Volume 10, Issue 4 pp. 722-729

Alleged Medical Abandonment in Chronic Opioid Analgesic Therapy: Case Report

David A. Fishbain MD, FAPA

Corresponding Author

David A. Fishbain MD, FAPA

Departments of Psychiatry,

Neurological Surgery, and

Anesthesiology, Miller School of Medicine, University of Miami, Miami;

The Rosomoff, Comprehensive Pain and Rehabilitation Center, Douglas Gardens, Miami;

Department of Psychiatry, Miami Veterans Administration Hospital, Miami, Florida, USA;

David A. Fishbain, MD, FAPA, Department of Psychiatry, University of Miami, 1400 Northwest 10th Avenue (D-79), Miami, FL 33136, USA. Tel: 305-243-4060; Fax: 305-243-4061; E-mail: [email protected].Search for more papers by this author
John E. Lewis PhD

John E. Lewis PhD

Departments of Psychiatry,

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Jinrun Gao PhD

Jinrun Gao PhD

State Farm Insurance, Bloomington, IL, USA

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Brandly Cole PsyD

Brandly Cole PsyD

The Rosomoff, Comprehensive Pain and Rehabilitation Center, Douglas Gardens, Miami;

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Rennee Steele Rosomoff BSN, MBA

Rennee Steele Rosomoff BSN, MBA

The Rosomoff, Comprehensive Pain and Rehabilitation Center, Douglas Gardens, Miami;

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First published: 05 June 2009
Citations: 3

ABSTRACT

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 avoid and protect themselves against potential abandonment allegations when termination of the physician–patient relationship is warranted, physicians are advised to consider following the outlined procedures.

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