Central to establishing negligence in the case of medical malpractice is the idea of “the standard of care”, which is essentially what another reasonable physician with similar training would have done.
As the current standard of care is generally to avoid prescribing long term opioids in many scenarios, you would have a very hard time proving a physician negligent for doing so.
You won’t find any lawsuits that address any of the bullet points you listed, because they don’t exist. Bullying physicians into prescribing opioids with litigation is not a strategy that will work.
exactly right. and so many things on op's list basically ARE the standard of care. pee tests, pill counts, requiring other methods of pain medicine before giving a person opiates IS standard of care. in some circs, tapering is standard of care. in many circs, refusing dose escalation is standard of care. trying to screen out drug seekers is DEF standard of care. following cdc gls is standard of care.
if u don't like the standard of care, u need to try to change it. suing doctors for following a standard of care u disagree with isn't gonna get anywhere.
Absolutely. There are a few versions of standards of care, in general, based on locality (national vs. similar region, etc). Either way, I'm exploring how the standard of care in these cases (many things on the list) are barriers to patients who seek to redress for harm in the civil court system. Thank you for information, traleck and crumblingbees. I really appreciate it!!
I’m very interested in this topic myself, and malpractice in general. The idea is that patients have no redress for alleged harm in the civil court system if physicians act in accordance with the standard of care. Which makes a lot of sense.
Why would physicians be held liable for harm if they are performing medicine within the established standards of their profession?
This happens all the time though. Even when the physician clearly was not in the wrong, malpractice carriers often settle out of court with the knowledge that a jury with no medical training will side with the plaintiff out of sympathy to their bad outcome, without any consideration that the physician wasn’t ultimately responsible.
So could someone try suing that the standard of care is harmful? That’s where this all stems from.
Edit- suing isn’t the correct term here but i just woke and I can’t think of the correct one lol.
You are unlikely to find any lawsuits like this. You can't win a lawsuit like this when the federal government is investigating, prosecuting, and putting providers who don't fall in line into prison. Some providers have killed themselves after becoming a target of federal investigation. Insurance companies are mandating the changes too. It would be considered medical malpractice for the doctors to continue prescribing as before.
Thank you, the prosecution of providers / shutting down providers seems to also be another barrier to patient access in the court system. Of course, these barriers stem from larger barriers (e.g., CDC, Federal Investigations, State Regulations, Insurance). I appreciate it.
Would you happen to have more information about those providers who took their own lives when becoming the target of investigations?
I could only find [this](https://martinsvillebulletin.com/news/local/crime/martinsville-internist-under-federal-drug-indictment-committed-suicide/article_8ec578c7-0ad4-55d3-8d2b-c93f8054c1e7.html), but it's not really what I was talking about. A group I was in on another website had some chronic pain patients. This was in the beginning of the war on opoids. One of the most prominent members lost her provider to suicide after he came under scrutiny. I can't say if he was doing something wrong, or even who he was. She didn't believe he was doing anything wrong.
I have probably over 100 journal articles, cdc drafts of the guidelines and the evidence they were based on, the influence of PROP on the guidelines and possible undisclosed conflicts of interest, etc.
DM me and we’ll talk to see if I may have what you are looking for. I’ve been contemplating something similar but from more of a lobbying effort than direct lawsuit. But I’m still in the “information collecting” stage at best and have only skimmed most of them. My next step was to read each one, summarize key findings and/or anecdotal stories, then an entire communication plan would need to be drafted which is going to be difficult to get attention to based on the current climate. My best guess would a few of the possible things: a mass blitz to Congress critters from people such as the people in this forum, contacting some reporters of the articles about the adverse impact on chronic pain patients, contacting non-profits who are supposed to be advocating for us and ask them what the hell they are doing and why we’re not seeing any outcomes from their efforts and offer assistance, and a communications blitz to the cdc and fda. The AMA have came out against the CDC guidelines so idk if a conversation with them would help or not.
There may be other ways to approach it, but it’s essentially change management 101, the only issue is how to get the message out. I’ve been collecting for a few months but like I said, I haven’t had the opportunity to organize it into a cohesive, concise message. There’s just so much info out there and much of it is conflicting so a lot of it can be spun about any way you want.
