Allegations of Medical Malpractice in Chronic Opioid Analgesic Therapy Possibly Related to Collaborative/Split Treatment and the P-450 Enzyme System: Forensic Case Report

David A. Fishbain, John E. Lewis, Jinrun Gao

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

A medicolegal forensic case report of allegations of medical malpractice during chronic opioid analgesic therapy is presented. Here, issues relating to split treatment and the P450 enzyme system are discussed. Objectives: The objectives of this forensic medicolegal case report were the following: 1) present details of a patient on chronic opioid analgesic therapy (COAT) where a disastrous outcome resulted in allegations of malpractice; 2) detail the plaintiff's and defendant's medical experts' opinions on this allegation; and 3) discuss issues potentially related to these allegations, i.e., split treatment and the P450 enzyme system. Methods Case Report Results: Medicolegal issues surrounding these malpractice allegations are discussed. Conclusions: Split treatment can increase the difficulties in performing COAT. Clinicians should routinely consider the effects of all utilized drugs on the ability of the P450 enzyme system to metabolize/clear opioids. Wiley Periodicals, Inc.

Original languageEnglish (US)
Pages (from-to)1419-1425
Number of pages7
JournalPain Medicine
Volume11
Issue number9
DOIs
StatePublished - Sep 2010

Keywords

  • Aberrant Drug Related Behaviors
  • Breaches of Standards
  • Chronic Opioid Analgesic Therapy
  • Chronic Pain
  • CYP 2D6
  • Intractable Pain
  • Medical Malpractice Allegations
  • Opioids
  • P-450 Enzyme System
  • Split Treatment
  • Standards of Medical Care

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine

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