Meet me in New Orleans in August all of you, please, at Hastings' Pharmacy. But, on your way to there go backwards, backwards in time, to August of 1867. There we will together see, be reminded, that the more things change, the more they stay the same. There we will see that * * *

On Monday, the 26th of August, the wife of William McCubbin became ill with yellow fever. By the Wednesday following, her physician found her to be faring better, but deemed that an enema would be advisable. The prescription he ordered was a mixture of several drugs, as follows:

McCubbin brought the prescription to the pharmacy of Samuel Hastings to be compounded. In preparing the prescription, the pharmacist used Spirits of Camphor instead of Camphor Water. On being administered the first portion of the enema by a nurse caring for her at her home, Mrs. McCubbin, in the words of the court, instantly experienced "spasms and convulsions, causing her to purge and vomit at the same time," and she was "writhing in agony." Her physician was called, who "... did all that his science allowed him to do for relief. He called in another physician. Their efforts were fruitless," and " ... she sank gradually from the time the enema was administered until three days afterwards, when she died."

Alleging that his wife's sufferings and her death were caused by negligence of the pharmacist, William McCubbin filed suit on behalf of himself and his minor child seeking damages in the total amount of $35,000. The pharmacist won the case at the trial court level. The plaintiff appealed to the Louisiana Supreme Court.

The issues before the Supreme Court were: (a) whether or not the Spirits of Camphor, or the yellow fever, caused the suffering and the death of Mrs. McCubbin, and if the cause was the Spirits of Camphor, then (b) whether or not it was an act of negligence for the pharmacist to have used Spirits of Camphor in the enema preparation.

The court held, after reviewing the treating physician's testimony and the other evidence introduced during the trial, that: Camphor Water is "a very innocent preparation"; Spirits of Camphor is "a decoction of camphor and alcohol"; the Spirits of Camphor was the cause of the sufferings (convulsions, spasms, etc.) of Mrs. McCubbin; and, the Spirits of Camphor caused, or at the least contributed to, the death of Mrs. McCubbin.

The Supreme Court further held that it was carelessness, and as a matter of law an act of negligence, for a pharmacist to compound a prescription to be used as an enema with Spirits of Camphor, describing Spirits of Camphor and its use in an enema preparation as "... a substance as powerful as alcohol, in which Camphor, a violent stimulant, has been dissolved" for "inject[ion] into one of the tenderest parts of the human frame." The court even likened the pharmacist's having put Spirits of Camphor into the enema preparation to a driver of a carriage "wantonly" running into and destroying the carriage of another.

Having found the pharmacist negligent, and the negligence to have been the cause of the sufferings and death of Mrs. McCubbin, the court awarded damages to the minor child in the amount of $2,500. For reasons not explained by the court in its decision, William McCubbin had chosen not to introduce any evidence of his own losses, and he was not awarded any damages.

There is one feature I omitted until now from these events we have been witnessing. The prescription was not compounded by Samuel Hastings, the pharmacist, rather by an employee. It was an "assistant" (today he would be referred to as a pharmacy technician) who, although he "... was reputed to be a competent druggist, [was not] a graduate in pharmacy from any medical institute." One of Hastings' defenses was that he could not be held liable to the plaintiff because it was not he to have filled the prescription, a defense that will not be allowed to the employer of a negligent or careless employee today any more than it was allowed in this case in the late 1800s.

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As now permitted by Boards of Pharmacy in many states, including Louisiana, many of you have started using pharmacist assistants, pharmacy technicians, for more of the tasks required for the distributive service of "filing a prescription," so that you as the licensed pharmacist have the time to devote to patient counseling and other cognitive services. As you do so, go boldly, but go carefully, prudently. You should be mindful of the added risks taken on and be certain you have trained and qualified persons performing those permitted distributive service tasks for you and your patients.