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.
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 plaintiffs 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 plaintiffs 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.
Fishbain
David A
DA
Department of Psychiatry, Miller School of Medicine, University of Miami, Florida, USA.
Lewis
John E
JE
Cole
Brandly
B
Rosomoff
Renné Steele
RS
Rosomoff
Hubert L
HL
D000063:Accidents, Traffic / Q000331:legislation & jurisprudence*; D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000627:therapeutic use; D001334:Automobile Driving / Q000592:standards*; D002908:Chronic Disease; D005104:Expert Testimony; D005431:Florida; D006801:Humans; D008297:Male; D008318:Malpractice / Q000331:legislation & jurisprudence; D008691:Methadone / Q000627:therapeutic use*; D010146:Pain / Q000188:drug therapy*; D018710:Pain Clinics / Q000592:standards; D010148:Intractable Pain / Q000188:drug therapy*; D011787:Quality of Health Care / Q000592:standards*
D000701:Analgesics, Opioid; D008691:Methadone