A family in Hawaii has filed a lawsuit against a doctor who prescribed the fentanyl pain patch to his wife to treat chronic pain and the pharmacy that filled her prescription. The lawsuit alleges that Andrea Benedi-Wells was improperly given the fentanyl patch by her doctor, Jason Florimonte, her pharmacy, Long’s Drugs, and her pharmacist, Catherine Lau, despite the fact that she should not have been using fentanyl because of other medications she was taking and because she was not sufficiently opioid tolerant. According to a report by the Honolulu medical examiner, Benedi-Wells died from the combined effects of fentanyl and Tramadol, another painkiller that she was prescribed.
Because of its extreme potency—about 80-100 times more powerful than morphine—the Food and Drug Administration has set strict guidelines on how the fentanyl pain patch and other fentanyl products can be prescribed. FDA regulations state that fentanyl should only be prescribed to patients who have already been treated with other opioid medications and who are thus already developed a tolerance for these drugs. The agency also states that fentanyl should not be prescribed in combination with other opioid painkiller or other central nervous system depressant drugs because they could increase the risk of a combined drug overdose.
Commenting on the lawsuit, an attorney for the family said that all three defendants in the case shared responsibility for providing Benedi-Wells with the fentanyl patch despite the fact that she was not eligible to take the drug. The attorney said that Wells was prescribed a fentanyl dose that was far in excess of what it was safe for her to be taking:
[According to the manufacturer’s warning] for patients who are not opioid tolerant, the amount of Fentanyl in one Fentanyl patch of the lowest strength—and remember, hers was triple—is large enough to cause dangerous side effects, such as respiratory depression and death.
Dr. Bill Haning, a pain specialist from the University of Hawaii, said that both the doctor who prescribed the pain patch and the pharmacy that filled the prescription share responsibility for ensuring that dangerous painkillers such as fentanyl are prescribed in a manner that will not jeopardize the health of patients:
We just don’t quite understand what the doctor was thinking because these warnings are available to any doctor. Long’s has the knowledge and expertise to sort of act as a backup and they hold themselves out as doing that.