At this point, it was conclusively determined Lorena was experiencing a Thyroid
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Storm (although it was still not known why it had occurred), and she was heavily sedated, having
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a feeding tube, catheter, and PIK line inserted, and put into a 100% sedated state – basically a

medically induced coma.

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Lorena remained in this state for 5 days, having to be 100% cared for by the ICU staff as
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they provided her body the drugs needed to try to reverse the effects of the Thyroid Storm.
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Once her thyroid and other conditions (pulse rate, heart rate, etc.) were normalized 5 days later,
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 she was slowly awakened. Lorena remained in the ICU for a few more days slowly recovering

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from an almost two-week ordeal of having this violation to her mental and physical health.

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Dr. Lopez-Gonzalez was discharged on March 23, 2016. During the discharge, the

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doctor indicated that Lorena should go see an endocrinologist as they could not really yet

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identify what caused the Thyroid Storm.

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Once Dr. Lopez-Gonzalez came home, she spent several weeks working on her mental

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and physical strength especially given she lost over 15 pounds during the ordeal. Lorena was

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extremely weak and needed assistance in completing all the activities of daily living. She also

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needed supervision 24 hours a day. Lorena and Bryan also spent the next several weeks visiting a

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litany of specialists in an effort to insure her immediate health and to try to determine what
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caused the Thyroid Storm.
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Lorena was determined to find out the cause of the Thyroid Storm. After exhausting
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other potential causes, she ultimately approached Stonegate Pharmacy and asked Stonegate to
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check the prescription medication it provided to her in order to ensure that Stonegate had
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provided the proper dosage.

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Incredibly, the compounding error with Levothyroxine was not news to Stonegate and
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not an isolated incident, but Stonegate hid that from Lorena. Upon information and belief, at
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least two other patients of Stonegate were also overdosed with Levothyroxine due to Defendants

compounding error at or near the same time that Defendants overdosed Lorena. In one such
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event, on March 3, 2106, Stonegate and its Director of Pharmacy compounded a 1,000 fold
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overdose of Levothyroxine and the patient took it for three days before Stonegate discovered the
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error and contacted that patient to instruct her to stop taking the medication. That patient was
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hospitalized and suffered damage. In another incident, Stonegate and Defendant Grimslid

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 dispensed a compounded prescription of T4 T3 to a patient. After taking two doses of the

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prescription, the Patient sought immediate medical treatment after having being notified of a

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possible error by Stonegate and was hospitalized for approximately two days and experienced

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adverse effects over several weeks, including fever, rapid heartrate and anxiety. Yet despite

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knowing of its Levothyroxine errors in early March of 2016, Stonegate never made any attempt

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to contact Lorena to check on her prescription of Levothyroxine or whether it had likewise been

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improperly compounded. Callously, Stonegate just let it ride and said nothing. In fact,

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Stonegate concealed the other incident from Lorena and said nothing about it even later when

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Lorena contacted Stonegate to explain what had happened to her and have the dosage

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investigated. Several weeks after being approached by Lorena, Stonegate confirmed through an
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independent lab report that Stonegate had made a huge, life changing error and admitted that to
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Lorena. But, Stonegate still said nothing about other patients suffering the same fate. Defendant
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Stonegate admitted it improperly filled and/or compounded Lorena’s prescription, delivering a

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near fatal and life altering dosage to Lorena that was exponentially higher than called for and
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almost lethal. In fact, it was a miracle that she did not die from the negligence of Defendant
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Stonegate and the Thyroid Storm it caused. While she escaped death, Lorena did not escape
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permanent damage from the poisonous dosage.

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Lorena’s treatment and struggles with the damage caused by Defendants’ negligence and

gross negligence continues to date and will into the future. Dr. Lopez-Gonzalez continues to
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suffer damages that include residual cognitive deficits secondary to a traumatic brain injury from
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the insult and her thyrotoxicosis crisis. As a result of Defendants’ negligence and gross
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negligence, the Plaintiffs now bring this action for fair and full compensation for the damages
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they have suffered and will continue to suffer.

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 V.

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NEGLIGENCE/GROSS NEGLIGENCE OF

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DEFENDANT STONEGATE PHARMACY, LP and KYLE GRIMSLID, PHARM.D.

