Doctor P, 56, was a primary care physician who shared a practice with several other general medicine practitioners. He had been in the same practice for over a decade and some of his patients had been with him that long. One of those patients was Mr G, 36, who had been coming to the practice since he moved nearby at the age of 27.
Mr G had a history of generalized anxiety, panic disorder, and depression. Five years earlier, Dr P had referred him to a psychiatrist for treatment of these issues. The psychiatrist, Dr M, saw the patient monthly thereafter, and managed his mental health medications, including escitalopram, zolpidem, bupropion, and alprazolam. Doctor P was aware of the psychiatric medications that the patient was taking.
Doctor P primarily treated the patient for minor illnesses, including chronic neck and shoulder pain. In June, Mr G came in asking for something to help with the neck and shoulder pain, which had been exacerbated by his being involved in a minor car accident. The physician prescribed oxycodone/acetaminophen for the pain and sent the patient home.
A month later, the patient came in again, complaining that he still wasn’t getting relief for his shoulder pain. Doctor P wrote a prescription for a low dose of oxycodone extended-release tablets. Three days later, after Mr G was still experiencing pain, Dr P tripled the dose, which gave the patient relief.
At his next psychiatry appointment, Mr G did not mention the pain medication prescription, and Dr M did not ask. Doctor M did renew the patient’s anti-anxiety medications. Three weeks later, Mr G was found unresponsive in his home. He was rushed to the hospital, but they were unable to revive him. An autopsy revealed that Mr G’s cause of death was the cumulative toxic effect of alprazolam and the opioids.
The parents of Mr G could not understand how this had happened when their son was seeing not one, but two doctors. Even if one doctor had not picked up on the bad combination of medications, shouldn’t the other have, they questioned. They sought the counsel of attorneys who specialized in medical malpractice, but almost all the attorneys said the same thing: the odds of getting a big settlement in this case, where the patient may have played some part in his own accidental overdose, were not good, and the costs of going to trial are very high.