Methadone Case Study

1. What are the important facts of the case?
There are numerous facts about this case that will be legally significant. The facts about the accident would include:
1. The patient being involved in an auto accident after escaping from a detention center
2. The patient seemed alert and claimed to be going through drug withdrawals
3. The patient stated he was in a methadone program but did not know his normal dosage
4. The dose of Methadone given was moderate
5. The patient was never an addict, nor was he in a Methadone program
The important physical findings facts include:
6. The blood pressure was low and this was likely from internal bleeding
7. The patient was in need of blood but refused the treatment
8. The physician ordered a CT but did not mark the order as STAT
9.

The staff believed the patient’s altered behavior was due to the possible drug withdrawals. While the symptoms are similar, there are distinct differences between hypovolemic shock- secondary to blood loss, and acute opiate withdrawals. With a thorough exam, the staff should have been able to recognize this difference. The Clinical Opiate Withdrawal Scale, (Wesson, D. R., & Ling, W., 2003) would have been the proper objective measurement tool to be able accurately, assess the patient. Another breach of duty was not getting the CT scan down in an appropriate amount of time. The physician had a high index of suspicion that the patient was bleeding internally, yet the CT was not completed until the following morning. Lastly, the patient admitted to a substance abuse problem, yet a drug screen was not ordered. If it had been, they would have seen there were no opiates in his system and he was positive for alcohol and benzodiazepines.
The fact the patient died from internal bleeding shows there were damages. The patient’s death was directly linked to the time delay finding the proper diagnosis, and inability to find the extent of internal bleeding from which he was