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Through the substandard care and treatment of Lorena Lopez-Gonzalez, Ph.D.,

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Defendant Stonegate, Defendant Kyle Grimslid and/or their agents, representatives and/or

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employees fell below the applicable standard of care due to her. Those negligent failures

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included one or more of the following negligent acts or omissions, acting singularly or in

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combination:

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1. Failure to properly fill and/or compound a prescription;

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2. Failure to conform to the standard of care a reasonably prudent healthcare

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provider would have done under the same or similar circumstances;
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3. Failure to discover the compounding error during a check of the prescription, if
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any;
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4. Failure to properly hire, train, oversee, supervise, retain and/or review employees,
agents or servants.
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5. Failure to investigate and alert Plaintiffs when Stonegate became aware it had
committed egregious and dangerous errors compounding the Levothyroxine
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prescriptions of other patients at or near the same time as it provided one to

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Plaintiff.
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The acts and/or omissions of Defendants constitute negligence. Such conduct was a
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proximate cause of the injuries and damages of the Plaintiffs. Conduct attributable to the
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Defendants also constitutes gross negligence and was a proximate cause of damages to Plaintiffs.
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Upon information and belief, at all relevant times, the involved agents, employees,
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servants and/or pharmacist(s) at Stonegate were agents or employees or servants of Stonegate

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Pharmacy, LP. The pharmacist(s) improper compounding of the medication for Plaintiff Lopez-
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Gonzalez was performed within the course and scope of duties with Stonegate Pharmacy, LP.

Therefore, Stonegate Pharmacy, LP is also vicariously liable for the negligence of Defendant

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 Grimslid and any/all others the involved agents, employees, servants, pharmacist(s) through the

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doctrine of respondeat superior, agency and all other applicable direct and vicarious liability

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doctrines at law and equity.

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VI.

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DAMAGES

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The conduct and/or negligence of Defendants, jointly and severally, proximately caused

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damages to Plaintiffs. Plaintiff Lorena Lopez-Gonzalez, Ph.D. has suffered bodily injuries and

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damages and Plaintiff Lorena Lopez-Gonzalez, Ph.D. has incurred expenses for medical care and

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attention. These expenses incurred were necessary for the care and treatment of the injuries

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sustained by Plaintiff Lorena Lopez-Gonzalez, Ph.D., and the charges made and to be made were
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the usual and customary charges for such services in Travis County, Texas. Plaintiff will require
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further medical care and attention and will incur reasonable expenses in the future for such
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medical needs.
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Further, Plaintiff Lorena Lopez-Gonzalez, Ph.D. would show that reasonable

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compensation should be awarded for her pain, disability, disfigurement, loss of earnings, loss of
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earning capacity, physical impairment, medical care and expenses and mental anguish, in the
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past and future.

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Plaintiff Bryan Havel, her husband, has also suffered damages, including loss of

household services and loss of consortium.

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The parties seek monetary relief over the amount of $1,000,000.00.

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 VII.

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EXEMPLARY DAMAGES

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Defendants also are liable for exemplary damages caused by their gross neglect and/or

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gross negligence, which were a proximate cause of the injuries and the resulting damages to

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Plaintiffs.

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VIII.

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INTEREST

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Plaintiffs would show that they are entitled to recover interest for all elements of damages

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recovered for which the law provides for pre-judgment interest, beginning (1) on either the 180th

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day after the Defendants received written notice of claim from the Plaintiffs, or (2) the day that
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the lawsuit was filed, whichever is earlier, and ending on the day preceding the date judgment is
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rendered, at the pre-judgment interest rate governed by the laws of the State of Texas. Plaintiffs
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are also entitled to post-judgment interest at the lawful and legal rate.

All conditions precedent have been performed or have occurred.

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IX.
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JURY DEMAND
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Plaintiffs hereby respectfully demand a trial by jury.

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X.
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REQUEST FOR DISCLOSURE

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Plaintiffs request the defendant provide information responsive to Texas Rules of Civil
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Procedure 194.2 (a)-(l) within fifty days of service of this petition.

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 XI.

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PRAYER

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WHEREFORE, PREMISES CONSIDERED, Plaintiffs pray that upon final trial hereof,

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they recover Judgment against Defendants for all damages, for costs and interest, both

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prejudgment and postjudgment, and all other such relief at law and in equity, both general and

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special, to which they may show themselves justly entitled and for which they now pray.

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Respectfully submitted,

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HOWRY BREEN & HERMAN, L.L.P.

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__________________________________
Sean E. Breen
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State Bar No. 00783715

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1900 Pearl Street

Austin, Texas 78705-5408
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E-mail: sbreen@howrybreen.com
Phone: (512) 474-7300
Fax: (512) 474-8557
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ATTORNEYS FOR PLAINTIFFS

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 CERTIFICATE OF SERVICE

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I hereby certify that a true and correct copy of the foregoing instrument has been
served in the manner indicated pursuant to the Texas Rules of Civil Procedure on this the 22nd

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day of May, 2018, to the following:

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Mark Keene
Keene & Seibert, P.C.

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609 Castle Ridge Rd., Suite 100

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Austin, Texas 78746

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________________________________

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Sean Breen

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