$10 Million Verdict After Kayexalate Causes Fatal Colon Necrosis at UMMC

Dennis Allen, a 63-year-old pastor, was admitted to the University of Maryland Medical Center on March 11, 2013, with renal failure and rhabdomyolysis. His condition was serious but his death was not inevitable. Nine days later he was gone.

On March 18, 2013, Allen's blood potassium reached a dangerous 7.3 mmol/L. To bring the level down, Dr. Allen Burks administered 30 grams of Kayexalate orally, suspended in a solution containing approximately 36 percent sorbitol. The prescription was written without obtaining informed consent, and Allen's family says no one warned them of the risks.

Kayexalate combined with sorbitol had been flagged in medical literature for years as capable of causing ischemic colitis, a condition in which blood flow to the colon is cut off. The American Journal of Emergency Medicine described colonic necrosis from Kayexalate as 'rare, but potentially avoidable.' For Allen, avoidance came too late. He developed colonic necrosis, required emergency removal of his entire colon, and died the following day.

Laura Zois of Miller and Zois tried the case in Baltimore City Circuit Court before Judge Julie Rubin. The plaintiffs argued that Burks and UMMC departed from the standard of care by prescribing Kayexalate with sorbitol in the presence of Allen's underlying liver disease and cirrhosis, conditions that heightened his vulnerability. UMMS denied any negligence and contended at trial that the care was 'stellar' and the plaintiff's evidence was lacking.

The jury rejected that defense in September 2016 and returned a $10 million verdict, allocating $2 million to Allen's estate and $1 million each to his widow, Cynthia Allen, and their seven adult children.

UMMS appealed. Justin Zuber handled the appeal for the family. The trial court had already cut the award to $906,250 under Maryland's statutory cap on non-economic damages: $181,250 to the estate and $90,625 to the widow and to each of the seven children. In 2018 the Maryland Court of Special Appeals affirmed in Burks v. Allen, 238 Md.App. 418, 192 A.3d 847, upholding the jury's liability finding and rejecting the family's constitutional challenge to the cap.

The case drew coverage in the Baltimore Sun and the Maryland Daily Record at the time of verdict. Zois described Allen's final day as 'the most gripping, horrific 24 hours you can imagine,' and told the Baltimore Sun that the family felt vindicated that their father and husband's story was finally told.