Abstract
The objectives of this forensic medicolegal case report were the following: 1) present details of a patient on chronic opioid analgesic therapy (COAT) where a disastrous outcome resulted in allegations of malpractice; 2) detail the plaintiff's and defendant's medical experts' opinions on this allegation; and 3) discuss issues potentially related to these allegations, i.e., split treatment and the P450 enzyme system. METHODS CASE REPORT RESULTS: Medicolegal issues surrounding these malpractice allegations are discussed. Split treatment can increase the difficulties in performing COAT. Clinicians should routinely consider the effects of all utilized drugs on the ability of the P450 enzyme system to metabolize/clear opioids.
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