In January 2012, plaintiff’s decedent Christopher Taylor, 52, a self-employed mortgage broker and former police officer, contacted his primary care physician, Dr. Michael Johnson, to report that he was having gastrointestinal problems after his Cymbalta prescription was increased to 90-milligrams. Taylor was bipolar and had other serious psychiatric issues. As a result, Taylor had issues with his wife, who was tired of fighting with her husband about it. Specifically, Taylor suffered from hypersexuality and was interested in chemical castration, or castration via drugs. He also scheduled an appointment with a doctor in Philadelphia for physical castration. Taylor was also obsessive compulsive about being right and having things his way. In addition, he suffered from anxiety and allegedly had control issues with his wife. For example, Taylor would often tell his wife that she was “punished” and that she could not watch any television, but would then say he loved her. He would also make numerous films saying how much he loved his wife. However, As a result of his psychiatric issues, Taylor started seeing his physician, Johnson, in 2000, and the two communicated regularly for the following 12 years via Taylor’s medical plan’s email system. As a result, there were several emails about Taylor’s various issues with time stamps on them reading from midnight to 6 a.m. However, even though Johnson and Taylor had a trusting relationship, Johnson was part of the health care plan for Palo Alto Medical Foundation, so any psychiatric care had to be referred to outside care. As a result, in 2005, Johnson told Taylor that he could not prescribe him any psychotropic medications, just antidepressants, and that Taylor should seek psychiatric help. Taylor had numerous shotguns and, admittedly, he had attempted suicide over 20 times in the following seven years. As a result, he began seeing a psychiatrist in July 2011, who ultimately changed Taylor’s medication from Zoloft to Cymbalta. Taylor was started on 30-milligrams a day, then raised to 60-milligrams, and then, in January 2012, was increased to 90-milligrams, as he had increasing anxiety, depression and panic attacks that were not being controlled on 60-milligrams. Taylor then stayed on the 90-milligrams of Cymbalta regime over the spring, and on March 28, 2012, he reported to Johnson that he was “doing great on the 90-milligrams.” However, earlier that year, in January 2012, Taylor reported to Johnson that he was having gastrointestinal problems. Taylor also purchased a 12-gauge shotgun and ammunition that month, and stored them in his home, below the stairs. On Feb. 22, 2012, Taylor saw Johnson, who advised him that he thought Taylor’s gastrointestinal problems were due to the Cymbalta. Johnson allegedly told Taylor that he should reduce his Cymbalta to 30-milligrams per day, and then referred Taylor to Dr. Joseph Palascak, a gastroenterologist. Johnson then allegedly told Palascak that he had told Taylor to reduce his Cymbalta. Palascak opined that Taylor’s gastrological issues were probably due to the Cymbalta. He then saw Taylor on Feb. 24, 2012, and documented that Taylor seemed improved since Johnson reduced his dosage of Cymbalta. Palascak gave Taylor a written instruction to “please stop Cymbalta as recommended by Dr. Johnson.” Johnson testified that he told Taylor to check to see if it’s okay with Taylor’s psychiatrist to stop Cymbalta, but the medical records do not reflect this. Taylor then emailed Johnson and said, “Thanks for reducing Cymbalta to 30-milligrams, I’m already better. Maybe I should go down to 0,” to which Johnson emailed back and told Taylor to check with his psychiatrist before doing that. On March 3, 2012, Taylor allegedly told Palascak’s medical assistant that he was off Cymbalta. However, on March 20, 2012, Taylor emailed Johnson and told him, “Since you have had me reduce my Cymbalta to 30-milligrams, there’s been no improvement in my condition.” On April 25, 2012, Taylor’s wife told her husband that she received a ticket for talking on her cell phone. Taylor allegedly became enraged and told her that he would take away her cell phone. As a result, his wife allegedly told him to “go jump in a lake” and that she would go to a hotel, as she had previously done on an intermittent basis, but would always return home. She then left and did not call Taylor back until her cousin called her to inform her that Taylor contacted her mother to say that he might commit suicide. As a result, Taylor and his wife talked on the phone for 25 minutes after midnight on April 26, 2012. She claimed that at the end of the conversation, Taylor said, “I’m going to do it now,” and then she heard a shotgun blast. Taylor’s wife subsequently called 911 and police responded to their home. Taylor was found on an unmade bed, with his wedding ring on the bureau, and a police scanner on the bed. He was also holding his 12-gauge shotgun. He inserted it into his mouth and engaged the trigger. Taylor’s wife, plaintiff Shana Taylor, sued Johnson, Palascak, Palo Alto Foundation Medical Group, and Palo Alto Medical Foundation. Ms. Taylor alleged that the defendants were negligent in the treatment of her husband and in the monitoring of his Cymbalta prescription. She alleged that as a result of their negligence, the defendants were liable for her husband’s wrongful death. The parties stipulated that Palo Alto Foundation Medical Group would be responsible for Johnson and Palascak, and the two doctors were subsequently dismissed from the case. Ms. Taylor contended that if her husband’s Cymbalta was not discontinued, then he would not have committed suicide. The plaintiff’s family medicine expert testified that a physician cannot take a patient’s word and that the physician would have to call the patient’s psychiatrist themselves. The expert opined that Johnson’s failure to call the decedent’s psychiatrist led to an unraveling of the continuity of care, in that the decedent’s psychiatrist would have said that the patient was taking 90-milligrams of Cymbalta and that he should have been kept on it. The plaintiff’s psychiatric expert testified that, based on the lab test, there was no Cymbalta in the decedent’s system. The expert opined that even 30-milligrams of Cymbalta was not a therapeutic dose and would not have provided the decedent with any benefits in terms of treating his severe depression, panic/anxiety disorder, or obsessive compulsive disorder. Plaintiff’s counsel noted that the defense’s expert psychiatrist agreed with that opinion. In addition, the plaintiff’s psychiatric expert testified that in the early morning hours of April 26, 2012, without the benefit of a therapeutic dose of Cymbalta, the decedent became severely depressed and was overcome by an uncontrollable anxiety/panic attack, resulting in an uncontrollable impulse that took his own life. Defense counsel responded that the lab test was set at a high level of toxicity, and did not account for anything below that, so it would be impossible to detect how much, if any, Cymbalta the decedent was taking. As a result, the defense’s psychiatric expert opined that one would not know how much Cymbalta the decedent was taking, or even if he was taking it, and that there was no guarantee the decedent would not have committed suicide anyway. Defense counsel contended that there was an established trust between Johnson and the decedent and that, historically, Johnson would tell the decedent to do something and the decedent would do it. Counsel also contended that even though Johnson admitted that he did not document the conversation in which he told the decedent to consult with his psychiatrist in the first instance, Johnson did email the decedent and tell him to check with his psychiatrist in the second instance. Defense counsel further contended that handling such matters by way of email, in light of the relationship between Johnson and the decedent, was okay. Defense counsel maintained that Palascak was a consultant to Johnson, and not the decedent, and that Palascak was not involved and gave no advice to the decedent. In addition, defense counsel argued that the decedent had longstanding issues and that his suicide was a planned act. Counsel contended that the decedent had problems even before he was on Cymbalta and that the decedent even said that if he ever lost his wife, he was going to kill himself. Thus, defense counsel proffered that the conversation between the decedent and his wife must have been more intense than she led others to believe., Mr. Taylor died from a self-inflicted gunshot to his head on April 26, 2012. He was 52 years old and is survived by his wife. Thus, the decedent’s wife, Ms. Taylor, sought recovery of wrongful death damages.