Relatives of a Billings man who was prescribed a lethal mix of narcotic painkillers following a 2011 surgery at West Park Hospital have filed a lawsuit claiming negligence by the operating surgeon, hospital and other staff.
The estate of Russell Monaco, represented by his wife and brother, filed the federal lawsuit July 22 in Cheyenne after a medical review panel said the estate could proceed with legal action. Paperwork filed with the review panel calculates damages at more than $14 million.
The lawsuit accuses former WPH neurosurgeon Dr. John Schneider of negligently contributing to the death of Monaco in late 2011 by treating Monaco’s post-surgery pain with an opiate patch and other drugs despite warnings against giving such medication to someone with little opiate history.
“The Monaco case is just an unbelievable tragedy, and should not have occurred under any circumstances,” attorney Jon M. Moyers of Billings told the Associated Press.
Monaco was admitted to a Billings emergency room Nov. 20, 2011, complaining of severe back pain. He arrived in Cody eight days later for a consultation with Schneider.
At that time, Schneider apparently advised the 47-year-old Monaco that he was in need of spinal surgery and would be admitted to WPH for an emergency procedure.
Still recovering in the hospital on Nov. 30, Monaco was prescribed a Fentanyl transdermal patch for pain control.
The lawsuit states this was done “in contravention to an FDA black-box warning” describing the “life-threatening adverse affects” (including respiratory depression) of the medication for anyone who has not demonstrated an opioid tolerance.
Schneider “knew or should have known” of this danger, Moyers alleges.
Within 24 hours of the Fentanyl application, Monaco began experiencing symptoms of overdose with a documented “low oxygen saturation event” or hypoxia. On the morning of Dec. 1, his recorded oxygen saturation fell to 75 percent, court records state.
While hospital staff made Schneider aware of the incident, the surgeon apparently decided to discharge Monaco that same day as scheduled, court records state. Monaco received an injection of pain and anti-nausea medication before leaving.
He then returned to his Billings home with five additional Fentanyl patches as well as prescriptions for hydromorphone, oxycodone and Valium. That evening, he took the medication as prescribed and fell asleep.
His wife and two children awoke Dec. 2, 2011, to find Monaco unresponsive.
A Yellowstone County coroner said based on an autopsy and pathology report, Monaco died from a “mixed drug overdose (including oxycodone, Fentanyl and other drugs).”
“The discharge of Monaco in his medical condition on these medications without any oxygen monitoring or supplemental oxygen placed him at high risk of respiratory event, which event in fact caused his premature death,” Moyers wrote in the lawsuit complaint.
Following Monaco’s death, Schneider allegedly engaged in fraudulent transfers of his assets to avoid payment to creditors and injured patients, court records state.
“Unless relief sought in this court is granted, Schneider will have succeeded in fraudulently transferring his assets to the substantial detriment of plaintiffs,” Moyers stated.
The estate claims Schneider’s company Northern Rockies Neuro-Spine and former physician assistant Harley Morrell, as well as WPH management company Quorum Health Resources of Delaware, WPH District and other unknown people also are complicit in the negligent care of Monaco prior to his death.
These parties were jointly responsible for ensuring the quality of care provided to Monaco and additionally “knew or should have known” of the danger associated with Schneider’s alleged treatment plan, court records state.
Following Monaco’s death, the Wyoming Board of Medicine temporarily suspended Schneider’s medical license. It was reinstated in March 2012, with a restriction on prescribing Fentanyl patches and condition that he attend a “controlled substance prescribing course.”
The lawsuit states Schneider is believed to be living in either Wyoming or California at this time.
Schneider reached a confidential settlement in a separate lawsuit last May. Dr. Jimmie Biles of Cody, an orthopedic surgeon, accused him of being behind the mass mailing of a defamatory flyer.
WPH spokesman Joel Hunt declined to comment on the lawsuit. Calls to the hospital’s attorney and Schneider’s attorney were not returned by press time.
(The Associated Press contributed to this story. Heidi Hansen can be reached at email@example.com.)