Malpractice or wrongful death?

What is the name of your state? Kentucky

Hello everyone. This is like the 5th time I've typed this post, so forgive me if there are spelling errors or if I forget to mention something.

My mother died last month. The cause of death is pending the toxicology report, but I'm not really concerned what actually killed her. What bothers me are the events that lead to her death.

In 1996 and '97, she had both of her ovaries removed because of noncancerous, beign cysts. Im told it is a common procedure, and her case went smoothly. But, she was prescribed morphine for post surgery pain. And then she became a junkie. Really bad. I dont know how many people here have had to deal with a junkie first hand before, but I can say from experience that it killed me to see it happen to my mother.

Ok, so yeah,yeah she turned into a junkie. Her own fault right? Well I disagree. The hospital that she had surgery in, also supplied her with morphine for 5 years. No apparent attempts to change her medications, no pill counts, no monitoring, nothing. For 7 years. Now, to give the hospital credit, in 2001 the classified one of her visits as 'narcotic seeking'. And after that they started to ween her from it with methadone.But come on, it takes 5 years for them to identify junkie behavior, after they seemingly just hand her a highly addictive controlled substance. Oh and btw, the 'weening' dose didnt seem to much like weening to me. The night she died she filled a prescribtion for 200 80mg tablets of methadone.

Anyhow it seems to me that the hospital it liable for the 7 years of grief my sister and I had to endure, and possibly for sending her down the road that eventually killed her. Would I be right to take it to court? Do I even have a case?

Oh, and before I get flamed about this: I didnt ever try to do any sort of intervention because by the time I realized that she was a full fledged junkie, she had already convinced me and everyone else that she had ovarian cancer, and that was what the operations and morphine were for. I didnt find out otherwise until after her death.

Any how, thanks for your time, and any futher questions will be answered.

Yoiu say you are in Kentucky. I'd like to know which hospital and what the doctor's specialty is.
First, no hospital can write a prescription for a drug. So, you must assume the doctor who did the surgery wrote the prescription for morphine. I'd suspect from that that he goofed in the original surgery. Was this a total hysterectomy? Was it done by abdominal surgery or by laparoscopy? These are fairly important bits of information anyone who tries to analyze your case needs. I suspect the doctor who did the surgery is the one who ordered the morphine. Now any doctor who keeps a non-addicted patient on morphine for five years is doing something bad. He could have started weaning her within a few weeks of the surgery, if she did not have excruciating pain. Most doctors are unskilled in handling an addict, but he is worse than unskilled, he did nothing to prevent her addiction.
Methadone is just about as addictive as morphine. It about the same as giving a smoker nicotine to quit smoking. More recent information tells a doctor not to use methadone. Further in most States a general practice physician and a general or gynecologic surgeon is required to seek help or to transfer the addicted patient to a mental health facility and/or a psychiatrist experienced in drug addiction treatment.
I think the first thing you need to do is to see a good malpractice lawyer. You can find web sites that list lawyers in your county in Google search. I think you go to Google and enter in the search box "medical malpractice lawyers", and a list should pop up for you.
You ask if you have a wrongful death or a medical malpractice case. A malpractice lawyer will combine the two into one case. Get your lawyer and work with him. Do not try to handle any of this yourself. The first thing he will do is to get your mother's records.
I don't know what your family situation is. That is something that will be of utmost importance in seeking help from a lawyer. If you and your sister were not dependent on your mother for support it may create some problems. Your lawyer will help you on that.
Anyway, find a lawyer NOW. Don't wonder what you should do. Your mother should not have become an addict and she should not have died. I suspect the og/gyn (if he was one) goofed at surgery. He may have hidden evidence from the hospital, or worse, he may be in cahoots with the hospital. Something is wrong in Kentucky.

I want to add another thought. Over the past 35 years I have worked on perhaps twenty or thirty cases in which the doctor maintained a patient who was addicted. The common thread in all those cases was the doctor's addiction. Be sure to tell your lawyer this because he may not have run into this situation.

You've gotten some good advice so far, but I would encouarge you TO BE concerned with the "cause of death" here. I'd like to make some comments and ask some questions.

Originally posted by dacheeba
What is the name of your state? Kentucky

Hello everyone. This is like the 5th time I've typed this post, so forgive me if there are spelling errors or if I forget to mention something.

