Kailua doctor & Longs Drugs pharmacist sued in marine wife's overdose death

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rxgolfer

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http://m.hawaiinewsnow.com/#!/newsDetail/25000905

It's so sad. I feel bad for the patients family and for the pharmacist. :(
A Kailua doctor and a Longs Drugs pharmacist are being sued by a Marine who claims their negligence lead to his wife's overdose death. 32-year-old Andrea Wells died July 31, 2012 -- five days after she began using prescription drug fentanyl. Court documents indicate it is 100 times more potent than morphine. "We believe this was a totally unnecessary death due to a horrendously excessive dose of the very, very strong fentanyl patch," explained the Wells family attorney, Richard Fried. The fentanyl patch has been investigated by the Food and Drug Administration since the first generic version of it became available in 2005. The most recent FDA warning was issued in 2012 after numerous deaths and life-threatening side effects were reported nationwide. "The fentanyl patch contains fentanyl, a very potent narcotic pain medicine. It is only intended for treating persistent, moderate to severe pain in patients who are opioid-tolerant, meaning those patients who take a regular, daily, around-the-clock narcotic pain medicine," indicates the warning about the drug on the FDA's website.

"For patients who are not opioid-tolerant, the amount of fentanyl in one fentanyl patch of the lowest strength is large enough to cause dangerous side effects, such as respiratory depression (severe trouble breathing or very slow or shallow breathing) and death," the FDA statement goes on to warn.

What kind of changes need to be made to ensure this never happens again? How do you deal with patients being prescribed fentanyl patches?

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How could this be the pharmacist's fault. Who knows what else she was or wasn't taking now that people transfer their prescriptions to 27 different pharmacies to save 10 cents off gas. I blame the MD if she truly was opioid naïve and the patient should have read the med guide. Was there a toxicology report?
 
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When people sue, they sue every single possible party involved. This one is only on the prescribing doctor.
 
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When those things first came out, there was a story about an ORAL SURGEON (!!!!!!!!) who prescribed this for a teenager who'd had his wisdom teeth pulled. The boy died.
 
I always question people filling fentanyl patches for the first time. I have had to call doctors several times because they were prescribing them in appropriately (ie opiate naïve patients, or extremely high doses because they had made conversion errors.) Fentanyl is like warfarin.....it always needs to be especially carefully checked.
 
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Pharmacist gets the script, looks in patients profile and doesn't see any opioids in her med history. I don't think med guides or ASSUMING the patient may or may not be filling at another pharmacy is a valid excuse to not do anything further. We all know no one reads med guides. I don't think telling the patient to read the med guide will cover your butt in this case. Did the tech even mention the med guide? Was it just stapled onto the bag? Your license is on the line. Put a note with the med to counsel the patient when she gets there.
 
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What I want to know is if the pharmacist were to counsel and the patient were to say "yes I fill other narcotics at xyz pharmacy" how does the pharmacist document that so it is retrievable in a situation like this. Is there a spot for this information to be logged in most pharmacy systems such as CVS and Walgreens? How do you safeguard yourself without keeping your own log?
 
What I want to know is if the pharmacist were to counsel and the patient were to say "yes I fill other narcotics at xyz pharmacy" how does the pharmacist document that so it is retrievable in a situation like this. Is there a spot for this information to be logged in most pharmacy systems such as CVS and Walgreens? How do you safeguard yourself without keeping your own log?

Writing it on the scrip would be a good place to start
 
Didn't you guys know? The doctor wrote them this pain medicine, and you shouldn't question the doctor, because they're the DOCTOR and they know more about the patient's pain than you do!

Now fill my oxycodone and soma NOW!
 
What I want to know is if the pharmacist were to counsel and the patient were to say "yes I fill other narcotics at xyz pharmacy" how does the pharmacist document that so it is retrievable in a situation like this. Is there a spot for this information to be logged in most pharmacy systems such as CVS and Walgreens? How do you safeguard yourself without keeping your own log?
Check on CURES to get a history of pt control meds.
 
I don't fill fentanyl without a documented opioid history in either my RX system or from the doctor. I do not take the patient's word for it.
 
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