Medicolegal rounds: Medicolegal issues and alleged breaches of standards of medical care in a patient motor vehicle accident allegedly related to chronic opioid analgesic therapy

Authors

  • David A. Fishbain, MD, FAPA
  • John E. Lewis, PhD
  • Brandly Cole, PsyD
  • Renné Steele Rosomoff, BSN, MBA
  • Hubert L. Rosomoff, MD, DMedSc, FAAPM

DOI:

https://doi.org/10.5055/jom.2007.0034

Keywords:

chronic pain, intractable pain, opioids, chronic opioid analgesic therapy, driving, motor vehicle accidents, standards of medical care, informed consent, breaches of standards, methadone

Abstract

The objective of this medicolegal case report is to present the details of the case of a chronic pain patient (CPP) who was placed on chronic opioid analgesic therapy (COAT) and was involved in a motor vehicle accident, alleged in litigation to be related to COAT. COAT standards are in a process of evolution, and this process is influenced by recent literature developments. We aim to present both the plaintiff's and defendant's expert witnesses' opinions on whether the defendant physician fell below the "standard" in allowing the CPP to drive. Both the methadone and the driving literature are utilized to explain the defendant's and plaintiff's experts' opinions and the differences between them. Based on these opinions, we have attempted to develop some recommendations on how pain physicians should approach the problem of deciding whether patients should be allowed to drive when on COAT.

Author Biographies

David A. Fishbain, MD, FAPA

Departments of Psychiatry, Neurological Surgery, and Anesthesiology, Miller School of Medicine at the University of Miami; the Rosomoff Comprehensive Pain Center at Douglas Gardens; Department of Psychiatry at Miami Veterans Administration Hospital, Miami, Florida.

John E. Lewis, PhD

Departments of Psychiatry, Miller School of Medicine at the University of Miami, Miami, Florida.

Brandly Cole, PsyD

the Rosomoff Comprehensive Pain Center at Douglas Gardens, Miami, Florida.

Renné Steele Rosomoff, BSN, MBA

the Rosomoff Comprehensive Pain Center at Douglas Gardens, Miami, Florida.

Hubert L. Rosomoff, MD, DMedSc, FAAPM

Departments of Neurological Surgery and Anesthesiology, Miller School of Medicine at the University of Miami; the Rosomoff Comprehensive Pain Center at Douglas Gardens, Miami, Florida.

References

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Published

01/01/2007

How to Cite

Fishbain, MD, FAPA, D. A., J. E. Lewis, PhD, B. Cole, PsyD, R. S. Rosomoff, BSN, MBA, and H. L. Rosomoff, MD, DMedSc, FAAPM. “Medicolegal Rounds: Medicolegal Issues and Alleged Breaches of Standards of Medical Care in a Patient Motor Vehicle Accident Allegedly Related to Chronic Opioid Analgesic Therapy”. Journal of Opioid Management, vol. 3, no. 1, Jan. 2007, pp. 16-20, doi:10.5055/jom.2007.0034.