The family of a 68-year-old man who died from an accidental overdose of opioid painkillers and benzodiazepines has filed a lawsuit against the world-renowned hospital that treated him and two of its physicians. The family alleges that the doctors failed to modify the patient’s prescriptions even though it was obvious that he was suffering from addiction and from other adverse effects related to the drugs.
The patient, a man from North Royalton, Ohio, had retired from his job as a long-distance truck driver after 35 years of physically demanding work. Despite the fact that he suffered from chronic pain, he remained as physically and socially active as possible. He played the drums, coached youth sports, and enjoyed spending time with his wife, two sons, two daughters, and grandchildren.
The patient had a history of injuries that contributed to his chronic pain. In addition to the physical stress of his work as a truck driver, he had sustained injuries in two motorcycle accidents when he was a young man. He had undergone several surgeries to treat the underlying causes of his pain, including shoulder surgeries, a knee replacement, and an operation to fuse several of his vertebrae. In addition to these problems, he also suffered from rheumatoid arthritis.
To manage his pain, the patient sought treatment at a local hospital, and his doctor prescribed him two opioid painkillers and an anti-anxiety drug, to be taken on an ongoing basis. The two opioids were oxycodone, which is sold under the brand names OxyContin and Percocet, and hydrocodone, known by the brand name Vicodin; both of these drugs are addictive and have a high potential for abuse. The anti-anxiety drug was benzodiazepine, known commercially as Xanax, which also has abuse potential and can cause catastrophic withdrawal symptoms.
In the months leading up to his death, the patient’s family began to notice changes in his behavior. They expressed concern that his mood changes were related to the medications he was taking to manage his chronic pain. In October 2015, his family took him to the emergency room because they were concerned about what they describe as his “altered mental status.” Physicians in the emergency room determined that the man was suffering from opioid overdose, and they administered naloxone (Narcan), a drug that can rapidly reverse the effects of opioid intoxication; it has prevented many overdose deaths. It appears that the medical team at the hospital was aware of how the drugs were affecting him, but they did not change his prescriptions.
After the patient’s first overdose, his family intensified their attempts to persuade the doctors to modify his treatment, but in fact, the patient continued to receive the same prescriptions up until his death. In May 2016, the patient’s wife accompanied him to an appointment where she told the doctor that she was worried about her husband’s neurologic state and obvious dependence on the drugs he had been prescribed. She said that, in addition to the mood changes, her husband had become increasingly confused and socially withdrawn. Still, the doctor did not change the prescription.
Several weeks later, the patient died in his sleep while sitting in an easy chair after a family outing. An autopsy showed that the cause of death was an accidental overdose of oxycodone, as well as a hardening of the arteries. His family filed a medical malpractice lawsuit against the prescribing doctor
Opioid painkillers are undoubtedly dangerous, and patients have filed malpractice suits against doctors who have prescribed them; these lawsuits have had varying results. In this case, expert witnesses for the defendant argue that the opioids and benzodiazepine were necessary for the patient’s pain management, as his pain persisted despite having tried a variety of other treatments. They also argue that drug addiction was not the only possible cause of his neurological decline; it is fairly common for men in their late 60s to suffer from confusion and mood changes, as this patient did, and, for that matter, to die from a hardening of the arteries. They also argue that reducing a patient’s dose of opioids is no simple feat; it has only an 8% success rate. Some doctors argue that continuing to prescribe opioids to patients with chronic pain is the humane thing to do.
Did the doctor breach the standard of care by letting the patient get addicted to painkillers, or was he simply doing his best to treat a patient with complex health problems? The outcome of this case will depend on the testimony of medical expert witnesses.
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