A medical malpractice suit was filed against two Belleville internists for negligently prescribing a potent narcotic medication to a non-opioid-tolerant patient.

The estate of Mary F. Koch filed suit in St. Clair County Circuit Court March 28 claiming Mark D. Irwin, M.D. administered a Duragesic patch and demerol without first determining whether Koch had a significant tolerance for narcotics. Koch was admitted to St. Elizabeth's Hospital in Belleville for intractable back pain on April 2, 2005. She died on April 4, 2005.

At the time, Irwin was the "on-call" physician for Koch's principal care provider Deborah McDermott, M.D.

According to the suit, Irwin failed to discuss with McDermott the ordering of the increased doses of narcotic drugs. The suit also claims Irwin failed to appear at Koch's bedside at the time she was "somnolent" and not able to swallow.

The suit claims Irwin "negligently and carelessly prescribed Duragesic without following the warnings on the 'black box' of Duragesic which warns of the life threatening hypoventilation that can occur in non 'opioid-tolerant' patients."

It also claims that Irwin failed to determine Koch had been treated for chronic obstructive lung disease which would increase her risk for life-threatening hypotensive ventilation.

The suit alleges McDermott was negligent in supervising or caring for Koch.

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