My mother died last month. The cause of death is pending the toxicology report, but I'm not really concerned what actually killed her. What bothers me are the events that lead to her death.

**A Did she have terminal cancer?

In 1996 and '97, she had both of her ovaries removed because of noncancerous, beign cysts. Im told it is a common procedure, and her case went smoothly. But, she was prescribed morphine for post surgery pain. And then she became a junkie. Really bad. I dont know how many people here have had to deal with a junkie first hand before, but I can say from experience that it killed me to see it happen to my mother.

**A What do you mean by a "bad junkie" (symptoms). Was she ever hospitalized for addiction / withdrawal? How often was she being seen by the physician prescribing the medicine?


Ok, so yeah,yeah she turned into a junkie. Her own fault right? Well I disagree. The hospital that she had surgery in, also supplied her with morphine for 5 years. No apparent attempts to change her medications, no pill counts, no monitoring, nothing. For 7 years.

**A: Who supplied her with Morphine / Methadone? When I ask the following question, I'm not "blaming" your mother for becoming addicted post surgical procedure, but I want to ask: Did she have ANY history of drug abuse / addiction in her past that you know of? (even alcoholism)

Now, to give the hospital credit, in 2001 the classified one of her visits as 'narcotic seeking'. And after that they started to ween her from it with methadone. But come on, it takes 5 years for them to identify junkie behavior, after they seemingly just hand her a highly addictive controlled substance. Oh and btw, the 'weening' dose didnt seem to much like weening to me. The night she died she filled a prescribtion for 200 80mg tablets of methadone.

Anyhow it seems to me that the hospital it liable for the 7 years of grief my sister and I had to endure, and possibly for sending her down the road that eventually killed her. Would I be right to take it to court? Do I even have a case?

**A: Something seems to be missing here. Was she being treated for chronic pain during this five years?

Oh, and before I get flamed about this: I didnt ever try to do any sort of intervention because by the time I realized that she was a full fledged junkie, she had already convinced me and everyone else that she had ovarian cancer, and that was what the operations and morphine were for. I didnt find out otherwise until after her death.

**A: This is where I need more information before I would say "sure, take this to an attorney". How did you come to believe that she was "strung out" on inappropriate pain medicine? (Don't get me wrong -- I'm not trying to minimize your concerns regards this morphine / methadone -- I'm just not clear on the events). How many surgeries did she have during five years? Do you think she died from methadone overdose / withdrawal, or was she a terminal cancer patient who was being treated for chronic pain? YOu said the hospital prescribed morphine. How many times was she in the hospital for this cancer?


Any how, thanks for your time, and any futher questions will be answered.

**A: Thanks for clarifying.


hmmbrdzz

First, thanks to all for the replys.

Ok, now to answer some of the questions:

Q:I'd like to know which hospital and what the doctor's specialty is.

A: Since the case hasnt been started yet, I'm hesitant to say the name of the hospital. As for the doctor, I dont have that info as of yet. The reason I mention liability against the hospital is because I know she saw and was given prescribtions by many doctors of the same hospital.

Q:Was this a total hysterectomy? Was it done by abdominal surgery or by laparoscopy?

A: No, not total. She had one ovary removed in '96, the other in '97. I dont know what procedure was used as of yet.

Q: Did she have terminal cancer?

A: I answered this in my previous post, but will clarify. My mother told me and my family that she had been diagnosed with ovarian cancer. Until her death, that was why we all believed her need for the 'treatment'. The coroner however, enlightened us to her medical records, telling us that she was in fact, NEVER diagnosed with any sort of cancer, and that the closest thing was the beign cysts she had removed. It was quite shocking to us, because we had lived for so long thinking that she did, and her days were numbered. This is why it bothers me so that she recieved these drugs for so long, because in reality, there was nothing wrong with her.

Q: What do you mean by a "bad junkie" (symptoms). Was she ever hospitalized for addiction / withdrawal? How often was she being seen by the physician prescribing the medicine?

A: OK, this is a tough one. Symptoms? Well, she became dependant not only on the drugs, but also to anyone that would supply them to her(monetarly). She lied to,stole from, and hurt
everyone who cared for her. My sister and I became completely estranged from her because of it, we both had to move to different states to protect our own children from her.I've seen her go into 'nods', where she would just stare into oblivion with drool running down her face, with a lit cigarette in hand. She would get hives on her legs so bad they would bleed. I've seen her fall flat on her face from a standing position and pass out. She would 'mainline' her pills, etc. There is lot to say about that, because it went on for so long. Whether or not she had ever been hospitalized for addiction/withdrawl, not to my knowledge. And as I stated earlier, she was seen by several doctors, and I couldnt tell you the frequency. I would guess about every 2 weeks.

