Outrage led CID to a case in which an 85-year old lung cancer patient received 25-milligran injections of Demerol as needed, despite his repeated reports of pain scores of 7 to 10. As Joanne Lynn, M.D., has noted in her quality improvement work, the use of Demerol to treat such instances of pain is in itself evidence that a hospital is not up-to-date in its pain management protocols.
CID filed a complaint on the family’s behalf with the California State Medical Board, but the board did not act against the physician. With CID’s Director of Legal Affairs, Kathryn Tucker, as co-counsel the family then pursued an elder abuse case. This turn is significant because under California’s elder abuse statutes, families can seek redress for a deceased patient’s pain and suffering. This cannot occur in cases of medical malpractice. The case is now before the Alameda County Superior Court.
CID often conducts a clinical and legal record review for families who believe a loved one’s pain was not treated adequately. When appropriate, CID will help families submit complaints to the facility, the medical and nursing boards, JCAHO, or the local Peer Review Organization.
In addition to helping patients and families in such cases, CID defends physicians wrongly accused of over-prescribing narcotics. “When a doctor is being wrongly punished for vigorous pain treatment, the chilling effect goes beyond that treating physician,” Tucker said. Such cases are now underway in Louisiana, Utah, California, Iowa, and Arizona. One medical board retracted its Letter of Warning after receiving an amicus letter from CID. ABCD has supported CID’s initiatives by writing letters to medical boards and to the courts involved in hearing cases.
“State medical boards do not understand this issue. They need to balance corrections for doctors who undertreat pain with sanctions for those who truly abuse the prescribing function,” Tucker said.
CID is working to educate state medical boards on appropriate pain treatment, and is encouraging boards to take complaints of undertreatment seriously and to act accordingly. In the 2000-2001 California State Legislative session, CID promoted a bill to require remedial education for physicians who fail to treat pain adequately and appropriately. “The measure will probably pass the California assembly as a requirement that the state medical board investigate complaints of inadequate pain care and, report the outcome of those investigations. In addition, physicians will need pain management continuing education to maintain licensure,” Tucker said.
“We want to remedy what happened in California by seeking accountability and by defending appropriate treatment,” Tucker said. “We are not an attack dog organization, but we will raise the profile of cases where doctors have failed to treat pain.”
For more information:
Compassion in Dying Federation
6312 SW Capitol Hwy, #415
Portland, OR 97201
www.compassionindying.org
<<< Previous Next >>> [ Go Up ]