This fentanyl lawsuit alleges that Charles Addison died of acute fentanyl intoxication while wearing a Duragesic fentanyl patch.  Judging by the date of his death, it’s possible he was wearing one of the Duragesic fentanyl patches that was included in the recall notice sent out in 2008.

INTRODUCTION

Plaintiff Lucille Lilly, individually and in her capacity as the duly appointed Administratrix of the Estate of Charles Edward Addison (“Charles Edward Addison”) hereby brings suit against the above named defendants, Johnson & Johnson, Janssen Pharmaceutica Products, L.P., and ALZA Corporation and alleges as follows:

PARTIES

1. Plaintiff Lucille Lilly (“Ms. Lilly”) is an individual residing in Baltimore, Maryland. She is the mother of the late CHARLES EDWARD ADDISON and Administratrix of the Estate of CHARLES EDWARD ADDISON. Hereinafter, the Estate and Ms. Lilly (individually and in her capacities as the Administratrix of the Estate are collectively referred to as “Plaintiffs.”

2. Pursuant to an Order by the New York State Surrogate's Court for the County of Erie dated February 5, 2009, plaintiff Lucille Lilly was awarded Letters of Limited Administration for the Estate of Charles Edward Addison for the purpose of commencing this lawsuit. A copy of said Letters of Limited Administration is annexed hereto and incorporated herein by reference as Exhibit A.

3. Decedent CHARLES EDWARD ADDISON expired on or about February 27, 2008 as a result of “Acute Fentanyl Intoxication” while utilizing a defective Duragesic (fentanyl) patch.

4. Defendant Johnson & Johnson (“J&J”) is a New Jersey corporation with a substantial presence worldwide in the Consumer, Pharmaceutical, and Medical Device and Diagnostics markets. J&J is based in New Brunswick, New Jersey, at Johnson & Johnson Plaza, and first began to operate in New Jersey in 1886. J&J has a substantial and ongoing presence in the State of New York such that it is subject to general jurisdiction of courts within the State of New York. J&J is the sole shareholder of defendant ALZA Corporation and the sole shareholder of the general partner of defendant Janssen, L.P., a New Jersey limited partnership.

5. In its 2004 Annual Report to its shareholders, J&J reported revenues from sales of the product at issue in this action, its Duragesic patch, in fiscal 2004 of $2.083 billon, up 27.7% from $1.631 billion in 2003, which itself was up 35.6% from its 2002 sales of $1.203 billion of the product. On information and belief, a significant portion of these revenues were realized from sales made in New York. Continue Reading Lawsuit filed in New York against makers of Duragesic fentanyl patch

This fentanyl lawsuit was filed in California against Watson Pharmaceuticals.  Watson makes their own reservoir patch, which is the same type of design as the Duragesic fentanyl patch.  As far as I’m aware, Watson operates the only other manufacturing plant besides ALZA’s in Vacaville that makes reservoir fentanyl patches. 

Plaintiffs Monika Standing and Chris Bristol (collectively, “Plaintiffs”) the parents and wrongful death heirs of Nicole Bristol (“Decedent”), file this First Amended Complaint for Damages complaining of Defendants Watson Pharmaceuticals, Inc., Watson Laboratories, Inc., Watson Pharma, Inc., and John Does 1-100, and for cause of action would show:

PARTIES

1. Plaintiff Monika Standing is a citizen of the State of Colorado and the surviving mother and wrongful death heir of Decedent. Plaintiff Chris Bristol is a citizen of the State of California and the surviving father and wrongful death heir of Decedent.

2. Defendant Watson Pharmaceuticals, Inc. was and is a corporation organized and existing under the laws of the State of Nevada. Watson Pharmaceuticals, Inc.'s home office is at 311 Bonnie Circle, Corona, CA 92880-2882. Watson Pharmaceuticals, Inc. has done and is doing business in California. Watson Pharmaceuticals, Inc. may be served with process by serving its registered agent, CT Corporation System at 818 W. 7th Street, Los Angeles, CA 90017-3407 or by delivering a copy of the summons and complaint to Paul Bisaro any other officer or managing agent at 311 Bonnie Circle, Corona, CA 92880-2882.