Q: Who supplied her with Morphine / Methadone? When I ask the following question, I'm not "blaming" your mother for becoming addicted post surgical procedure, but I want to ask: Did she have ANY history of drug abuse / addiction in her past that you know of?

A: I dont know the details of who specifically, but I'm know a couple doctors are involved. As far as her history is concerned, I dont know about any prior addictions. BUT I do know that when I was a little boy, she had problems with Social Services concerning my sister. I believe she even went to a shrink, and was diagnosed with Munchousen By Proxy. I intend to further clarify this with SS.This was back in '84 though.

Q:Something seems to be missing here. Was she being treated for chronic pain during this five years?

A: Yes, but I dont know that this has any bearing. There are so many pain meds available, many of them even more available than morphine. Besides which, pain is such an intangable factor, it cant always be proven to exist. That coupled with someone who would say just about anything to get a 'fix' seems to make it questionable.

Q:How did you come to believe that she was "strung out" on inappropriate pain medicine?

A: See my response to the symptoms question.

Q: How many surgeries did she have during five years?

A: Just the two for her hysterectomy, as far as I know.

Qo you think she died from methadone overdose / withdrawal, or was she a terminal cancer patient who was being treated for chronic pain?

A: I asked the coroner about the likelyhood of overdose, and he didnt see any indication of it, but as I said, her cause of death is pending the toixicology report and germinology(sp?). He said he wasn't sure what those reports would tell us, but he personally didnt think overdose. Withdrawl is a different matter that hadnt crossed my mind until you mentioned it. I will mention it to him the next time I speak with him. And again, she didnt have terminal cancer. But there was several mentions of chronic pain mentioned in her med records, but see my other response about that.


Anyhow, thanks to Jack for the support, and thanks to you hmmbrdzz for the tough questions and feedback.

Hi Dacheeba: I don't mean to be "tough" (not at all) -- I was just trying to find out more about her medical history, her diagnosis, and your knowledge of it (or perhaps your lack of knowledge regarding her condition and or perhaps her level of pain).

I don't know how "estranged" you were from her or for how long you've been estranged. Depending on the degree of "estrangement" between you and your mom, it's possible (in my eyes) that -- in addition to your belief that she was not under good medical care with respect to the methadone -- that you also may not be aware of some history in your mom's case, and that it MAY (and that's a may) be possible that she was on methadone maintenance for opiate use from chronic pain and/or from heroin addiction). I don't know what access you have been given to her medical records, but if you do not have them and do not know the extent of her medical history -- I guess what I'm trying to say is that "in reality" there could have been things going on with her that you didn't know about it and that she didn't want you to know about.

Methadone is addicting, (and it is therefore a highly regulated form of treatment), but it is a form of treatment for both chronic pain and heroin addiction, and is actually safer for the patient to be on methadone and under the care of a physician than NOT to be. When on methadone, the patient can sometimes get off the drug altogether, the risk of HIV transmission through having to share needles is greatly reduced as are other high risk behaviors (drug seeking and illegal behaviors) associated with addiction.

I am very sorry about your mom's addiction and her death. I do hope you find some answers that will give you some peace of mind. I've attached some URL's on Methadone that might help you understand methadone a little better and why it's used in treatment sometime.

If you have any questions, feel free.


[url]http://www.jackstem.com/methadone.htm[/url]

[url]http://www.medsch.wisc.edu/painpolicy/publicat/97apsmm.htm[/url]

[url]http://www.allsands.com/Science/methadonemainte_bfn_gn.htm[/url]



hmmbrdzz

Originally posted by hmmbrdzz
Hi Dacheeba: I don't mean to be "tough" (not at all) -- I was just trying to find out more about her medical history, her diagnosis, and your knowledge of it (or perhaps your lack of knowledge regarding her condition and or perhaps her level of pain).

