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Doctor, Pharmacy Named in Opioid Suit

Thu, 03/10/2022 - 10:51
Peter D. Bistrian alleges in a lawsuit that his doctor knew that "there was a strong potential for a dangerous adverse reaction" when he prescribed osycodone to him while he was also taking a muscle relaxer and a medication to treat a prior opioid addiction.

A man who says he’s still recovering from a years-long struggle with opioid addiction is suing an East Hampton doctor and a local pharmacy, alleging that they were negligent in his care by overprescribing and overfilling highly addictive drugs.

Peter D. Bistrian of Southampton has filed suit in New York State Supreme Court against Dr. Ralph M. Gibson and White’s Pharmacy, claiming that they disregarded “the known adverse reactions and dangerous health risks associated with” oxycodone, an opiate, and Carisoprodol, a muscle relaxer, which he says were both prescribed and filled in “abnormally large doses.”

According to court documents, on or about Jan. 16, 2016, Mr. Bistrian was rushed to the emergency room of Southampton Hospital after suffering an adverse reaction from the oxycodone and Carisoprodol with Suboxone, which he had been taking for about a year to treat a prior opioid addiction. The medications were used to treat pain from injuries that Mr. Bistrian, 64, who previously lived in East Hampton, has said he sustained when he was assaulted at the Federal Detention Center in Philadelphia in 2006, where he was serving 51 months on a wire fraud charge.

Suboxone had been prescribed by a different physician, who is not named in the suit. Mr. Bistrian alleges that Dr. Gibson knew “there was strong potential for a dangerous adverse reaction — but nevertheless instructed plaintiff to take both drugs along with Suboxone. Despite the life-threatening adverse reaction plaintiff sustained as a result of his ill-advised prescriptions, Dr. Gibson continued to prescribe plaintiff escalating doses of oxycodone.”

Seeking treatment for chronic pain, Mr. Bistrian had been a patient of Dr. Gibson since August 2015. At various times since then, he claims in court papers, Dr. Gibson prescribed hydromorphone, another opioid, and several drugs in a class known as benzodiazepines, which are also known to have addictive effects. American Addiction Centers, a nationwide network of addiction recovery facilities, says that taking benzodiazepines with Suboxone “is extremely dangerous . . . and can cause impairment, unconsciousness, respiratory failure, coma, or even death if taken together.”

Mr. Bistrian’s medical malpractice suit alleges that Dr. Gibson did not explore pain management options outside of opioids, and that he also mistreated another chronic condition, osteomyelitis, a type of bone inflammation caused by infection, by giving him twice-weekly injections of a corticosteroid called Kenalog that he says exacerbated his issues. Then in 2018, according to the lawsuit, Dr. Gibson abruptly discharged him as a patient.

That was when heavy withdrawal symptoms set in, Mr. Bistrian said in an interview. “He filled a prescription for 30 days and said, ‘See you later,’ “ said Mr. Bistrian, who then had difficulty finding a new physician. “I spiraled right down.”

Leading up to that point, he said, as his addiction issues drove away his family members, wife, and friends, he realized something was amiss, he said. Other signs were there, too — his skin was as papery-thin as tissue, he’d bruise too easily, and he was in a dense mental fog.

“You think you’re yourself, but you’re not,” Mr. Bistrian said. “Initially, I didn’t think much of it, but it got to the point where I added up how many pills a month I was taking, and it scared the hell out of me.”

Among the court documents is an official medical evaluation by Dr. Matthew Lee, a physician, pharmacist, pharmacologist, and toxicologist who practices in Virginia.

“When opioids are started, clinicians should prescribe the lowest effective dosage. Clinicians should use caution when prescribing opioids at any dosage,” Dr. Lee wrote, noting that Dr. Gibson’s own records indicated that Mr. Bistrian was taking 924 morphine-milligram equivalents per day. That was “10 times the recommended upper limit to avoid,” Dr. Lee wrote.

He said there was no evidence that anyone at Dr. Gibson’s office regularly documented Mr. Bistrian’s vital signs, other than to take his temperature. Dr. Lee also wrote that the prescription of both opioids and benzodiazepines together “makes no clinical sense.”

“Dr. Gibson essentially took a patient with known opioid use disorder, who was on the appropriate treatment for patients with such condition, Suboxone, and re-addicted him, and supported his addiction for more than two years before abandoning him,” Dr. Lee wrote.

Neither Dr. Gibson nor White’s responded to multiple requests for comment sought via phone, email, and fax over the past two weeks. However, Mr. Bistrian said, they have denied the charges in correspondence with his attorney, Daniel A. Schnapp of Nixon and Peabody L.L.P., a high-profile firm that has represented Hunter Biden, and which recently hired former Suffolk County District Attorney Tim Sini following his failed re-election bid in November.

Mr. Bistrian said he has also been working with New York State officials on a larger investigation into the over-prescribing of opioids. Outside of attorneys’ fees, his suit does not specify damages sought, but he said that “it’s not about money.” He decided to sue, he said, to make people aware that opioids are still a dangerous epidemic that claims many, many lives each year.

“It will help the families to see the signs of it,” he said. “The broader picture is the opiate problem for the kids in the town and elsewhere. If somebody doesn’t put a face to something or do something about it, it will slide, and it will continue.”

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