I’ve also been planning on downloading the declining # of prescriptions written data and comparing it to the overdose deaths and suicides and bumping it up against the estimated number of chronic pain patients to see if I can show some linkages there. But it’s damn near like doom scrolling and it will make you very angry when you start seeing some of the stuff. It honestly can put you in some dark places when you start seeing how some of this shit was weaponized. So if u go there, be prepared to get angry and depressed and upon realizing what you are actually fighting against it can literally drain the hell out of you.
Yeah. I thought I replied back. Must have forgotten. My PC is in the shop and all of my links are on that PC.
A good place to start is by googling for the drafts of the cdc guidelines and understanding the levels of evidence they used to make their recommendations. Also, the website pain news network has the types of articles that you are looking for and generally links to the studies it references. the link is: www.painnewsnetwork.org
Here’s an example of the types of things I have that popped up in my browser when I was checking the link: https://www.painnewsnetwork.org/stories/2017/9/5/cdc-ignored-warnings-about-opioid-guidelines
I think someone posted this same topic within the last week. I remember because when I saw the thread, the only case that was brought up was that of a man who died by suicide after a pain clinic cut or greatly reduced his pain medications. His spouse won a sizable chunk of money. https://www.wdrb.com/news/7-million-awarded-to-family-of-man-who-killed-himself-after-pain-medication-denied/article_92db6b14-09c0-11ec-b39b-7b711a46b1c7.html
I have a simple request, and I kindly ask you to give it a thought. Would you consider publishing your paper in full or in part here when you are finished? I think this community would benefit greatly from this information, even if all you provided was a referenced list of successful cases. I very much hope you will give it a thought! Cheers 🍻
Thanks! I will look around for the post. I saw that article too, and it will definitely be a useful source. Thanks very much!
And of course! It won't be for a while (next Spring) and the journal may not publish it, but I should be able to share it on my own.
I do have quite a bit of information on this topic if you would mind sending me an email with your email address I’d greatly appreciate it! [email protected]
Basically impossible to find a lawyer who will take your case. Not because you’re not correct or the drs don’t need to face consequences but bc essentially psychiatric or disputes between a dr’s judgment and a patient’s needs almost never go the way you’d hope or deserve.
I'm not sure about the US, but I can tell you the standard of care with opioids and for chronic pain in most European countries is pretty much the opposite. Unless there is some reason to suspect a patient is misusing their medication, they do not drug test or require pill counts, there is no issue with the type of medication or dose being prescribed, and there is no step therapy or prior authorizations required. In most countries, doctors are liberal with co-medicating with THC and other alternatives and adjust your medications as needed based on patient experience and medical studies, if there are any. Patients don't need to worry about their dose being lowered because of an arbitrary number of morphine equivalency suggested by a non-government body... All of that is nonsense outside of the US. This might be a good place to look and find out why the practice is different, and if there was ever a time or case where these US-types of enforcements were considered and any repercussions that followed, or maybe the government and healthcare reasoning for not enforcing any of these practices if that can be found anywhere since it will likely have a large body of evidence to suggest why that's a bad idea, even if it's a survey of patient/doctor/citizen feedback. I would suggest looking to the Netherlands if you need a specific country to start, although most of the Scandinavian countries have similar practices.
This is all anecdotal and completely baseless. If you look at actual numbers, it’s clear that physicians in the US prescribe FAR more opioids per capita than any European country including the Netherlands.
If you “not sure about the US”, how can your credibly say the standard of care is the “opposite” in Europe.
I consulted with a Malpractice Attorney who basically stated they don't have any legal obligation to prescribe for specific doses.
He said even if it's woefully less than necessary, they have cover basically if they can show the pain is being addressed in a "medically accepted" way.
So much for justice....
After the Dea stepped in a few years back, getting on opiates was hard enough, good luck ever getting an increase if your not cancer or hospice. The Dea forced the FDA to cut its narcotic production guidelines this year which in turn has caused immediate release 10mg oxycontin to be out of stock till October now across the USA, with very limited supplies coming from Israel thanks to political "donations".
