Are healthcare providers at legal risk for prescribing opioids?

A hospital in another state has agreed to pay a fine of $400,000 plus over $77,000 in investigation costs after the State Board of Pharmacy found excessive painkiller doses prescribed to dozens of patients who subsequently died. In addition, its operational license will be on probation for three years and its compliance with pharmacy board rules and regulations will have to be reviewed by a consulting pharmacist or pharmacy organization.

Mount Carmel Health System in the Columbus, Ohio, area has since fired the doctor who prescribed the allegedly excessive doses and closed its Mount Carmel West hospital. The doctor, who argues he was merely providing palliative care for dying patients, has been charged with 25 counts of murder. He has pled not guilty to all charges.

Two pharmacists were also cited in the investigation for verifying large doses of fentanyl and were fined $1,000 and $2,000. They will be required to undergo additional training in pain management and palliative care. A third pharmacist was cited for supervisory failures.

Mount Carmel also fired 23 nurses, pharmacists and managers after its own internal investigation, and referred additional cases to their professional boards for review. And, 25 nurses are facing administrative hearings and possible disciplinary action.

According to reports, nurses sometimes overrode the controls on automated painkiller dispensers to administer the doses requested by the doctor. This was done even though no emergency was noted.

The doctor who prescribed the drugs is only charged with murder in cases where he prescribed at least 500 micrograms of fentanyl. Prosecutors say that this dose indicates an intent to kill.

The doctor has sued the Mount Carmel Health System for defamation, as have 10 others. Some of the others have also filed wrongful termination suits.

Could this happen in North Carolina?

Yes, it could easily happen here. All that is required is for prosecutors to become suspicious of your prescription and dispensing policies after a patient death.

Naturally, you will want to be very careful about following good medical practice whenever you prescribe potentially addictive opioids.

The Mount Carmel situation may be somewhat of an outlier, but it’s important to remember that doctors, nurses, pharmacists and other health care staff can face everything from disciplinary action and termination to criminal charges when a patient dies from an overdose of a prescription opioid.

If your organization begins investigating after a fatality, or if a local prosecutor becomes involved, it is crucial to obtain counsel experienced in health care law.