Toxicology Experts Opine on Inappropriate Painkiller Administration

Pain Medication Expert WitnessThis case takes place in Virginia and involves a patient who died from an accidental overdose of prescription drugs repeatedly prescribed. The patient presented due to a chronic medical condition which required an ongoing pain management regime. The patient was prescribed a range of opioid medications, for which dosages were progressively increased over the course of several years. Eventually, the patient was killed by an overdose of her pain medication, enabled in part by the large dosage she had been prescribed.

Question(s) For Expert Witness

  • 1. Do you have extensive experience working with pain management medications?
  • 2. Please explain your knowledge the complications that can arise from prescribing these medications before obtain the proper patient information?
  • 3. What is you experience working on similar cases?

Expert Witness Response E-003798

I am a practicing Primary Care Physician and Hospital Pharmacist, with extensive experience as a retail pharmacist. I have a Master’s of Science in Pharmacology and Toxicology with the focus of my research in the area of drugs of abuse. As a practicing Physician and Pharmacist, I have extensive experience working with the medications identified in this case. My knowledge regarding the potential complications of these particular medications is derived from my education and experience as a Practicing Physician and Pharmacist, as well as having a Masters in Clinical Pharmacology and Toxicology. The most relevant interaction is going to be regarding sedation, from central nervous system depression, as well as potential metabolic interaction from liver metabolism resulting in potential unintended elevated levels of certain medications that share the same pathways. My experience is extensive in working on cases involving the above medications on both plaintiff and defensive side, outpatients and inpatients (hospitalized), relative to pharmacist and physician errors.

Expert Witness Response E-030614

Yes, I have extensive experience with pain medication management. I consult primarily at long-term care facilities where there is a relatively large focus on pain management monitored by quality measure indicators. The absence of a complete assessment of pain, including source, type, location, and intensity as well as covariates impacting the reporting of pain, will likely result in overmedicating, potentially with an inappropriate selection of pain medication. The use of multiple pain medications will increase the risk of interactions, typically a synergistic effect of a common side effect. I have experience with similar cases, both plaintiff and defendant.


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