Opinion ID: 613517
Heading Depth: 2
Heading Rank: 5

Heading: Death of Patient Terri Morris

Text: Webb first saw Trebble Terri Morris (Terri) in 2000. Webb had already been treating her husband, Kevin Morris (Kevin), since August 1999. Kevin abused the drugs Webb prescribed for him. One of Terri's previous doctors testified that he had dismissed her from his practice in the mid-1990s because he was uncomfortable having her as a patient. The reasons for his discomfort included Terri's seeking drugs from emergency rooms, refusing drug rehabilitation and other forms of help, and inappropriately using narcotics. At her first office visit with Webb, Terri reported no medical problems, except for migraines and bipolar or manic depressive disorder ... and she reported to be on no medicines. In addition to other medicines, Webb prescribed five tablets of Oxy-Contin 20 mg. Pharmacy expert Paul Doering testified that OxyContin is a terrible choice for treating migraine headaches because OxyContin's controlled release does not do a good job combating the acute pain caused by migraines. Dr. Parran opined that prescribing opiates to treat headaches is discouraged because opiates may cause another headache. Terri and Kevin both frequently requested early refills. On one occasion, to justify his early refill, Kevin told Webb that Terri was stealing his medicines. After the stealing incident, Webb advised Terri and Kevin not to use each other's medicines, but continued prescribing them narcotics without mentioning the issue again. Both Morrises abused the Duragesic (fentanyl) patch that Webb prescribed Kevin by poking holes in the patch and squeezing the substance into their mouths to get high. Webb knew that Terri had hepatitis C, which most commonly results from IV drug abuse, but did not ask Terri how she had contracted the disease. Despite these signs of drug abuse, Webb continued to prescribe controlled substances to Terri up until her death on September 9, 2003. Terri and Kevin staggered their visits to Webb to ensure that they would have a steady supply of narcotics. On September 5, 2003, Webb prescribed 30 alprazolam (Xanax), 75 Soma tablets, and 50 Darvocet tablets to Terri. On September 9, Webb prescribed, inter alia, 15 Duragesic patches to Kevin. When Kevin found Terri's dead body, she had one of the Duragesic patches on her body, and he found several more in the trash with pinpricks in them. Stephen Spinella, a detective with the Fort Walton Beach Police Department, contacted Webb after seeing Webb's name on the pill bottles in Terri's room. Webb told Detective Spinella that he had no indication that Terri was sharing medications with her husband, that he had no indication that she was suicidal, and that as far as Webb knew, Terri took the medications as prescribed. The toxicology report done after Terri's death revealed significant levels of fentanyl and alprazolam in her blood. The toxicologist testified that the level of fentanyl in Terri's blood indicated misuse of the Duragesic patch, was consistent with ingesting or injecting the patch's contents, and that putting such a high level of fentanyl into the body would be immediately fatal. Terri's blood contained varying amounts of other drugs, and the cause of her death was complications of polypharmacy, or multiple drug intoxication. Based on his review of the two Morrises' medical files, Dr. Parran opined that Webb's prescribing appears to have been done inconsistent with the usual course of medical practice and appears to have been for other than legitimate medical purpose. Importantly, the prescribing played a contributory role in [Terri Morris's] death. Dr. Parran further noted that Terri's history and behavior require[d] intervention and  and a changing of prescribing at that moment. However, Webb's prescribing was absolutely unchanged after the husband reported [Terri's stealing his medications], up until the time of [Terri's] death.