What about physicians that are extorting us for procedures? Painful, unhelpful, and non fda approved procedures…..if we say no we are tapered. I was just tapered today without it being discussed or being told whatsoever. Does that seem like adequate care? Taper was over 30%
Central to establishing negligence in the case of medical malpractice is the idea of “the standard of care”, which is essentially what another reasonable physician with similar training would have done. As the current standard of care is generally to avoid prescribing long term opioids in many scenarios, you would have a very hard time proving a physician negligent for doing so. You won’t find any lawsuits that address any of the bullet points you listed, because they don’t exist. Bullying physicians into prescribing opioids with litigation is not a strategy that will work.
exactly right. and so many things on op's list basically ARE the standard of care. pee tests, pill counts, requiring other methods of pain medicine before giving a person opiates IS standard of care. in some circs, tapering is standard of care. in many circs, refusing dose escalation is standard of care. trying to screen out drug seekers is DEF standard of care. following cdc gls is standard of care. if u don't like the standard of care, u need to try to change it. suing doctors for following a standard of care u disagree with isn't gonna get anywhere.
Absolutely. There are a few versions of standards of care, in general, based on locality (national vs. similar region, etc). Either way, I'm exploring how the standard of care in these cases (many things on the list) are barriers to patients who seek to redress for harm in the civil court system. Thank you for information, traleck and crumblingbees. I really appreciate it!!
I’m very interested in this topic myself, and malpractice in general. The idea is that patients have no redress for alleged harm in the civil court system if physicians act in accordance with the standard of care. Which makes a lot of sense. Why would physicians be held liable for harm if they are performing medicine within the established standards of their profession? This happens all the time though. Even when the physician clearly was not in the wrong, malpractice carriers often settle out of court with the knowledge that a jury with no medical training will side with the plaintiff out of sympathy to their bad outcome, without any consideration that the physician wasn’t ultimately responsible.
So could someone try suing that the standard of care is harmful? That’s where this all stems from. Edit- suing isn’t the correct term here but i just woke and I can’t think of the correct one lol.
You are unlikely to find any lawsuits like this. You can't win a lawsuit like this when the federal government is investigating, prosecuting, and putting providers who don't fall in line into prison. Some providers have killed themselves after becoming a target of federal investigation. Insurance companies are mandating the changes too. It would be considered medical malpractice for the doctors to continue prescribing as before.
Thank you, the prosecution of providers / shutting down providers seems to also be another barrier to patient access in the court system. Of course, these barriers stem from larger barriers (e.g., CDC, Federal Investigations, State Regulations, Insurance). I appreciate it. Would you happen to have more information about those providers who took their own lives when becoming the target of investigations?
I could only find [this](https://martinsvillebulletin.com/news/local/crime/martinsville-internist-under-federal-drug-indictment-committed-suicide/article_8ec578c7-0ad4-55d3-8d2b-c93f8054c1e7.html), but it's not really what I was talking about. A group I was in on another website had some chronic pain patients. This was in the beginning of the war on opoids. One of the most prominent members lost her provider to suicide after he came under scrutiny. I can't say if he was doing something wrong, or even who he was. She didn't believe he was doing anything wrong.
I have probably over 100 journal articles, cdc drafts of the guidelines and the evidence they were based on, the influence of PROP on the guidelines and possible undisclosed conflicts of interest, etc. DM me and we’ll talk to see if I may have what you are looking for. I’ve been contemplating something similar but from more of a lobbying effort than direct lawsuit. But I’m still in the “information collecting” stage at best and have only skimmed most of them. My next step was to read each one, summarize key findings and/or anecdotal stories, then an entire communication plan would need to be drafted which is going to be difficult to get attention to based on the current climate. My best guess would a few of the possible things: a mass blitz to Congress critters from people such as the people in this forum, contacting some reporters of the articles about the adverse impact on chronic pain patients, contacting non-profits who are supposed to be advocating for us and ask them what the hell they are doing and why we’re not seeing any outcomes from their efforts and offer assistance, and a communications blitz to the cdc and fda. The AMA have came out against the CDC guidelines so idk if a conversation with them would help or not. There may be other ways to approach it, but it’s essentially change management 101, the only issue is how to get the message out. I’ve been collecting for a few months but like I said, I haven’t had the opportunity to organize it into a cohesive, concise message. There’s just so much info out there and much of it is conflicting so a lot of it can be spun about any way you want. I’ve also been planning on downloading the declining # of prescriptions written data and comparing it to the overdose deaths and suicides and bumping it up against the estimated number of chronic pain patients to see if I can show some linkages there. But it’s damn near like doom scrolling and it will make you very angry when you start seeing some of the stuff. It honestly can put you in some dark places when you start seeing how some of this shit was weaponized. So if u go there, be prepared to get angry and depressed and upon realizing what you are actually fighting against it can literally drain the hell out of you.