3. Defendant Watson Laboratories, Inc., a subsidiary of Watson Pharmaceuticals, Inc., was and is a corporation organized and existing under the laws of the State of Nevada. Watson Laboratories, Inc.'s home office is 311 Bonnie Circle, Corona, CA 92880-2882. Watson Laboratories, Inc. has done and is doing business in California. Watson Laboratories, Inc. may be served with process by serving its registered agent, CT Corporation System at 818 W. 7th Street, Los Angeles, CA 90017-3407 or by delivering a copy of the summons and complaint to Paul Bisaro any other officer or managing agent at 311 Bonnie Circle, Corona, CA 92880-2882.

4. Defendant Watson Pharma, Inc., a subsidiary of Watson Pharmaceuticals, Inc., is corporation organized and existing under the laws of the State of Delaware, with its principal place of business in New Jersey. Watson Pharma, Inc. has done and is doing business in California. Watson Pharma, Inc. may be served with process by serving its registered agent, CT Corporation System at 818 W. 7th Street, Los Angeles, CA 90017-3407 or by delivering a copy of the summons and complaint to Allen Chao or any other officer or managing agent at 360 Mount Kemble Avenue, Morristown, NJ 07960-6662.

5. The true names or capacities, whether individual, corporate, or otherwise, of Defendants Does 1-100, inclusive, are unknown to Plaintiffs who therefore sue said Defendants by such fictitious names. Plaintiffs believe and allege that each of the Defendants designated herein by fictitious names is in some manner legally responsible for the events and happenings herein referred to and caused damages proximately and foreseeably to Plaintiffs as alleged herein.

JURISDICTION AND VENUE

6. This Court lacks subject matter jurisdiction over this case because the claims in this case are based on state law and there is no diversity of citizenship because Plaintiff Chris Bristol and Defendants Watson Pharmaceuticals, Inc. and Watson Laboratories, Inc. are residents of the State of California. Venue is proper in Orange County (once the case is remanded) because, at all times relevant hereto, the Watson Defendants promoted, marketed, distributed, warranted, and sold the Patch in interstate commerce and in the County of Orange, State of California. Furthermore, Defendants conducted substantial business in the County of Orange, advertised the Patch in this county, received substantial compensation and profits from sales of the Patch in this county, and made material omissions and misrepresentations and committed breaches of warranties in this county. Venue is also proper in Los Angeles because Decedent's fentanyl overdose and resulting death occurred in Los Angeles County.

FACTS

7. This suit arises out of the wrongful death of Decedent due to the wrongful conduct of Defendants. Decedent, while a patient of Dr. Jeanne Myriam Axler, was given a prescription for 75 mcg Watson (fentanyl transdermal system) patches. Decedent was wearing one of these patches (the “Bristol Patch”) at the time of her death and it was the cause of her death. The Watson Patch worn by Decedent at the time of her death was designed and manufactured by Defendant Watson Laboratories, Inc. The Bristol Patch was marketed and distributed by Defendants Watson Pharmaceuticals, Inc. and Watson Pharma, Inc. Watson Pharmaceuticals, Inc., Watson Laboratories, Inc., Watson Pharma, Inc. shall hereinafter be collectively referred to as the “Watson Defendants.”

8. Watson (fentanyl transdermal system) patches also came in other sizes such as 25, 50, and 100 mcg. As referenced herein, the “Patch” shall refer to Watson (fentanyl transdermal system) patches of any size unless specified otherwise.

9. The Patch is a multi-layer system containing a gel which has the drug fentanyl in it. Fentanyl is an extremely dangerous drug that is at least 80 times stronger than morphine. Fentanyl is classified as a Schedule II controlled substance by the FDA and is generally used to relieve pain.

