On May 14, 2014, a California Family Practice physician received a Medical Board of California investigative inquiry following the death of a young adult patient from a poly-drug overdose while the patient was in-patient at a residential facility to treat Methadone addiction and related issues. The Medical Board requested the patient records and a formal, written statement from the physician detailing all care provided to the deceased patient.
The patient had presented to the physician's Family Practice clinic accompanied by a residential treatment staff member. The physician was not affiliated with the treatment facility. According to the facility staff, the patient needed an admission physical and had complaints of withdrawal from prior Methadone treatment. A Physician Assistant conducted the routine physical exam. Later the same day, the patient presented at the physician's other clinic in a nearby city, again accompanied by residential treatment facility staff. The staff and patient requested evaluation and prescriptions for anxiety and Methadone withdrawal. The patient claimed that he or she could provide documentation of having previous, high dose Methadone prescriptions within a few hours. The physician issued prescriptions for Methadone and other drugs based on the patient's medical indications, but advised he would only provide the prescriptions to the treatment facility staff and not to the patient directly. The physician directed the staff to withhold the medications from the patient until confirmation was received regarding the previous prescriptions. The facility staff assured the physician the prescriptions would only be filled when the documentation was received, that all drugs would be held securely under lockand key at the facility, and administered only as directed by the physician.
When the physician did not receive confirmation of the prior prescriptions for the patient from the facility a few hours later, he contacted the pharmacy and cancelled the prescription order. Unbeknownst to the physician, the prescriptions had already been filled. Contacting the facility in follow-up, the physician was told that the patient was doing fine. However, two days later the physician was informed that the patient had expired from apparent drug overdose. The patient had apparently been allowed access to the drugs at the facility unsupervised.
The physician contacted our office for assistance in responding to the request from the Medical Board for patient records and a written narrative treatment statement regarding the treatment and care of the deceased patient. We reviewed the relevant records with the physician and helped with the compilation and submission of the requested statement to the Board. On August 4, 2014, the physician received a letter from the Medical Board advising the case was closed and that no further action was anticipated.