Yes, there are bad docs too. 80mg of Oxycontin twice a day for a sore throat can’t really be called standard of care:

The doctor treated Michael Osgood during Christmas break from Iowa State University, which the teen attended on an academic scholarship. By Jan. 6, 2003, he couldn’t swallow and had a fever and other signs of flu, records show. Slavin has testified that Osgood was crying from throat pain but rejected a number of painkillers, saying he couldn’t swallow.

Slavin prescribed 80 milligrams of OxyContin every 12 hours. “Because of the severity of pain he was having, I felt that that was [the] dose that he was going to need,” Slavin testified in a January 2004 deposition. He said he had the patient’s mother fill the prescription and bring it to the office, where he watched as the teen took the first dose.

Two days later, after Alicia Osgood couldn’t rouse her son, he was airlifted in a coma to Georgetown University Hospital. He died Jan. 12, 2003, from accidental “oxycodone intoxication” after the third dose, according to the District of Columbia medical examiner’s office.

Seventeen of the 20 pills remained, records show.

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  • Anonymous

    Yes, there are bad docs.

    Standard Oxycontin dosage is 10 to 160 mg. BID. So this patient was only given a middle range dose.

    However, standard reccommendations from the manufacturer is to start at 10 mg. BID and reserve 80 mg. tabs for opiate dependant users only.

    My bet is this practitioner cursorily looked up the Oxycontin dosage range, and because this patient probably was a otherwise healthy 17 year old, merely chose the middle of the range for his prescribed dosage.

    Maybe this practitioner is most careful, and spends adequate, unhurried, time with all his patients. Or maybe he’s the average doc, spending 6-8 minutes per patient as a consequence of reduced third party payments and rising overhead. Bad mistake.

  • Anonymous

    I could have made the same mistake. I never prescribe Oxycontin, perhaps the parent requested this medicine. I probably have made a similar mistake. Any doc who doesn’t hear about a story like this and think “this could have been me” is lying.

  • Anonymous

    Ok… I’ll just say it: This could not have happened to me; and for so many reasons:

    1-You do not treat a soar throat with MOTHERFUCKING OXYCONTIN.
    2-You don’t use a drug like oxycontin as a 1st line for sudden, acute onset pain.
    3-If for some reason you did decide to treat a soar throat with oxycontin, you don’t start off with that strong a dose.
    4-You don’t give 20 pills of an extremely powerful pain medication to someone who’s soar throat should only reasonably last a few days.
    a) because, if after a few days, the pain is con’t, you should start thinking of more things than a PND.
    b) giving 20pills to a teenager is asking his to either get high, or sell them.

  • Anonymous

    Ok… I’ll just say it: This could not have happened to me; and for so many reasons:

    1-You do not treat a soar throat with f—ing OXYCONTIN.
    2-You don’t use a drug like oxycontin as a 1st line for sudden, acute onset pain.
    3-If for some reason you did decide to treat a soar throat with oxycontin, you don’t start off with that strong a dose.
    4-You don’t give 20 pills of an extremely powerful pain medication to someone who’s soar throat should only reasonably last a few days.
    a) because, if after a few days, the pain is con’t, you should start thinking of more things than a PND.
    b) giving 20pills to a teenager is asking his to either get high, or sell them.

  • Anonymous

    anon 3:59, I hear what you’re saying, and we all make mistakes, but other than if the parent requested this particular drug, I have to wonder why it was prescribed? Even if you had to give a narcotic for sore throat, why not an old standby like tylenol 3, vicodin, or vicodin es?

  • Anonymous

    I guess this guy never heard of viscous lidocaine…

    hey, anyone here ever use “magic mouthwash” 1:1:1 lidocaine/benadryl/maalox?

  • Anonymous

    there will probably be an article about me on this blog next week when I give some fool medrol dose pak for sore throat and he gets avascular necrosis of the hip…

  • Anonymous

    Look up Lemierre’s Syndrome…another rare disease entity that one in a million teenagers get who present with a sore throat, new moneymaker for the lawyers. I always think Lemierre’s and acute Leukemia when I see pharyngitis (Yes, mono too). Some poor schmuck locally lost a $4 million dollar suit when he missed acute leukemia in a teenager with a sore throat….I’ll often get a CBC on these kids.

  • Anonymous

    thanks for the info…that lemierre’s is something I’ll lookout for…I don’t see kids thank God…

  • Anonymous

    In case anyone’s interested, Lemierre’s Syndrome is thrombosis of the internal jugular vein usually following an oropharyngeal infection. Medscape has good reviews. 186 known cases. Sounds like a cousin of septic pelvic thrombophlebitis, familiar to Ob’s.

  • Anonymous

    I have been an ER doc for 12 years. I have never prescribed oxycontin as a new prescription, only to temporarilly renew it for someone with intractable cancer pain or something of the sort. For a kid with a really bad sore throat some motrin and maybe 6 vicodins would do.

  • Anonymous

    I’m a “mid-level” practitioner and I would usually give someone like this a liquid either the Tylenol c codeine or the Roxicet. I have also used the viscous Lido. Somewhat depends on what had already been tried at home. I wouldn’t start with a long-acting formulation like this. But as others have said we don’t know all the circumstances.

  • Anonymous

    I’m a “mid-level” practitioner and I would usually give someone like this a liquid either the Tylenol c codeine or the Roxicet if they needed a narcotic. I have also used the viscous Lido. Somewhat depends on what had already been tried at home. I wouldn’t start with a long-acting formulation like this. But as others have said we don’t know all the circumstances. What other work-up I perform (CBC, heterophile would depend on persistence of symptoms.) Don’t forget HIV as possibility.

  • Dr. Jones

    I am Dr. Jones, I read this article and I would like to know if Alicia Osgood is one of my old patients from San francisco (Tanforan). She is from Venezula and had a son named Michael who was very smart as a 4 year old. This is very important to me. I would never give a patient that dosage or treat a patient with oxycotin for a sore throat.

  • Anonymous

    I am a patient of cronic pain management, and I have taken many types of pain pills, trying to get my pain under control. It wasnt until my doctor started me on oxycontin before i finally got some relief. I can now do things that I wouldnt be able to do unless I had this to take. I dont think that its something that should be used for short term situations that require pain pills, for many reasons 1st being that its something that in the wrong hands can be abused by selling or just using to get high 2nd its very addicting and once you start taking it if you are on it very long amount of time you cant just stop without going through some serious withdraws. Ifound that out the hard way, because no one told me that it was habitforming, and I went out of town for a week and ran out on vacation. I ended up in the hospital and was told i was a drug attic and the only thing differnt about me and someone off the street was that my doctor had made me that way. That i basically was a legal druggie. When a doctor puts you on this medicene he should tell you that your body will become dependit on the oxys and that you cant just stop if you decide you want to. My message to everyone is this its a great medicene to take for longterm usage. Just dont use it unless you really need it. Dont overtake it or tell peope that your on it because if the wrong person gets ahold of it they will still from you or take it for thereselves. Ask your doctor about all the risks and effects it will have on you. Its a very hard drug to come off when its time.

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