Syracuse Personal Injury Law Blog
Medical malpractice claims involving prescription medications often turn on more than whether a healthcare provider made a questionable treatment decision. A plaintiff must also establish that the departure from accepted medical practice actually caused the patient’s injury or death. A recent federal decision applying New York law illustrates how the causation requirement can determine the outcome of a malpractice action even when the prescribing practices themselves remain disputed. If you believe negligent prescribing or medication management caused you or a loved one to suffer serious harm, you should speak with an experienced Syracuse medical malpractice attorney about your possible claims.
History of the Case
Allegedly, the decedent had a lengthy history of substance abuse and received primary care from the defendants for several years. He also had paraplegia after a prior accident and later suffered significant burns to his legs. During treatment for those burns, a medical provider prescribed hydrocodone for pain. The prescriptions continued for more than a year, even though the patient had a known history of opioid misuse, received early refills, took benzodiazepines, and produced drug-screen results showing multiple controlled substances. Family members also expressed concern that the patient was engaging in drug-seeking behavior and had resumed abusing drugs.
Reportedly, the patient was found deceased in his home in July 2021, surrounded by drug paraphernalia and evidence of recent illicit drug use. The medical examiner attributed the death to acute intoxication caused by the combined effects of several substances, including hydrocodone, alprazolam, fentanyl, and norfentanyl. The estate commenced an action asserting medical malpractice, wrongful death, and related claims against the healthcare providers and the United States under the Federal Tort Claims Act. The defendants moved for summary judgment, maintaining that the plaintiff could not prove that any prescribed medication caused or contributed to the death.
It is alleged that the plaintiff relied on expert opinions asserting that prescribing opioids together with benzodiazepines departed from accepted medical practice and increased the risk of respiratory depression. The plaintiff’s experts also maintained that the continued opioid prescriptions contributed to the patient’s renewed addiction and eventual overdose. The defendants’ toxicology expert, however, concluded that the prescribed hydrocodone and alprazolam were present at therapeutic, nonlethal levels and that the fentanyl concentration alone fell within a fatal range. The matter came before a federal magistrate judge for a report and recommendation on the summary judgment motions.
Causation in New York Medical Malpractice Cases
The court explained that a New York medical malpractice plaintiff must prove both a departure from accepted medical practice and that the departure proximately caused the claimed injury. A defendant may obtain summary judgment by establishing either that no departure occurred or that any departure did not cause the harm. Once the defendant makes that showing, the plaintiff must submit competent medical evidence raising a genuine factual dispute.
For purposes of the motions, the defendants did not rely primarily on whether the prescribing decisions met accepted standards. Instead, they argued that the plaintiff could not connect those decisions to the fatal overdose. Their expert reviewed the toxicology results substance by substance and concluded that the patient’s hydrocodone level was consistent with the prescribed dosage and far below an overdose level. He reached a similar conclusion regarding alprazolam and the other prescribed medications. By contrast, the fentanyl concentration was within the range associated with fatal overdoses, and the level of norfentanyl indicated that the patient consumed fentanyl shortly before his death. No defendant had prescribed that substance.
The court found the plaintiff’s expert submissions insufficient because they discussed the general dangers of combining opioids and benzodiazepines but did not address the lethal fentanyl concentration, the therapeutic levels of the prescribed medications, or the evidence of recent illicit fentanyl use. An expert opinion must confront the material medical evidence rather than rely on a generalized theory of risk. Because the plaintiff’s experts did not explain how the prescribed drugs remained a substantial factor despite the independently fatal fentanyl dose, the court characterized the plaintiff’s causation theory as speculative.
The court therefore recommended granting summary judgment to all defendants on the medical malpractice claim. It concluded that no reasonable factfinder could determine from the submitted evidence that the challenged prescriptions caused the death.
Consult a Knowledgeable Syracuse Medical Malpractice Attorney Today
If you or a loved one suffered serious harm because a medical provider negligently prescribed, combined, or monitored medications, obtaining a careful review of the medical records and expert evidence is essential. At DeFrancisco & Falgiatano Personal Injury Lawyers, our knowledgeable Syracuse medical malpractice attorneys can assess your case and help you to determine your options. Contact our office through our online form or call 833-200-2000 today to schedule a free, confidential meeting.