Approximately one hour and fifteen minutes into the episode, Dr. Fleming has asked Columbo to turn out the lights when leaving his office. Columbo reaches for the light switches but they are both down (off). He simply touches the top of one of the switches and the lights go out.
When Dr. Fleming smashes the balcony window, his shadow can be seen on the background, revealing it to be a simple backdrop.
Fleming: You never stop, do you?
Fleming: The insinuations, the change of pace. You're a bag of tricks, Columbo, right down to that prop cigar you use.
Columbo: Oh, come on, Doc.
Fleming: I'm going to tell you something about yourself. You think you need a psychologist. Maybe you do, maybe you don't, but you are a textbook example of compensation.
Columbo: Oh, what, Doc?
Fleming: Compensation. Adaptability. You're an intelligent man, Columbo, but you hide it. You pretend you're something you're not. Why, because of your appearance you think you can't get by on looks or polish, so you turn a defect into a virtue. You take people by surprise. They underestimate you. And that's where you trip them up.
Columbo: I was wondering, Doctor. Would you take me on as a patient?
Fleming: Take you on as a what?!?
Columbo: No, I mean it. Maybe you can help me. I don't know that... There must be something wrong with me. I seem to bother people. I seem to make them nervous and maybe you could tell me why.
Fleming: You know, sometimes I get the impression you think I killed my wife.
Columbo: You? Oh no, Doc. How could you? You were out of town.
Fleming: I'm glad you remembered that. Unless you think I hired someone to kill her. The boy who confessed, maybe I paid him to do it.
Columbo: No, Doc. You didn't do that.
Fleming: How do you know?
Columbo: I already asked him.
(while Columbo looks on)
Fleming: Oh, Doctor, I'm the patient's husband. Is she, is she all right?
Doctor: I'm sorry. She passed away.
Fleming: Did she...did she say anything?
Doctor: If it's any consolation, the one thing she said was your name.
Columbo: Uh, I'm sorry. I was, uh, I was just thinking about something.
Gordon: What was that?
Columbo: No, it's nothing important. It's, uh, Dr. Fleming, he didn't call to his wife when he came back to his apartment.
Gordon: I don't follow you.
Columbo: Oh, well, I was in the bedroom. I was checking some things and I heard him open the front door and he didn't say anything. Gee, it's funny how people are different, isn't it? Now you take myself. When I come home from a trip, uh, first thing I do is I say, "Honey, you here?"
Gordon: (annoyed) Exactly what is your point, Lieutenant?
Columbo: Point? Well, I wasn't making a point.
Originally, the writers suggested Lee J. Cobb or Bing Crosby for the role of Columbo. Lee J. Cobb was unavailable, however, and Bing Crosby turned them down.
This first pilot, along with the second pilot "Ransom for a Dead Man" are considered seperate TV Movies, and have not been included in the syndicated and cable packages of "Columbo" reruns, and are therefore the rarest episodes to be broadcast. In the summer of 1994 ABC aired weekly reruns of the revived series on Thursday nights. When they ran out of episodes to show, ABC ran these two 20 year-old pilots, as well as the then 13 year-old two hour pilot for "Mrs. Columbo", as 'new' movies.
The script for the TV movie "Prescription: Murder" was adapted from the stage play of the same name that first introduced the character of Lt Columbo. The cast of that Broadway play was: Thomas Mitchell as Lieutenant Columbo, Joseph Cotten as Dr. Roy Flemming, Agnes Moorehead as Claire Flemming and Patricia Medina as Susan Hudson.