Stephanie Musich’s doctor should have heeded her fears that narcotic painkillers were ruining her life, the western Iowa woman’s survivors say.
Musich shared her concerns in a 2008 letter to Dr. Timothy Brelje, her family practitioner in Harlan. “I believe I either am or soon will be addicted to pain killers,” she wrote. “… It seems I have to ask for more & higher scripts, and I can’t spend the rest of my life on pills, pain or not. … Would you be willing to work with me on (this) and also help me to adjust to lower doses?”
Musich died last April of a drug overdose at her home in Earling. She was 36 and left behind four children, ages 8 through 15. Her family filed a lawsuit this month accusing her doctor of prescribing dangerous amounts of narcotics despite clear signs that she was struggling to limit her use of them.
“She was smart. She knew she had a problem,” Musich’s mother, Jean Green, said in an interview. “Apparently, she was reaching out for help, and she didn’t get it.”
The lawsuit, filed in Pottawattamie County District Court, comes amid growing concern nationally over abuse of narcotic painkillers, which can lead to addiction and death.
It’s also the latest in a string of legal troubles involving Iowa health care professionals and addictive narcotics.
A Des Moines pain medicine physician was charged recently with eight counts of involuntary manslaughter and could lose his medical license for allegedly prescribing large amounts of narcotics to patients who died of overdoses. A Newton doctor surrendered his license and faces a lawsuit over similar accusations. And a Des Moines pharmacist had his license suspended after more than 700,000 doses of narcotics allegedly disappeared from his small drug store.
The new lawsuit says Musich suffered from chronic low back pain, for which she had undergone two surgeries that failed to fix the problem. In her 2008 letter to Brelje, the lawsuit says, she admitted that she had sometimes taken an extra pill or dose of the medicine he’d prescribed. The letter also said she had consulted addiction recovery counselors, who suggested she talk to him.
The suit says the doctor placed her letter in her medical file, then noted he had found out “that there was a possibility that she changed a prescription at a pharmacy. Due to this, am more concerned that she may not be taking medicine appropriately due to miscommunication, according to her.”
The lawsuit also quotes a 2009 note that Musich’s neurosurgeon wrote to Brelje, asking him not to order any more narcotics for her because the surgeon was taking over her pain control. But Brelje continued to prescribe heavy doses of addictive painkillers to her, the lawsuit says.
Green, who lives in Des Moines, said her daughter was an energetic mom and community volunteer despite years of severe back pain. She taught Sunday school, served as a Girl Scout leader and worked as a counselor at a facility for people with mental disabilities. She also was a volunteer firefighter and was taking classes to be certified as an emergency medical technician so she could serve on the local ambulance service.
“She always had a goal,” Green said.
Green recalled how Musich stepped in to coach the soccer team of her daughter Majesta, who was 5. “She didn’t know a thing about soccer, but she learned real quick, and her team kicked butt,” Green said with a bittersweet laugh.
Brelje, 48, declined to comment. His lawyer and leaders of Myrtue Medical Center in Harlan, which is named as a co-defendant in the lawsuit because it owns the clinic where Brelje practices, did not respond to requests for comment.
The lawsuit says the doctor prescribed numerous drugs to Musich, including oxycodone pain pills and skin patches filled with the narcotic fentanyl. The suit says she also had been prescribed sleeping pills and muscle relaxants. She died on April 27, 2012, of “acute mixed drug intoxication,” the lawsuit says.
The suit says the doctor failed to properly assess his patient’s need for the drugs, and “knew or should have known of the propensity of Musich to misuse such medications.” It also says he should have referred her to a pain-management specialist.
Green, speaking at the office of her lawyer, Tom Slater, said she wants other people to consider the dangers of prescribing or taking too many painkillers.
“I hope this will help to prevent anybody else from going through this,” she said of the lawsuit.
Brelje has never been publicly sanctioned by the Iowa Board of Medicine. The medical licensing board does not disclose whether it is investigating complaints against physicians unless it decides to file formal administrative charges.
The Musich family lawsuit names Wal-Mart Stores Inc. as a third defendant. The suit says two Council Bluffs pharmacies owned by the retailing giant failed to follow state and federal regulations when filling multiple prescriptions for painkillers and muscle relaxants for Musich.
Wal-Mart spokesman Dan Fogelman said last week that company officials had not yet seen the lawsuit. Fogelman, who works at the company’s headquarters in Arkansas, expressed condolences to Musich’s family. He said Wal-Mart pharmacies dispense medications according to doctors’ orders but watch for possible dangers from drug interactions.
“We’re always working to ensure the safety and well-being of our customers,” he said, adding that the company would review what happened in the case.
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