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Joseph Reese and Chris Eagan obtained a defense judgment following a three day arbitration of a nursing home malpractice case involving the death of a resident from “Metformin associated lactic acidosis.” During the course of conducting an autopsy, it was determined the resident had a level of Metformin in her blood that greatly exceeded the therapeutic level. Metformin was a medication the resident was both prescribed to receive and administered at the nursing home. It was alleged the resident was allowed to gain access to more than her prescribed amount of Metformin and overdosed on that medication. It was also alleged the nursing home staff failed to appropriately respond to the resident’s complaints of nausea, vomiting, and diarrhea in the two days leading up to her death, and that the staff negligently allowed the resident to become dehydrated. All of this was claimed to have caused and/or contributed to cause the resident’s death. The defense established through peer reviewed medical literature, expert testimony, and the medication administration procedure followed at the nursing home that the resident’s Metformin associated lactic acidosis was not caused by a medication error but, instead, by a gradual accumulation of Metformin that resulted from the resident’s decreased renal function which, in turn, impeded the resident’s ability to excrete the Metformin from her system. The defense was able to prove there was no breach of the standard of care in terms of monitoring the resident and that the resident’s death was not caused by any negligent nursing care.