Painkiller death was misadventure — (South China Morning Post)

SSRI Ed note: Woman in hospital for overdose of antidepressants given fentanyl for back pain. She overdoses and dies from the painkiller. Son sues.

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South China Morning Post

PUBLISHED : Friday, 03 December, 2010, 12:00am

Philanthropist Anita Chan Lai-ling, who overdosed on potent painkiller patches prescribed by a doctor, died of misadventure, a jury decided.

Chan’s death was caused by fentanyl, said to be 80 to 100 times more potent than morphine.

By a majority of three to two, the inquest jury decided against returning an open verdict or unlawful killing on the basis of gross negligence.

Chan died on October 17, 2007, aged 69. ‘The jury decided it was misadventure. We obviously think this is unfortunate,’ her eldest son, Anson Chan, said. His sister, Lily Chan, wept on hearing the verdict.

Radiologist Dr Yau Yat-yin, Anita Chan’s goddaughter, prescribed six patches containing the painkiller for Chan’s back pain while she was being treated for a drug overdose at Adventist Hospital on October 8, 2007.

The jurors recommended that fentanyl patches – which last three days and can be used only one at a time – should not be prescribed on an ‘as required’ basis.

They adopted recommendations made by expert witness Professor Brian Tomlinson, of Chinese University, who said fentanyl should be given with replacements every 72 hours.

Dr Simon Chan, an associate professor and director of pain medicine at Chinese University, said painkilling patches generally included morphine. ‘In general, an overdose of morphine will suppress the central nervous system. The person affected will breathe more slowly and can die of suffocation,’ he said.

Anson Chan questioned why the radiologist could prescribe as many as 6,000 tablets of anti-depressants, controlled under the Dangerous Drugs Ordinance, between January 2003 and his mother’s death.

‘She has no experience or expertise to prescribe such medication. In other countries, this would not be allowed,’ Chan said. He urged the Medical Council to follow up the matter.

Simon Chan said all registered doctors had the authority to prescribe all approved drugs. But in the case of blunders, they would be subject to investigation to see if they had received relevant specialty training.

Before the inquest reopened last week after a year-long adjournment, Anson Chan had already filed a civil claim in October against the hospital, Yau and Dr Richard Kay – a neurologist at the hospital who gave medication to his mother, for breach of contract or negligence.

He alleged the defendants did not tell Anita Chan of the mind-altering effect of the drug, which resulted in his mother uncharacteristically making unduly hazardous investments in the two days before she died.

In an earlier claim brought by Shine Grace Investments, a banker at Citibank was accused of undue influence or oppressive conduct in dealings with Anita Chan. The company, in the writ filed in the Court of First Instance in June 2008, demands the bank repay losses from transactions of US$3.2 million to US$5 million, and to declare the contracts invalid.

Anson Chan said if the claim was won, the money would go to charity.