Was a physician responsible for overprescribing opioids and the wrongful death of a patient?
A Kalamazoo County man, the surviving spouse of the deceased patient
An internal medicine primary care provider, affiliated with the sixth-largest health network in Michigan
In 2014, a man found his wife dead in their home in Kalamazoo County, Michigan. He believed his wife’s primary care physician caused her death. He filed a lawsuit against the physician in 2017, alleging she had overprescribed opioids to his wife which resulted in respiratory depression. His settlement demand was over $1 million, which he later reduced to $800,000.
The physician’s health care network retained Smith Haughey attorneys – Vanessa McCamant, Natalie Winquist, and Monica Meier – to respond and fight the claim. They recommended and pursued one strategy: no negotiating. Defend the case until it’s dismissed or tried to verdict.
THE DISCOVERY PROCESS
To build their defense, McCamant, Winquist, and Meier dove into the patient’s medical history and relationship with her primary care physician.
In 2012, the physician inherited the patient from a colleague in their practice. At this time, the patient had numerous comorbidities, a complex medical and surgical history, and unrelenting chronic pain. She was on an extensive pain medication regimen, which included opioids. She went absent from the practice for over four months due to an extended inpatient stay, at which time, medical providers increased her pain medication.
Once discharged, the patient returned to her routine primary care appointments where the physician maintained her increased medication levels. The patient was hospitalized and discharged on several other occasions to treat acute infections, during which the multitude of medical providers she encountered also maintained her pain medication regimen. In September 2014, she was found dead in her home. A medical examiner performed an autopsy and determined the cause of death was medically significant complications of obesity.
The Smith Haughey team also studied the evolution of pain management. They learned that national health organizations established mandates on how to treat pain. Initiatives, such as declaring pain as the fifth vital sign, set a standard for practitioners and encouraged them to manage patients’ pain. Not addressing pain was equated to patient abuse.
Years later, the world would learn these standards helped fuel the national opioid epidemic.
SMITH HAUGHEY TRIAL TEAM
Natalie Winquist, Second Chair
Due to adjournments, the COVID-19 pandemic, and other factors, the case didn’t see trial until September 2022. Five years after the initial allegation. When the trial began, the Smith Haughey team argued the following:
- When the patient sought treatment, pain management and standards of care were vastly different than they are today.
- The physician didn’t initiate dosage levels for the patient; she maintained medications set by other medical providers.
- The patient had a multitude of health problems. Each in isolation posed a risk of imminent death.
Smith Haughey’s defense relied heavily on the evolution of pain management and its timeline, as well as literature and propaganda on the subject. They sought to educate the jury on how the medical community began treating pain and how the approach changed over the years. They described the propriety of the physician’s care according to pain treatment standards at the time of care (2012) along with the specific needs of this particularly complicated patient. They brought in expert testimony from internal medicine providers and a pharmacologist.
The plaintiff’s counsel focused on current pain management standards and prescribing patterns to show the patient was overprescribed. And, she argued the medications played a greater role in the patient’s death, not her ongoing health issues.
Eight jurors deliberated and came to a unanimous decision in less than an hour. The verdict? No negligence on the part of the physician and no cause for action against the defendant. Smith Haughey had won the clearest, best verdict for the physician. Plus, the health care system wasn’t required to pay the plaintiff’s $800,000 settlement demand.