On the actual day of the consultation, Dr. P sat with the patient and obtained and documented a list of Mrs. L’s prescription use, and past and current medical history. The patient was currently on methadone, and a urine analysis was performed to check the patient’s methadone level. Dr. P noted in her file that the results indicated that the methadone level was appropriate for Mrs. L’s height and weight, and reflected that the patient was taking methadone within the normal range.

Dr. P also had, along with the referral, a copy of a drug screen performed on the patient three weeks prior to the consultation. Neither the drug screen, nor the urine analysis, nor her discussion with the patient raised any “red flags” or unusual concerns for the physician about the patient. Based on this information, Dr. P prescribed Mrs. L methadone for the next 28 days and had the patient read and sign a regimen compliance agreement. The agreement clearly stated, and Dr. P reinforced verbally, that Mrs. L was agreeing to only use pain medication prescribed by Dr. P. Mrs. L agreed, signed the form, thanked the physician and left the office.

Fifteen days later, Mrs. L was found dead at home. An autopsy revealed the cause of death to be methadone toxicity.


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After the patient’s husband recovered from the shock and grief at her death, he retained an attorney who filed a wrongful death lawsuit against multiple defendants, including Dr. P, the referring physicians, and several local pharmacies.