I don't know how "estranged" you were from her or for how long you've been estranged. Depending on the degree of "estrangement" between you and your mom, it's possible (in my eyes) that -- in addition to your belief that she was not under good medical care with respect to the methadone -- that you also may not be aware of some history in your mom's case, and that it MAY (and that's a may) be possible that she was on methadone maintenance for opiate use from chronic pain and/or from heroin addiction). I don't know what access you have been given to her medical records, but if you do not have them and do not know the extent of her medical history -- I guess what I'm trying to say is that "in reality" there could have been things going on with her that you didn't know about it and that she didn't want you to know about.

Methadone is addicting, (and it is therefore a highly regulated form of treatment), but it is a form of treatment for both chronic pain and heroin addiction, and is actually safer for the patient to be on methadone and under the care of a physician than NOT to be. When on methadone, the patient can sometimes get off the drug altogether, the risk of HIV transmission through having to share needles is greatly reduced as are other high risk behaviors (drug seeking and illegal behaviors) associated with addiction.

Hi.

I just want to clarify somethings.

First, my estrangment from my mom didnt begin until 2001, so I was with from the begining. I know that there was no prior addiction. I know a lot from her med records as was told to me by the coroner. The facts of the matter were that she had a typical surgery that is done every day, and I have never heard of anyone that was in such pain afterwards it required 5 years of MORPHINE. The info on methadone was nice, but I have been doing research since she died. According to medical records, she wasnt even introduced to methadone until 2001. So for 5 years she was on morphine solely. That just doesnt seem right me, without some sort of supervision or management program. As I said, there were never any pill counts or check up or anything. If that had been the case, she would have been removed from morphine for sure, because I know she overmedicated herself after she started to become addicted. I have a friend who's mother is on pain manament, and she has monthly pill counts for oxycontin and lortab. Where was that sort of supervision for my mother?

Anyhow, I havent made many assumtions about my mothers medical history, and where I have, I have made clear that it was an assumtion. I am in the process of getting her med records for myself, but it is a slow process. I am finally going to be appointed admin of her estate on the 21st, and then it will take about another week before I will actually have the records in my hands.

Really, I just wanted to know if I should go though the steps to bring a case, or if I was just looking for a scapegoat. Are there any sort of precedence to a case like this? I need legal help more than medical help.

Thanks again.

[ellencee]

dacheeba
I'm giving you a link to the General Statutes for Kentucky, the medical malpractice section. What I understand from reading this information is that a one-year period (statute of limitations) begins to run when the act of malpractice was detected or should have been detected.

[url]http://www.louisvillelaw.com/medical/malpractice/stat_limitation.htm[/url]

You have a very convoluted issue and I think the best thing for you to do is to make an appointment with a malpractice attorney in your area and take advantage of a free consultation appointment.

I don't know if the above statute of limitations applies to when you first knew, since you had no legal 'right' to make a claim of malpractice at that time.

Also, there is the issue of contributing to the act that caused damages. Obviously, your mother contributed to her own damages. She recognized her own addiction and sought treatment through the pain management clinics and addiction clinics provided through the hospital.

The fact that your mother lied to you and other family members about the true cause of her drug usage does not imply that she thought she needed the medications for treatment of pain from having cancer. Her lying to you and other family members does not create a duty for the hospital, its employees, or her physicians to have notified family members of her treatment(s) or the reasons for her treatment(s).

The treatment of drug addicts is not always a clear path, either. Many people think if you take away the drug, the person will no longer be an addict. That is not so; what you end up with is a drug addict in need of drugs and motivated to obtain drugs. Only after the person has been through a detox program can efforts to change the addictive process begin. Obviously, the hospital did not have the authority to have your mother involuntarily committed to a rehab facility but did have a program of 'maintenance' that progressed to weaning to methadone.

Your mother remained responsible for her actions, her drug consumption, and her progress towards being sober. I don't recall seeing any mention of her efforts to become drug-free through a program of 'in-house' addiction treatment.

If I go back to the original prescribing of morphine following removal of her ovaries (oophorectomy, not a complete hysterectomy, JS, ), then I have to look at whether or not this was an act of negligence and the answer is no.

Was it negligence for her to be referred to the hospital's drug clinic? Again, I have to say no.

Was it negligent for her to remain a patient at the drug clinic for 5 or 7 years? Again, I have to say no.