10. The Patch is applied by the patient and delivers fentanyl though the patient's skin. The Watson Defendants design, manufacture, market and sell the Patch with the intention that it will release a certain amount of fentanyl into a patient at a certain rate, and thus produce a certain level of fentanyl in the blood of the patient. In other words, if a Patch functions as intended and it is properly used by the patient, the patient should not receive a harmful dose of fentanyl. Decedent never abused the Patch or used it inappropriately. Continue Reading Fentanyl patch lawsuit filed against Watson Pharmaceuticals

Here’s the text of a fentanyl lawsuit filed against Mylan Pharmaceuticals.  This one was filed in Georgia.

COMPLAINT FOR DAMAGES

Plaintiff, GLORIA STOYLES, (herein alternatively referred to as “Plaintiff”), residing at 682 Saddlebrook Drive, Dallas, GA 30132, by and through her attorneys C. Andrew Childers, Esq. and M. Brandon Smith, Esq., Childers & Schlueter, LLP, 260 Peachtree Street NW, Suite 1601, Atlanta, GA 30303 and of counsel Andrew G. Finkelstein, Esq., Kenneth B. Fromson, Esq., and Mary Ellen Wright, Esq., Finkelstein & Partners, LLP, 1279 Route 300, P.O., Box 1111, Newburgh, NY 12551, file this her Complaint For Damages against Mylan, Inc., Mylan Pharmaceuticals, Inc., and Mylan Technologies, Inc. (collectively referred herein after as “Defendants” or “Mylan Defendants”) herein alleges upon information and belief the following:

STATEMENT OF THE CASE

1. Plaintiff brings this action to recover damages for personal injuries sustained by, and the wrongful death of Plaintiff's Decedent, RONNIE STOYLES, as the direct and proximate result of defendants' wrongful conduct in connection with the designing, developing, manufacturing, distributing, labeling, advertising, marketing, promoting, and selling of the prescription Fentanyl Patch, which was marketed and sold by the defendants, MYLAN, INC., MYLAN PHARMACEUTICALS, INC., and MYLAN TECHNOLOGIES, INC.

PARTIES AND JURISDICTION

a) PLAINTIFFS

2. Plaintiff GLORIA STOYLES is an individual residing and domiciled in Paulding County, Georgia. Plaintiff GLORIA STOYLES is the surviving wife and next of kin of RONNIE STOYLES (“Decedent”). Plaintiff GLORIA STOYLES, as Administrator of the Estate of Ronnie Stoyles, brings this action on behalf of Decedent's Estate and on behalf of Decedent's wrongful death beneficiaries.
b) DEFENDANTS

3. Defendant Mylan, Inc. (formally known as Mylan Laboratories, Inc.) is a foreign corporation organized and existing under the laws of the State of Pennsylvania with its principle place of business located at 1500 Corporate Drive, Suite 400, Canonsburg, PA 15317. Mylan, Inc. has done and is doing business in Georgia. Defendant Mylan, Inc. may be served with process by and through its Registered Agent, Corporation Service Company, 209 West Washington Street, Charleston, West Virginia 25302. Defendant Mylan, Inc. is subject to the jurisdiction and venue of this Court.

4. Defendant Mylan Pharmaceuticals, Inc. is a foreign corporation organized and existing under the laws of the state of West Virginia with its principal place of business located at 781 Chestnut Ridge Road, Morgantown, West Virginia 26505. Upon information and belief, Mylan Pharmaceuticals, Inc. is a wholly owned subsidiary of Mylan, Inc. Mylan Pharmaceuticals has done and is doing business in Georgia. Defendant Mylan Pharmaceuticals may be served with process by and through its Registered Agent, Corporation Service Company, 209 West Washington Street, Charleston, West Virginia 25302. Defendant Mylan Pharmaceuticals, Inc. is subject to the jurisdiction and venue of this Court.

