Three weeks later, Ms W was found dead in her apartment by her parents. An autopsy was conducted, and the results indicated that the patient had died from suicide by oxycodone overdose. Ms W’s grieving family consulted a plaintiff’s attorney, who told them that he believed that they had a case against the two physicians. The attorney filed a lawsuit against the psychiatrist and the sleep specialist, alleging that they had failed to consider the patient’s suicide risk when prescribing medications.
Doctor P and Dr S met with the attorneys provided by their medical malpractice insurance. The attorneys hired medical experts to go over the patient’s records and identify potential issues with her care so that the attorneys could assess the strength of the case. When the experts returned their report, it was critical of the treatment that the physicians had provided.
“The communication was poor,” noted one expert. “In fact, the communication and care coordination between the psychiatrist and the sleep specialist appear to have ended with the initial referral.” The expert noted that once the referral was made, there was no further contact between the two healthcare providers, and that pertinent information regarding Ms W’s case and her medications was not coordinated between the clinicians.
The expert criticized the decision to prescribe and renew a narcotic in light of the
patient’s history of suicide attempts, ongoing depression, and use of other medications. “If the clinician was considering long-term opioid therapy, she needed to evaluate for known risk factors, including mental health history, depression and suicide attempts,” noted the expert.
The expert also noted that Dr S should have considered the potential lethal combination of opioids and benzodiazepines before prescribing oxycodone, since she was aware that the patient was taking lorazepam. The dispensing pharmacy did not pick up on this potential interaction either.
And finally, the expert was not impressed with Dr S’s practice of emailing the patient for updates to determine if the treatment was working. “Direct contact is always preferable,” noted the expert. “E-mail limits the ability to assess clinically meaningful improvements in pain and function. A face-to-face interaction is the way it should be done, but even the phone would have been preferable.”
With this information in hand, the attorneys decided that settling the case out of court was the best option. The case was settled for an amount within the doctors’ malpractice limits.