The plaintiffs brought a medical negligence action alleging that a hospitalist physician negligently prescribed excessive doses of hydromorphone (Dilaudid) to a patient who had previously received morphine and was allegedly opioid‑naive.
The patient died several hours after receiving multiple doses of Dilaudid, and the coroner’s report listed the cause of death as acute mixed hydromorphone and morphine intoxication.
The court heard competing expert evidence regarding opioid equivalency ratios, titration practices, and whether the physician’s 5 mg dosing fell below the standard of care for a hospitalist managing severe uncontrolled pain.
The court preferred the defence experts’ evidence that the dosing decision was a reasonable clinical judgment given the patient’s persistent severe pain and lack of response to morphine, and that reliance on experienced nurses for monitoring was appropriate.
The court also found the clinical course inconsistent with opioid toxicity and concluded the plaintiffs had not proven causation on a balance of probabilities.
The negligence claim was dismissed.