5. Defendant Mylan Technologies, Inc., is a foreign corporation organized and existing under the laws of the State of West Virginia with its principal place of business located at 110 Lake Street, Saint Albans, VT 05478. Upon information and belief, Mylan Technologies, Inc. is a wholly owned subsidiary of Mylan, Inc. Defendant Mylan Technologies, Inc. may be served with process by and through its Registered Agent, Corporation Service Company, 209 West Washington Street, Charleston, West Virginia 25302. Defendant Mylan Technologies, Inc. is subject to the jurisdiction and venue of this Court. Continue Reading Fentanyl lawsuit against Mylan Pharmaceuticals filed in Georgia

This fentanyl lawsuit was filed in California because the plaintiffs are citizens of California.  Some of the lawsuits against Mylan have been filed in West Virginia, because that’s where the company is based.  As a rule of thumb, California is a good venue for plaintiffs. 

No matter what state you live in, if you have a fentanyl claim, your lawyer will need to determine which states you MAY file your lawsuit in, and which state you SHOULD file it in.  I’d be happy to help you find the right fentanyl attorney – just contact me and tell me a little about your potential case.

Plaintiffs Candace Gholson and Kristy Gholson (“Plaintiffs”), wrongful death heirs of Philip Gholson (“Decedent”) complains against Defendants Mylan, Inc., Mylan Pharmaceuticals, Inc., and Mylan Technologies, Inc. (collectively, “Defendants”), and alleges as follows:

PARTIES

1. Plaintiff Candace Gholson is a citizen of the State of California, County of Napa and is the wife of Decedent Plaintiff Kristy Gholson is a citizen of State of California, County of Napa and is the daughter of Decedent.

2. Defendant Mylan, Inc. is a corporation organized and existing under the laws of the State of Pennsylvania. Mylan, Inc. has done and is doing business in California and may be served by delivering a summons and copy of the complaint to its President, Robert I. Coury, at 781 Chestnut Ridge Road, Morgantown, WV 26505, or any other officer or managing agent at such address.

3. Defendant Mylan Pharmaceuticals, Inc., a subsidiary of Mylan, Inc., is a corporation organized and existing under the laws of the West Virginia. Mylan Pharmaceuticals, Inc. has do and is doing business in California and may be served by delivering a summons and copy of the complaint to its President, Harry A. Korman, at 781 Chestnut Ridge Road, Morgantown, WV 26505, or any other officer or managing agent at such address.

4. Defendant Mylan Technologies, Inc., a subsidiary of Mylan, Inc., is a corporation organized and existing under the laws of the State of West Virginia. Mylan Technologies, Inc. has done and is doing business in California and may be served with process by delivering a summons and copy of the complaint to its President, Carolyn Myers, at 1500 Corporate Drive, Suite 400, Cannonsburg, PA 15317, or any other officer or managing agent at such address. Continue Reading Another fentanyl lawsuit filed against Mylan Pharmaceuticals

I’m starting to see more fentanl lawsuits filed against Mylan, the makers of a fentanyl patch that competes with the Duragesic patch.  The Mylan patch uses a matrix design in which the fentanyl is in the patch adhesive, as opposed to the reservoir design of the Duragesic patch.  Since there is no reservoir of gel, it isn’t possible for the Mylan patch to leak fentanyl, but there have apparently been several deaths of people wearing Mylan patches attributed to fentanyl toxicity.

As far as I know, there haven’t been any trials yet in any Mylan fentanyl lawsuits.

If you were injured or a loved one was injured or killed by what you believe to be a fentanyl patch of any brand, feel free to contact me and I’ll put you in contact with fentanyl attorneys who will investigate your claim.

