Alleged medical abandonment in chronic opioid analgesic therapy: Case report

David A. Fishbain, John E. Lewis, Jinrun Gao, Brandly Cole, Rennee Steele Rosomoff

Research output: Contribution to journalArticle

4 Scopus citations


Objectives. The objectives of this medicolegal case report were the following: 1) present details of a chronic pain patient (CPP) on chronic opioid analgesic therapy (COAT), who diverted her opioids and was terminated from treatment, and subsequently committed suicide; 2) present both the plaintiff's and defendant's (the COAT prescriber) expert witnesses' opinions as to the allegation of medical abandonment of this patient and other allegations; and 3) based on these opinions, to develop some recommendations as to how pain physicians can minimize their medicolegal risk when termination of the physician-patient relationship is warranted. Methods. This is a case report of a CPP treated by a pain physician who demonstrated aberrant drug-related behaviors and required large doses of controlled-release oxycodone. Results. Differences between the plaintiff's and defendant's experts' opinions are presented by utilizing the COAT literature. Options for avoiding allegations of abandonment are proposed. Conclusions. To avoidand protect themselves against potential abandonment allegations when termination of the physician-patient relationship is warranted, physicians are advised to consider following the outlined procedures.

Original languageEnglish (US)
Pages (from-to)722-729
Number of pages8
JournalPain Medicine
Issue number4
StatePublished - Jun 18 2009



  • Abandonment
  • Aberrant drug-related behaviors
  • Breaches of standards
  • Chronic opioid analgesic therapy
  • Chronic Pain
  • Death
  • Diversion
  • Intractable pain
  • Opioids
  • Standards of medical care
  • Suicide

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine

Cite this

Fishbain, D. A., Lewis, J. E., Gao, J., Cole, B., & Rosomoff, R. S. (2009). Alleged medical abandonment in chronic opioid analgesic therapy: Case report. Pain Medicine, 10(4), 722-729.