Was giving her a prescription for 200 methadone tablets an act of negligence? It could be. It also could have been a prescription for 20 tablets that she modified to 200 or it could have been a 3 months' or six months' supply. It seems absurd to me for drug addicts to be given 3 or 6 month's supply of anything, but it is an accepted practice. That's what you would have to look at--was this the standard practice of the hospital's methadone clinic and in methadone clinics in and around the same area in your state?

You will have to be able to show a reasonable connection between the acts of negligence (continuing her on narcotics and giving her 200 tablets) and the damages (her addiction and her death). This would be 'causation'; a negligent act caused damages and is an element that must be present in order to have a claim of malpractice.

This causation breaks down into two parts:
1) causation in fact (also has two parts)
a)the 'But For' test in which the plaintiff must prove that, in all reasonable medical probability, the damges would not have occurred 'but for' the negligence of the health care provider; and,
b) the 'substantial factor' test in which the plaintiff must prove that the defendant health care provider's negligence was a substantial factor in causing the alleged damages. The health care provider is not absolved from liability merely because other causes contributed to the damages.

2) forseeability--the plaintiff must prove that the defendant should have foreseen that the negligence could result in the alleged damages. The health care provider is only liable for foreseeable consequences of his/her acts.

I don't know how you could prove that 'but for' the hospital's treating your mother in its drug program, your mother would not have continued to be an addict and would not have died as a result of her addiction.

You may could prove it was a substantial factor, if you can prove they failed to follow acceptable standards of care for that type of treatment facility.

Then, you would have to prove that the hospital should have foreseen that their treatment(s) could result in the alleged damages. I think that forseability may be a very difficult part for you to prove. Forseability is based on what a reasonable person could or should have foreseen. A reasonable person should be able to see that a drug addict may overdose on any amount of medication prescribed or on any medication prescribed, so I don't think you could use the forseability issue to your advantage.

I've given you some 'legal' information from my experience as a medical-legal consultant, not as an attorney, and in hopes that by giving you some legal food for thought, it will help you decide what, if any, action to seek.

Best wishes,
EC

Originally posted by dacheeba
Hi.

I just want to clarify somethings.

First, my estrangment from my mom didnt begin until 2001, so I was with from the begining. I know that there was no prior addiction. I know a lot from her med records as was told to me by the coroner. The facts of the matter were that she had a typical surgery that is done every day, and I have never heard of anyone that was in such pain afterwards it required 5 years of MORPHINE. The info on methadone was nice, but I have been doing research since she died. According to medical records, she wasnt even introduced to methadone until 2001. So for 5 years she was on morphine solely. That just doesnt seem right me, without some sort of supervision or management program. As I said, there were never any pill counts or check up or anything. If that had been the case, she would have been removed from morphine for sure, because I know she overmedicated herself after she started to become addicted. I have a friend who's mother is on pain manament, and she has monthly pill counts for oxycontin and lortab. Where was that sort of supervision for my mother?

Anyhow, I havent made many assumtions about my mothers medical history, and where I have, I have made clear that it was an assumtion. I am in the process of getting her med records for myself, but it is a slow process. I am finally going to be appointed admin of her estate on the 21st, and then it will take about another week before I will actually have the records in my hands.

Really, I just wanted to know if I should go though the steps to bring a case, or if I was just looking for a scapegoat. Are there any sort of precedence to a case like this? I need legal help more than medical help.

Thanks again.

Hi Dacheeba: Things didn't sound quite right to me, either,
and that's why I was trying to narrow down some
understanding of her medical history, her cause of death,
etc., and also give you some info on Methadone.

I would strongly advise you to consult an attorney as soon
as possible (and consult only with an attorney). I
would strongly advise you not to communicate with anyone
from this site via private e-mail if you are contacted. I will
also remind you that no one here has any knowledge of
your mother's case whatsoever, and short of anyone
here attempting to get a history from you and/or give you
some information on what Methadone is, no one
(especially someone posing as a medical professional)
should encourage you to think that you don't have a case
or state where your mother's responsibility stopped and
started and what the hospital's duty was or wasn't. For
a medical professional to do something like that on-line in
the absence of the medical record is utter horsesh** and is,
in fact, medical malpractice in and of itself.

I did find some info on Methadone litigation for you.

Good luck.