Come now Plaintiffs Walter Richardson, Michael Rameraz, Sam Bloom, Chriss Bloom, and Stephanie Leewright (collectively, “Plaintiffs”), the wrongful death heirs of Sandra Richardson (“Decedent”), and for causes of action against defendants, and each of them, complain and allege as follows:

PARTIES

1. Plaintiff Walter Richardson is a citizen of the State of California and is the husband of Decedent.

2. Michael Remeraz is a citizen of the State of California and is the daughter of Decedent.

3. Sam Bloom is a citizen of the State of California and is the son of Decedent.

4. Chriss Bloom is a citizen of the State of California and is the daughter of Decedent.

5. Stephanie Leewright is a citizen of the State of California and is the daughter of Decedent.

6. Defendant Mylan, Inc. is a corporation organized and existing under the laws of the State of Pennsylvania. Mylan, Inc. has done and is doing business in California and may be served by delivering a summons and copy of the complaint to its President, Robert J. Coury, at 781 Chestnut Ridge Road, Morgantown, WV 26505, or any other officer or managing agent at such address.

7. Defendant Mylan Pharmaceuticals, Inc., a subsidiary of Mylan, Inc., is a corporation organized and existing under the laws of the West Virginia. Mylan Pharmaceuticals, Inc. has done and is doing business in California and may be served by delivering a summons and copy of the complaint to its President, Harry A. Korman, at 781 Chestnut Ridge Road, Morgantown, WV 26505, or any other officer or managing agent at such address.

8. Defendant Mylan Technologies, Inc., a subsidiary of Mylan, Inc., is a corporation organized and existing under the laws of the State of West Virginia. Mylan Technologies, Inc. has done and is doing business in California and may be served with process by delivering a summons and copy of the complaint its President, Carolyn Myers, at 1500 Corporate Drive, Suite 400, Cannonsburg, PA 15317, or any other officer or managing agent at such address.

9. The true names or capacities, whether individual, corporate, or otherwise, of Defendants Does 1-100, inclusive, are unknown to Plaintiffs who therefore sue said Defendants by such fictitious names. Plaintiffs believe and allege that each of the Defendants designated herein by fictitious names is in some manner legally responsible for the events and happenings herein referred to and caused damages legally and foreseeably to Plaintiffs as alleged herein.

VENUE

10. Under Cal. Civ. Proc. Code § 395, venue is proper in this county because the injury causing Decedent's death occurred in this county.

FACTS

11. This suit arises out of the wrongful death of Decedent due to the wrongful conduct of Defendants. Decedent was given a prescription for 100 mcg Mylan (fentanyl transdermal system) patches. Decedent was wearing one of these patches (the “Richardson Patch”) at the time of her death and it was the cause of her death. The Richardson Patch was designed, manufactured, marketed and/or distributed by Mylan, Inc., Mylan Pharmaceuticals, Inc., and Mylan Technologies, Inc. (collectively, the “Mylan Defendants”). Mylan (fentanyl transdermal) patches also came in other sizes such as 25, 50 and 75 mcg. As referenced herein, the “Patch” shall refer to Mylan (fentanyl transdermal) patches of any size unless specified otherwise.

12. The Patch is a matrix patch containing the drug fentanyl. Fentanyl is an extremely dangerous drug that is at least 80 times stronger than morphine. Fentanyl is classified as a Schedule II controlled substance by the FDA and is generally used to relieve pain.

13. The Patch is applied by the patient and delivers fentanyl though the patient's skin. The Mylan Defendants design, manufacture, market and sell the Patch with the intention that it will release a certain amount of fentanyl into a patient at a certain rate, and thus produce a certain level of fentanyl in the blood of the patient. In other words, if a Patch functions as intended and it is properly used by the patient, the patient should not receive a harmful dose of fentanyl. Decedent never abused the Patch or used it inappropriately. Continue Reading Text of Complaint in Mylan Fentanyl Patch Lawsuit, and Mylan’s Response

Several fentanyl attorneys who have sued Mylan Pharmaceuticals and Mylan Technologies have asked the court to order the production of many documents related to the design, manufacture, and distribution of Mylan fentanyl pain patches:

Plaintiff Monica Cunningham, as personal representative of the estate of John E. Edmonson, and on behalf of the Wrongful Death Beneficiaries of John E. Edmonson (“Plaintiff”), by and through her undersigned attorneys files this Motion to Compel Production of Documents Related to (1) Communications with Governmental Agencies, (2) Inspections of Facilities, (3) Recalls, (4) Batch Records, (5) Operating Procedures, (6) Product Returns, (7) Plaintiff, and (8) Intended Fentanyl Concentrations. Pursuant to Local Rule 3.01(j), Plaintiff requests oral argument on this motion and estimates the Court will need thirty minutes to hear the Motion.

