--

Hi,

This reporter has been covering the case of a women who was sent
to hospice on the "diagnosis" of cancer, and when an autopsy was later
done, it was found she had no cancer. She died of an overdose of
Dilaudid, an opioid medication which acts somewhat like morphine. I
spoke with the reporter last week and provided him with background
information on hospice, opioids and what is going on in our nation.

Intentionally misdiagnosing a patient with a bogus label such as
"cancer" is a common ploy used in order to get a patient into hospice,
and then killed. What happened in this case is not known. why the
patient was wrongly labeled as having cancer is the real question. And
we have jad many complaints over the years of patients who did NOT have
cancer who were labeled as having cancer, sent to hospice, who died
shortly after entering hospice, and then autopsies showed no cancer.

Obviously, in any case, the hospice does not diagnose patients and must
rely on the diagnosis from the experts.

Pain which is not well-managed with an opioid may respond to other
medications, such as anti-spasmodic medications (if pain is due to
severe intestinal cramping/spasms. I have seen cases where morphine did
nothing for pain, and nurses were just raising the dose up and up. I
called the doctor for an order of an antispasmodic and once
administered, the pain subsided within 20 minutes! No morphine was
needed at all.

Good clinical judgment is necessary to provide appropriate care.
Opioids are not always the best for all types of pain and every good
hospice nurse knows that. Simply increasing dosages of the wrong
medication obviously does no good, and can cause death.

Why the patient was given a diagnosis of cancer when there was no
evidence to support that is the real issue. But the case is ongoing.
We will have to watch this to see what happens.

See article below.

Best wishes!

If people contemplate and really see the sanctity of life, their
"quality of life" arguments fall away and they will understand that we
are here to care for each other, not to kill each other. Caring, and not
convenience, is the sign of a civilized and just society!


Ron Panzer
for Hospice Patients Alliance
http://www.hospicepatients.org

"What I do you cannot do
but what you do, I cannot do.
The needs are great, and none of us,
including me, ever do great things.
But we can all do small things, with great love,
and together we can do something wonderful." - Mother Teresa

*************************************************

The Hospice Patients Alliance is a 501(c)(3) charitable patient advocacy
organization acting to preserve the original hospice mission and to
promote quality end-of-life services.

The information provided by Hospice Patients Alliance is provided in the
spirit of consumer advocacy in the belief that informed consumers of
health care are best able to access quality care. Hospice Patients
Alliance does not provide legal or medical advice. If you are seeking
legal or medical advice, then a competent and experienced attorney or
physician should be consulted.

*************************************************



"Miss. Supreme Court to hear hospice overdose case"

By HOLBROOK MOHR Associated Press Writer May. 11, 2008
http://www.sunherald.com/306/story/551730-p2.html


JACKSON, Miss. -- After 66-year-old Ersel Allen was diagnosed with
pancreatic cancer and admitted to a hospice, she was dead within weeks.

The problem is, according to autopsy results and attorneys for her
family, Allen never had cancer. She died of an overdose.

Allen's family won a $4.5 million award in 2006 after suing Dr. William
Causey and Hospice Ministries in Ridgeland. The hospice settled. Causey,
who is in prison for child molestation, is appealing the verdict.

"This woman was not terminally ill. She was put to sleep," said
Philadelphia attorney Dan Mars, who is representing Allen's family.

Ray McNamara, Causey's attorney, acknowledges that Allen did not have
cancer, but said she suffered from other ailments.

The Mississippi Supreme Court was scheduled to hear the case Tuesday,
but that was postponed when a faulty sprinkler system flooded the court
building.

A former district attorney investigated Allen's death, but apparently
abandoned the investigation when Causey was charged in Louisiana with
molesting a 13-year-old boy.

"They didn't do anything because (the doctor) would never get out of
prison, anyway," said Allen's daughter, Reitha Sanders.

Causey was convicted in 2005 and sentenced to 25 years for molesting the
boy.

Hospice experts agree that Allen's case is different.

"Certainly a case like this garners sensational headlines, but it's not
the norm," said Todd Sitzman, past president of the American Academy of
Pain Medicine and the director of advanced pain therapy at Forrest
General Cancer Center in Hattiesburg.

"Unfortunately a case like this makes palliative care suspect," he said.

Accusations that hospices or their employees have given overdoses to
patients date back years. Most of the allegations were determined to be
unfounded.

Two employees of Sanctuary Hospice House in Tupelo were indicted last
month on misdemeanor charges related to neglect and practicing medicine
without a license. The relatives of several people claim their loved
ones were given lethal does of morphine. Dr. Paul White, the hospice
medical director, and clinical director Margaret Lehman, say they are
innocent and will be vindicated along with the facility.

In 1998, a panel of doctors found there was no evidence to support
claims by a medical examiner in Volusia County, Fla., that at least five
patients from two hospices were killed with lethal doses of morphine. A
grand jury in Oregon declined to indict a nurse accused of giving lethal
doses of morphine to four patients at a nursing home who died from
1987-1998.

In Allen's case, autopsy results say she died of an overdose of Dilaudid
after being admitted to the Ridgeland hospice in 2001. The story began
months earlier when Allen was diagnosed with gallstones and sent to the
University of Mississippi Medical Center in Jackson for treatment.

UMC physicians allegedly diagnosed Allen with terminal pancreatic cancer.

"They verified she had some kind of tumor but they never were able to
confirm it microscopically," McNamara said. "They considered exploratory
surgery but because of the weakened condition due to emphysema and
cardiac problems, they discussed it with the family, and a decision was
made not to operate."

UMC officials declined to comment on Allen's case.

That Allen never had cancer was discovered when her life insurance
company asked for an autopsy before paying benefits, Mars said. Allen's
family sued Causey, the hospice and the hospital.

"UMC was a party to the case and settled for a very nominal amount,"
said McNamara, adding that the hospice settled, too, but only because
its insurance company "paid to get the hospice out."

Mars said the case has far-reaching implications, because, he claims,
hospice physicians routinely overmedicate patients, sometimes with dire
consequences. He points to Causey's own defense to bolster the claim.

"While there are recommended dosages for the use of Dilaudid, morphine
and other opiates in an acute-care settings such as a hospital, there is
no upper limit on an amount that a person can take in the hospice
pain-care situation," according to testimony included in court documents
from Causey's expert witness.

Other hospice specialists agree that there are no maximum limits to the
amount of opiates that can be given to comfort the dying, but they say
hospices aren't in the business of accelerating anyone's death.

Dying patients build tolerances and need larger doses over time, hospice
specialists say.

"As long as the dose is calibrated against their pain severity, even at
very large doses patients can remain awake and alert," said Dr. David
Casarett, a professor with the University of Pennsylvania and a former
board member for the National Hospice and Palliative Care Organization.

"So please don't get the idea that those patients who receive very large
doses are choosing something like euthanasia."

That sentiment is lost on Allen's daughter.

"I lost a very important part of my life," Sanders said. "It's hard
everyday when you wake up knowing that she would be here if it wasn't
for that doctor."

Causey's attorney says the doctor should not have been held liable
because he worked for the hospice and it wasn't the facility's role to
re-diagnose Allen's condition.

"She'd been treated by a dozen specialists at UMC and they believed in
good faith she was terminal," McNamara said. "She had a number of
conditions that would have brought about her death."


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