[url]http://www.paulsonandnace.com/r_articles13.html[/url]

[url]http://www.mapinc.org/drugnews/v02/n1068/a08.html[/url]

[url]http://www.jointogether.org/gv/news/summaries/reader/0,2061,553689,00.html[/url]


Scroll down to Methadone on this one (wrongful death suit)

[url]http://216.239.57.100/search?q=cache:wJvt_yLOrqQC:[url]www.atla.org/subs/pnlr.pdf+Methadone+litigation+negligent+doctors&hl=en&ie=UTF-8[/url][/url]




hmmbrdzz

[ellencee]

as posted by hmmbrdzz: "I would strongly advise you not to communicate with anyone
from this site via private e-mail if you are contacted. I will
also remind you that no one here has any knowledge of
your mother's case whatsoever, and short of anyone
here attempting to get a history from you and/or give you
some information on what Methadone is, no one
(especially someone posing as a medical professional)
should encourage you to think that you don't have a case
or state where your mother's responsibility stopped and
started and what the hospital's duty was or wasn't. For
a medical professional to do something like that on-line in
the absence of the medical record is utter horsesh** and is,
in fact, medical malpractice in and of itself. "

hmmbrdzz
I have reported this response to administration and asked that the same standard be applied to your posts as was applied to DNR--either prove your slanderous remarks to be the truth or be banned from this forum.

You are certainly the rudest person to ever appear on this forum, in my opinion, and you exhibit total ignorance about medical-legal consulting. Use some of your computer skills and research skills to find out what an RN can do as a medical-legal consultant.

Then, read the terms of user agreement as provided by this site; there you will find that no one here has a duty to any person as no client relationship exists--your malpractice bs goes right out the window in light of those provisions.

Pay particular attention to this site's user agreement terms where you agreed not to harass, argue, be rude, fight, slander, or defame.

I have as much right to post on this forum as do you; and, those who come to this forum in search of advice on legal matters have the right to hear from posters other than you and your equally hostile buddies. There are two sides to every legal issue and there are many personal and professional opinions on each of the two sides. To insist that posters only listen to you is to deny the poster's receiving information and advice from those who have actual work experience with legal matters.

This site is owned by Advice Company, Do-It-Yourself.com. It is not owned and operated by and for the benefit of hmmbrdzz.

I will continue to post and to email those posters to whom I can provide information.

[ellencee]

dacheeba
The methadone clinic is probably either wholly or partially funded by state and, or federal funds. Therefore, the state, or the federal, guidelines for this methadone clinic are available for you to obtain and to review. More likely than not, in these guidelines, you will find standards for length of treatment, frequency of treatment, medication dispensing and medication prescribing, usage follow-up standards, etc.

I recommend that you find out who funds this methadone clinic and work from there in obtaining the guidelines that govern the clinic. If it is federally funded and state funded, the federal guidelines supercede all other guidelines and will set the minimum standards. The state may have additional guidelines that have to be met and the facility may have policy and procedure guidelines that have to be met, too.

Before you spend much more time on this issue, I hope you will consult with an attorney, as I suggested, to see if you even have a viable claim; then, if one exists, put the time and effort it will take to research these records and this clinic's responsibilities.

I am going to email you the name of another site that provides a different method of obtaining legal advice. The site to which I am referring has attorneys that list their names, addresses, phone numbers, fax numbers, and email addresses. I believe you can find the information and guidance that you need on the other site. If I am unable to email you from this site, you may email me and I will respond with the information. Thanks.

Best wishes,
EC

My response: I don't give a crap what you report. You were chased from this site months ago due to your notes (not me). For your information, my remarks are not close to slanderous (your name isn't even mentioned). They just happened to follow your post. And besides, they are factual. Wanna debate it? Here's my debate pertinent to this thread and your post.

[quote]Originally posted by ellencee
[b]
dacheeba
I'm giving you a link to the General Statutes for Kentucky, the medical malpractice section. What I understand from reading this information is that a one-year period (statute of limitations) begins to run when the act of malpractice was detected or should have been detected.

[url]http://www.louisvillelaw.com/medical/malpractice/stat_limitation.htm[/url]

You have a very convoluted issue and I think the best thing for you to do is to make an appointment with a malpractice attorney in your area and take advantage of a free consultation appointment.

I don't know if the above statute of limitations applies to when you first knew, since you had no legal 'right' to make a claim of malpractice at that time.

**A: You sure as heck don’t know, and you also don’t know that someone didn’t (or doesn't) have a “legal right” to make a claim of malpractice or at what time.