I’m not surprised at all that the fentanyl attorneys representing Mylan are refusing to hand these documents over without a protective order.  Similar documents produced in Duragesic lawsuits have shown fentanyl manufacturers to have shoddy manufacturing plants and lackluster quality control.  At this point, I haven’t seen any documents produced from a Mylan fentanyl patch lawsuit.  I can’t wait for some to be made available, and when they are, I’ll post them here.

Continue Reading Discovery Battle in Fentanyl Lawsuit Against Mylan Pharmaceuticals

Below is the text of the deposition taken of Robert Gale, the inventor of the Duragesic fentanyl patch.  This deposition was taken in Dicosolo v. Janssen Pharmaceutica, Inc.  The Duragesic attorneys who handled this case obtained a verdict of $16.6 million dollars in that case.

THE VIDEOGRAPHER: Good afternoon. We are now on the record.

The time on the screen is 1:16 p.m. Today's date is September 11, 2008.

This is the beginning of videotape number 1 in the deposition of Robert Gale, Volume 1, in the matter of West v ALZA Corp. and other cases, in the Superior Court of the State of California.

We are located at the Westin, Palo Alto, California.

The court reporter is John Squires, in association with Hundt Reporting.

My name is David Manzo, and I'm a Certified Legal Videographer, in association with Hundt Reporting.

Will counsel please state your appearance for the record.

MR. ORR: Jim Orr on behalf of the plaintiffs.

MS. BENEDICT: Mollie Benedict for Defendants ALZA and Janssen.

MS. DAVENPORT: Kirsten Davenport for Defendant Dr. Covington.

THE VIDEOGRAPHER: If there are no stipulations, will the court reporter please swear in the witness.

On Thursday, September 11, 2008, at the hour of 1:16 p.m. of said day, at the Westin Hotel, 675 El Camino Real, Palo Alto, California, before me, JOHN P. SQUIRES, a Certified Shorthand Reporter, personally appeared ROBERT MARTIN GALE, M.S., who was examined as a deponent in said cause.

ROBERT MARTIN GALE, M.S., the deponent herein, having been first duly sworn, was examined and testified as follows: Continue Reading Deposition of Inventor of Duragesic Fentanyl Patch Taken in Dicosolo v. Janssen Pharmaceutica, Inc.

Below is the expert witness report in the Duragesic lawsuit Adams v. Johnson & Johnson.  This is the report of Michael Kaufman, M.D., and he concluded fentanyl was responsible for the death of James Adams:

In my opinion, the cause of death of Mr. Adams was a fatal toxic overdose of Fentanyl due to a known product defect with the 75 microgram Fentanyl packages which was known at approximately that time period and which necessitated a product recall and was the cause of death of other individuals.

The strongest fentanyl lawsuits are those in which the patch may have caused the death of an individual.  However, I know some fentanyl attorneys who are accepting cases in which people were hospitalized but did not die.  If you’d like me to put you in touch with a Duragesic attorney or a fentanyl attorney, don’t hesitate to contact me.

