Suboxone off-label use and and fatal interactions

Hospitalists  work at the hospital full-time to provide care to hospitalized patients,  including attending to any emergencies that may arise. They must adhere to the generally accepted standards of internal medicine and/or surgery. In the news, the wife of Marine Corps veteran Jason Simcakoski has filed a wrongful death lawsuit against the the staff at Tomah (Wisconsin) VA Medical Center. In 2014 Heather Simcakoski filed a settlement claim with the U.S. Department of Veterans Affairs for damages due to alleged negligence of VA medical staff. Mrs. Simcakoski’s attorney states that government officials did not address the settlement claim she filed which prompted the lawsuit. Jason Simcakoski died from a mixture of drugs prescribed by his physicians. The complaint addresses hospital practices regarding prescription medicine:

Dr. Davis and Dr. Houlihan never informed Jason that they were prescribing Suboxone for an off-label use. Nor was Jason informed of the risks of initiating Suboxone treatment in any respect.

Suboxone is FDA-approved to treat patients with opioid dependence. Jason Simcakoski was not, at the time of this prescription, dependent on opioids.

Dr. Davis was not authorized to prescribe Suboxone to patients.

At the time Suboxone was ordered, given the other drugs Jason was receiving, the dispensing pharmacist should have warned the prescribing physician that the Suboxone prescription, together with the other drugs Jason was prescribed, results in a series of Class D drug interactions, indicating the clinician should consider other therapy options…

The Monroe County Medical Examiner determined that Jason’s cause of death was mixed drug toxicity.

A subsequent Office of Inspector General report found that the additive respiratory depressant effects of Buprenorphine and its metabolite NorBuprenorphine, together with Diazepam and its metabolites as prescribed to Jason Sirncakoski were the plausible cause of his death.

The complaint also addresses medical procedures.

On August 30, 2014, a nursing staff member found Jason unresponsive. Cardiopulmonary resuscitation was not initiated by hospital staff for approximately 10 minutes. Emergency responders did not arrive until approximately 20 minutes after Jason was found unresponsive. Resuscitation efforts were unsuccessful and Jason was pronounced dead at 3:39 p.m.

Litigation alleging a lapse in the standard of care in a hospital setting will often require the testimony of a hospitalist expert witness. Hospitalists typically spend most or all of their work day in the hospital rather than outside the hospital in a medical office.  They are able to focus specifically on the care of hospitalized patients. Hospitalists are trained to provide prompt and complete attention to all patient care needs.  When medical negligence regarding the diagnosis, treatment or performance of medical procedures in a hospital setting is alleged, the hospitalist expert witness is able to evaluate the evidence and opine on whether the standard of care was breached.

Share This

❯ You Might Also Like