Citation

Fishbain DA, Lewis JE, Gao J, Cole B, Rosomoff RS. Pain Med. 2009; 10(4): 722-729.

Copyright

(Copyright © 2009, Oxford University Press)

DOI

10.1111/j.1526-4637.2009.00620.x

PMID

19453957

Abstract

OBJECTIVES: The objectives of this medicolegal case report were the following: 1) present details of a chronic pain patient (CPP) on chronic opioid analgesic therapy (COAT), who diverted her opioids and was terminated from treatment, and subsequently committed suicide; 2) present both the plaintiff's and defendant's (the COAT prescriber) expert witnesses' opinions as to the allegation of medical abandonment of this patient and other allegations; and 3) based on these opinions, to develop some recommendations as to how pain physicians can minimize their medicolegal risk when termination of the physician-patient relationship is warranted.
METHODS: This is a case report of a CPP treated by a pain physician who demonstrated aberrant drug-related behaviors and required large doses of controlled-release oxycodone.
RESULTS: Differences between the plaintiff's and defendant's experts' opinions are presented by utilizing the COAT literature. Options for avoiding allegations of abandonment are proposed.
CONCLUSIONS: To avoid and protect themselves against potential abandonment allegations when termination of the physician-patient relationship is warranted, physicians are advised to consider following the outlined procedures.

Language: en

Keywords

Abdominal Pain; Adult; Alcoholism; Alprazolam; Analgesics, Opioid; Crime; Drug Administration Schedule; Fatal Outcome; Female; Humans; Hypnotics and Sedatives; Malpractice; Opioid-Related Disorders; Oxycodone; Pain, Intractable; Pancreatitis, Chronic; Patient Compliance; Physician-Patient Relations; Refusal to Treat; Self Medication; Suicide