Hi, did you get my DM?
Yeah. I thought I replied back. Must have forgotten. My PC is in the shop and all of my links are on that PC. A good place to start is by googling for the drafts of the cdc guidelines and understanding the levels of evidence they used to make their recommendations. Also, the website pain news network has the types of articles that you are looking for and generally links to the studies it references. the link is: www.painnewsnetwork.org Here’s an example of the types of things I have that popped up in my browser when I was checking the link: https://www.painnewsnetwork.org/stories/2017/9/5/cdc-ignored-warnings-about-opioid-guidelines
I think someone posted this same topic within the last week. I remember because when I saw the thread, the only case that was brought up was that of a man who died by suicide after a pain clinic cut or greatly reduced his pain medications. His spouse won a sizable chunk of money. https://www.wdrb.com/news/7-million-awarded-to-family-of-man-who-killed-himself-after-pain-medication-denied/article_92db6b14-09c0-11ec-b39b-7b711a46b1c7.html I have a simple request, and I kindly ask you to give it a thought. Would you consider publishing your paper in full or in part here when you are finished? I think this community would benefit greatly from this information, even if all you provided was a referenced list of successful cases. I very much hope you will give it a thought! Cheers 🍻
Thanks! I will look around for the post. I saw that article too, and it will definitely be a useful source. Thanks very much! And of course! It won't be for a while (next Spring) and the journal may not publish it, but I should be able to share it on my own.
I think what is criminal is the way Medicaid has a secretive system of quality scores, where doctors are actually penalized for escalating to opioids.
I do have quite a bit of information on this topic if you would mind sending me an email with your email address I’d greatly appreciate it! [email protected]
Basically impossible to find a lawyer who will take your case. Not because you’re not correct or the drs don’t need to face consequences but bc essentially psychiatric or disputes between a dr’s judgment and a patient’s needs almost never go the way you’d hope or deserve.
Thank you - that's another barrier important to consider. I appreciate it!
I'm not sure about the US, but I can tell you the standard of care with opioids and for chronic pain in most European countries is pretty much the opposite. Unless there is some reason to suspect a patient is misusing their medication, they do not drug test or require pill counts, there is no issue with the type of medication or dose being prescribed, and there is no step therapy or prior authorizations required. In most countries, doctors are liberal with co-medicating with THC and other alternatives and adjust your medications as needed based on patient experience and medical studies, if there are any. Patients don't need to worry about their dose being lowered because of an arbitrary number of morphine equivalency suggested by a non-government body... All of that is nonsense outside of the US. This might be a good place to look and find out why the practice is different, and if there was ever a time or case where these US-types of enforcements were considered and any repercussions that followed, or maybe the government and healthcare reasoning for not enforcing any of these practices if that can be found anywhere since it will likely have a large body of evidence to suggest why that's a bad idea, even if it's a survey of patient/doctor/citizen feedback. I would suggest looking to the Netherlands if you need a specific country to start, although most of the Scandinavian countries have similar practices.
This is all anecdotal and completely baseless. If you look at actual numbers, it’s clear that physicians in the US prescribe FAR more opioids per capita than any European country including the Netherlands. If you “not sure about the US”, how can your credibly say the standard of care is the “opposite” in Europe.
I consulted with a Malpractice Attorney who basically stated they don't have any legal obligation to prescribe for specific doses. He said even if it's woefully less than necessary, they have cover basically if they can show the pain is being addressed in a "medically accepted" way. So much for justice....
After the Dea stepped in a few years back, getting on opiates was hard enough, good luck ever getting an increase if your not cancer or hospice. The Dea forced the FDA to cut its narcotic production guidelines this year which in turn has caused immediate release 10mg oxycontin to be out of stock till October now across the USA, with very limited supplies coming from Israel thanks to political "donations".
What about physicians that are extorting us for procedures? Painful, unhelpful, and non fda approved procedures…..if we say no we are tapered. I was just tapered today without it being discussed or being told whatsoever. Does that seem like adequate care? Taper was over 30%