Dear Mr. Carlson;

Thank you for consulting with me on the above medico-legal case. I have received and reviewed the following materials:

1. Chronology of patient illness

2. Death certificate

3. Autopsy report and toxicology report

4. Lawrence County Memorial Hospital records dated 4/29/05

5. LCMH abmulance – April 29, 2005

6. LCMH blood tests from April 29, 2005

7. Pharmacy records

8. Medical records of Dr. John Grimm

9. Willow Creek Pain Center recorts

10. 10.Rural Health Clinic medical records

11. Vincennes Orthopedics Surgery Clinic records

12. LCMH physical therapy records

13. LCMH admission of January 21, 2005

14. LCMH admission of January 23, 2005

15. LCMH admission of January 28, 2005

16.Medical record of Dr. Jerrold Leikin of August 26, 2008

17. Deposition of Linda Adams

18. Deposition of Dr. John Grimm

19. Deposition of Dr. James Jacobi

20. Autopsy slides of James Adams

All opinions rendered in this report are given to a reasonable degree of medical and pathologic certainty. They are based upon review of the above records, as well as upon my education, training and experience in the field of anatomic pathology and particularly in the fields of autopsy pathology and toxicology.over the past 36 years. I have experience in the issues involved in this case. To my knowledge, I have never been barred from a court of law from testifying in the areas of my medical expertise.

In brief summary, Mr. James E. Adams, date of birth XX/XX/1957, sustained a job related injury on XX/XX/2005, in which he was injured by an inter-action with a cow in which his back was injured. He was under a physician's care for this injury and he required multiple medications for the back pain from which he suffered. He was started on a Fentanyl patch (Duragesic) 75 microgram transdermal patch, with the first patch applied on Monday, April 25, 2005. The first patch was removed on Thursday, April 28 and a new patch was put on. Mr. Adams was found suddenly and unexpectly dead by his wife the morning of Friday, April 29. An autopsy was performed by the Lawrence County, Illinois coroner's physician, James Jacobi, on April 29, 2005, The autopsy findings included focal severe coronary artery atherosclerosis of the left circumflex coronary artery with 70% narrowing, severe hepatic steatosis with an estimated liver weight of 3000 grams, and a toxic blood level of Fentanyl of 12.2 nannograms per milliliter (ng/ml). Dr. Jacobi's opinion was that the cause of death was due to a fatal cardiac arrhythmia secondary to focal severe coronary artery atheroscerlsis with a contributing factor of toxic blood level of Fentanyl. The manner of death was determined to be natural.

I was asked by your offices to review the medical and autopsy records to independently determine the cause and manner of death of Mr. Adams.

In my opinion, the cause of death of Mr. Adams was a fatal toxic overdose of Fentanyl due to a known product defect with the 75 microgram Fentanyl packages which was known at approximately that time period and which necessitated a product recall and was the cause of death of other individuals. The manner of death is accidental. Review of the autopsy report and slides indicates that while there was a focal narrowing of the left circumflext coronary artery of approximately 70% narrowing, this was an asymptomatic narrowing in that Mr. Adams did not complain of any chest pain or of atypical anginal symptoms either during exercise or at rest, It is a known pathologic finding that the degree of atherosclerotic narrowing seen at autopsy almost always overestimates the degree of narrowing which would have existed in life in view of the ability of the artery to expand during systole, whereas the post-mortem artery is collapsed. This is particularly true in atheromas which are eccentrically located within the arterial wall, are not calcified, and which are considered more “fatty” than fibrocalcific. Mr. Adams' left circumflex atherosclerotic narrowing fulfilled all of these criteria. In his deposition, Dr. Jacobi also made much of the severe fatty liver as a cause of Mr. Adams elevated level of Fentanyl. Were that the case, then the other pain medications he was taking should also have been elevated; yet they were all either sub-therapeutic or therapeutic in their levels. Review of the autopsy slide of the liver incidates only a moderate, not a severe, degree of fatty infiltration, which was unaccompanied by either co-existent liver disease, such as hepatofibrosis or steatohepatitis, which might be considered to have a potential effect on drug metabolism. There is no indication that Mr. Adams' liver was not functioning a normal levels at the time of his death. Continue Reading Expert Witness Report Concludes Fentanyl Toxicity Responsible for Death of Plaintiff in Duragesic Lawsuit