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Protecting Pain Physicians from Legal Challenges: Part 1

Sudden, unexpected deaths in opioid-treated chronic pain patients are an unfortunate—but not entirely unexpected—occurrence given the grave health issues these patients face; nevertheless, pain physicians should be aware of potential causes, take preventive actions and, if the unforeseen happens, be prepared to defend against legal challenges.

Out of the blue, you get a phone call. One of your best performing patients was found dead at home. No suicide note. No warning. Just a lifeless body who was quite pleasant and upbeat at your last clinic visit. You quickly review the chart. Same meds for the last few months. No warnings of an impending death.

Unfortunately, this scenario has become all too common to ignore it. The “Sudden Death Syndrome” in opioid-treated pain patients is an issue that all physician’s must now face lest it ruin medical careers and deprive needy patients of their hard-fought battle to win the rights for pain treatment. Patients ill enough to require opioids typically have a shorter life span. The sad fact is that physicians are erroneously being blamed for many of these deaths when, in fact, they have usually extended the pa tient’s life.

This two-part article outlines the common causes of sudden, unexpected deaths, and the usual post-mortem process that every pain-treating physician must understand. In Part 2, I will present recent sudden death case examples from my files. Both Parts 1 and 2 present an approach to avoiding and defending legal challenges. All physicians who treat pain with opioids need to immediately understand the blatant, malicious, and non-scientific challenges recently foisted on some excellent physicians. All of us need to institute means to protect ourselves from malpractice and other legal challenges that may occur when a pain patient suddenly and unexpectedly dies.

Last updated on: December 27, 2011
First published on: March 1, 2008