Also, there is the issue of contributing to the act that caused damages. Obviously, your mother contributed to her own damages. She recognized her own addiction and sought treatment through the pain management clinics and addiction clinics provided through the hospital.

**A: Any attorney who might take this case would “obviously" debate this.


The fact that your mother lied to you and other family members about the true cause of her drug usage does not imply that she thought she needed the medications for treatment of pain from having cancer. Her lying to you and other family members does not create a duty for the hospital, its employees, or her physicians to have notified family members of her treatment(s) or the reasons for her treatment(s).

**A: The "fact" ? ? ? Where are the facts regarding the mother lying to her healthcare providers? And besides -- when did you become aware of the reason she needed Methadone?

The treatment of drug addicts is not always a clear path, either. Many people think if you take away the drug, the person will no longer be an addict. That is not so; what you end up with is a drug addict in need of drugs and motivated to obtain drugs. Only after the person has been through a detox program can efforts to change the addictive process begin.

**A: You are saying such idiotic things in an attempt to sound impressive, it honestly makes me laugh. What is an "addictive process", anyhow?

Obviously, the hospital did not have the authority to have your mother involuntarily committed to a rehab facility but did have a program of 'maintenance' that progressed to weaning to methadone.

**A: You are SO "obviously" in need to make impressive sounding remarks that even you -- the claimed medical legal expert here -- can’t recognize (or can't admit) that you have no knowledge of this case that would give you ANY platform to say or imply "no, you don't have a case".


Your mother remained responsible for her actions, her drug consumption, and her progress towards being sober. I don't recall seeing any mention of her efforts to become drug-free through a program of 'in-house' addiction treatment.

**A: You sure as hell didn’t see any mention of it. Therefore your observations remain full of sh**.

If I go back to the original prescribing of morphine following removal of her ovaries (oophorectomy, not a complete hysterectomy, JS, then I have to look at whether or not this was an act of negligence and the answer is no.

Was it negligence for her to be referred to the hospital's drug clinic? Again, I have to say no.

Was it negligent for her to remain a patient at the drug clinic for 5 or 7 years? Again, I have to say no.

Was giving her a prescription for 200 methadone tablets an act of negligence? It could be.

**A: What are looking at? Nothing. No records, no history, no medication administration records, yet you can claim "I have to say no" but can then suddenly claim with respect to 200 methadone tabs "it could be".

It also could have been a prescription for 20 tablets that she modified to 200 or it could have been a 3 months' or six months' supply. It seems absurd to me for drug addicts to be given 3 or 6 month's supply of anything, but it is an accepted practice.

**A: Are you saying that absurdity is “standard practice” and therefore not malpractice? If so, that is the most absurd statement I've ever read coming from a claimed medical legal person.



That's what you would have to look at--was this the standard practice of the hospital's methadone clinic and in methadone clinics in and around the same area in your state?

**A: Care to elaborate on what the standards of care would have been for this patient and why it might have been acceptable practice to give this patient 200 tabs of methadone?

You will have to be able to show a reasonable connection between the acts of negligence (continuing her on narcotics and giving her 200 tablets) and the damages (her addiction and her death). This would be 'causation'; a negligent act caused damages and is an element that must be present in order to have a claim of malpractice.

This causation breaks down into two parts:
1) causation in fact (also has two parts)
a)the 'But For' test in which the plaintiff must prove that, in all reasonable medical probability, the damges would not have occurred 'but for' the negligence of the health care provider; and,
b) the 'substantial factor' test in which the plaintiff must prove that the defendant health care provider's negligence was a substantial factor in causing the alleged damages. The health care provider is not absolved from liability merely because other causes contributed to the damages.

2) forseeability--the plaintiff must prove that the defendant should have foreseen that the negligence could result in the alleged damages. The health care provider is only liable for foreseeable consequences of his/her acts.

**A: This “legal” mumbo jumbo crap you spit out is totally useless to most who come here (and you have historically used this line to discourage posters from thinking they might have a case with some merit). There is a person who died after being on Methadone for five years, and this is the best that you -- a medical legal consultant -- can see fit to explain in such detail after you've just said "no, I don't think it's negligence"? You have no idea whether it's negligence or not, so why imply you do.


I don't know how you could prove that 'but for' the hospital's treating your mother in its drug program, your mother would not have continued to be an addict and would not have died as a result of her addiction.

