CHARLESTON – A Raleigh County widower says Charleston Area Medical Center staff ignored obvious signs of a rare but well-known chemotherapy toxicity and failed for two weeks to provide the only antidote that could have saved his wife.
David B. Phelps Sr. filed his complaint May 15 in Kanawha Circuit Court against CAMC and oncologists Dr. Kok Hoe Chan and Dr. Saad Javaid, saying they are responsible for the “slow, painful and gruesome” death of his 57‑year‑old wife Rose Marie Phelps following treatment for anal cancer in August 2025.
According to the complaint, Rose Phelps was diagnosed in June 2025 with stage IIA squamous cell carcinoma of the anal canal and began concurrent radiation and chemotherapy August 13 with the oral drug Xeloda at CAMC under the care of Chan and Javaid.
Xeloda, also known as capecitabine, is part of a widely used class of chemotherapy drugs called fluoropyrimidines, which can cause early‑onset potentially fatal toxicity in patients with a genetic enzyme deficiency known as DPD deficiency, the lawsuit notes.
The complaint lays out a day‑by‑day narrative in which Rose Phelps’ symptoms rapidly escalated after she started Xeloda, while CAMC staff allegedly dismissed or misdiagnosed them.
Two days into treatment, she had facial redness and swelling, difficulty swallowing, hand‑and‑foot redness and an elevated temperature, yet she was sent home, according to the complaint. Three days later, she returned with nausea, vomiting, dizziness, sore throat and bright‑red lips. The complaint says CAMC staff diagnosed dehydration, gave her IV fluids and anti‑nausea medication, and discharged her.
The next day, she presented with a generalized rash, lip and facial edema and burning pain in her hands and feet. CAMC labeled it a “medication reaction” and suspend Xeloda, but the complaint says staff still not administer the antidote drug Vistogard.
Vistogard, or uridine triacetate, is the only known antidote for severe toxicity from Xeloda and is recommended to be given within 96 hours of the last chemotherapy dose to achieve a 96% survival rate.
The complaint says CAMC “did not have even one dose of Vistogard in its hospital pharmacy” during multiple days when Phelps showed classic signs of life‑threatening drug toxicity while her lab work revealed profound bone marrow suppression and systemic collapse.
Instead of treating her with Vistogard on August 21, when the complaint says her condition markedly had worsened, Javaid ordered gene sequencing to confirm a suspected genetic deficiency. But the test was placed on hold until Aug. 25, the filing states.
Phelps was re‑admitted August 25 with vomiting, swollen tongue, extensive rash, blisters on her hands and feet, shortness of breath, chest and abdominal pain, fever and signs of blood clots, according to the complaint. CAMC moved her to the intensive care unit the next day but still did not have Vistogard on hand. Staff continued treating her with Benadryl, steroids and topical medications, the complaint states.
The gene sequencing confirmed Phelps had compound heterozygous variants in the gene, making her a poor metabolizer of Xeloda and highly susceptible to severe toxicity, the complaint states.
Vistogard was prescribed August 29, but CAMC still had no doses in its pharmacy and had to order the drug from a distributor in Kentucky, causing another 24‑hour delay. The drug was administered August 30, 17 days after chemotherapy began and beyond the recommended 96‑hour window, the complaint states.
“Because of the long and inexcusable delay in the administration of the antidote Vistogard, Mrs. Phelps continued to suffer and decline,” the complaint states. “Mrs. Phelps spent the last few hours of her life restrained to her hospital bed.”
She died August 31 from complications due to early-onset severe Xeloda toxicity caused by DPD deficiency, the complaint states.
David Phelps accuses CAMC, Chan and Javaid of professional negligence for allegedly failing to provide proper informed consent, to warn about genetic risks and the availability of gene testing, to educate the couple about early signs of toxicity and to recognize and treat those signs once they appeared.
The suit also faults CAMC for failing to train its staff on fluoropyrimidine toxicity and for not stocking Vistogard despite what the complaint says were previous fatal cases at the hospital involving the same class of drugs.
Phelps also seeks compensatory damages for sorrow and mental anguish, lost income and services, medical and funeral expenses. He also seeks punitive damages, pre- and post-judgment interests, court costs and other relief.
He is being represented Raj A. Shah, John H. Tinney Jr. and John K. Cecil of Hendrickson & Long in Charleston and by Mark R. Staun of Hartley Law Group in Charleston. The case has been assigned to Circuit Judge Tera Salango.
Kanawha Circuit Court case number 26-C-609