**A: You sure as heck don't know how something could be proven; therefore, why are you so eager to say "I don't think so". You aren’t qualified to know how to prove anything in medical malpractice and therefore have no platform to say "I don't think you have a case".

You may could prove it was a substantial factor, if you can prove they failed to follow acceptable standards of care for that type of treatment facility.

**A: Again, mumbo jumbo crap. Are you self-doubting what you have just said and disputing what you just said?

Then, you would have to prove that the hospital should have foreseen that their treatment(s) could result in the alleged damages. I think that forseability may be a very difficult part for you to prove. Forseability is based on what a reasonable person could or should have foreseen. A reasonable person should be able to see that a drug addict may overdose on any amount of medication prescribed or on any medication prescribed, so I don't think you could use the forseability issue to your advantage.

I've given you some 'legal' information from my experience as a medical-legal consultant, not as an attorney, and in hopes that by giving you some legal food for thought, it will help you decide what, if any, action to seek.

**A: Go read your second paragraph about “convoluted” issues. Oh, but I forgot -- you can magnificently sift right through all convoluted medical issues without any records and can conclude "you have no case". Right? Well I've got news for you. You can't, and posters shouldn't be led to believe that you can by private e-mail. Rude? You daggone right I'll get rude about your advice here again if I think it will encouarge the poster to go seek the advice of an attorney before they feel discouraged on account of some note you write.



hmmbrdzz

i don't understand what all the bickering is about. dacheeba clearly said that his mother had been diagnosed with munchousen by proxy. it is obviouse that over the years, untreated, this turned into munchousen syndrom, or turned on herself instead of her daughter. the fact is, it would clearly be in her medical history, they do not remove that kind of thing. so he doctor should have known she had a problem from the start.i suggest that anyone who does not understand this kind of mental illness should refer to an encyclopedia or some such. that is the ony thing i felt should be pointed out. thank you.

Originally posted by pandapoo
i don't understand what all the bickering is about. dacheeba clearly said that his mother had been diagnosed with munchousen by proxy. it is obviouse that over the years, untreated, this turned into munchousen syndrom, or turned on herself instead of her daughter. the fact is, it would clearly be in her medical history, they do not remove that kind of thing. so he doctor should have known she had a problem from the start.i suggest that anyone who does not understand this kind of mental illness should refer to an encyclopedia or some such. that is the ony thing i felt should be pointed out. thank you.

=============================

This is a very significant point (the Munchausens), and this is the kind of medical history that is critical.

If the physician prescribing the methadone did not know about this history of (or diagnosis of) Munchausens (and there is ever a wrongful death lawsuit, and this point is argued), the physician will no doubt seek to avoid liability by claiming the patient failed to provide an accurate medical history or provided a false history that prevented an accurate diagnosis and proper treatment, BUT -- a patient's failure to volunteer a medical history (including a history of drug addiction somewhere in the past) DOES NOT necessarily equate to “contributory negligence“ IF the physician failed to interview and/or examine other medical records and resources that would be determined to have been readily available for review and contained this information.

Damages can be awarded when a medical history is sitting in a chart somewhere and the physician has failed to get this information (and the patient dies as a result).

With a death possibly related to Methadone and a history of Munchausens possibly sitting in a medical record somewhere, this case definitely needs to seek the advice of an attorney.



hmmbrdzz

[ellencee]

for readers that don't understand Munchausen syndrome or Munchausen syndrome by proxy, this definition is from a medical dictionary--
A type of malingering or ficticious disorder in which the patient may practice self-mutilation and deception in order to feign illness. When detected, such patients leave one hospital and appear in the emergency room of another. Patients of this type are seldom recognized in time to receive psychiatric diagnoses and therapy, which they need.

Muchausen syndrome by proxy is the fabrication of symptoms or physical evidence of another's illness, or the deliberate causing of another's illness, to gain medical attention.

The poster stated she 'believed' this diagnosis was given in 1984 and related to SS's being involved regarding her sister. Muchausen syndrome by proxy diagnosis at this time (1984) suggests the mother was fabricating illness in the daughter (sister) to gain medical attention.

I anticipate this diagnosis being relevant more to the aspect of defending against a claim of malpractice by the physician, hospital, or methadone clinic than to the assertion of a claim of malpractice, if it has any relevance at all to the posters concerns.