Legal Causation

Storyline  – TV show BULL  Season 4 Episode 1

As Bull prepares for fatherhood, his work at TAC suffers without his top attorney, Benny, who quit in reaction to Bull’s romantic reconnection to his ex-wife and Benny’s sister, Isabella (Yara Martinez). In addition, the team faces a difficult time in court as they mount a defense for a young bartender on trial for involuntary manslaughter.

https://legal-dictionary.thefreedictionary.com/causation

High blood pressure dangers: Hypertension’s effects on your body

Harmful effects of UNTREATED PAIN

The basic story line of this episode is that on new year’s eve a bartender sold a patron too much alcohol, left the bar, drove to his ex-wife’s house and killed his ex-wife and 3 friends at the house and he either committed suicide or was kill by the police.  In the interim the bar closed/went out of  business and the relatives of those that died was suing the bartender for serving the person too much alcohol before he killed everyone.

The Bull legal team defended the bartender with the concept that there was no causation between being served “too much alcohol” and him killing four people… of course Bull’s law firm WON…

As I heard the legal term “causation” … my mind started connecting the dots… as causation would apply to the chronic pain community.

I have listed above the link to the bad health consequences to a pt with elevated blood pressure and a table that lists all the complications to comorbidity issues for under/untreated pain.

I can’t count the number of times that pts have told me that when their pain meds were cut/eliminated… their blood pressure goes up dramatically and into unsafe levels.

If a pt’s blood pressure had been at normal/safe levels and starts going up when their meds are cut back/discontinued… and the prescriber doesn’t attempt to treat the pain nor unable to get it back to acceptable/safe levels… You can refer to the above link as to the potential consequences to the pt for under/untreated elevated blood pressure.

It is typically considered “bad medicine” to add medications to a pt’s therapy to deal with side effects of their other medications…  IMO, putting a pt on up to 5 different anti-hypertensive medications to treat their high blood pressure because their pain medication has been reduced/eliminated… should also be considered “bad medicine”

The medical records that a prescriber keeps on a pt should document this cause/effect of the pt’s pain management meds being lowered/discontinued.  Likewise, those same records should document what the prescriber did – if anything – to try to lower the pt’s blood pressure.

Once again, if the prescriber’s prescribing policies and procedures are being dictated by the prescriber’s employer… then the causation could be directed at the “deep pockets” of that employer.

Could those same records be used as documentation when “going after” those people who served on the CDC opiate dosing guidelines and created those same guidelines knew or should have known that they were going to cause pt harm and a path to legal actions against those individuals and/or legal case to get those guidelines revoked ?

 

5 Responses

  1. All of my Medications are Corrupted and have caused extreme Damage To My Health. Btwn a predatory and Terror inducing Gov and New Diseases resulting from EMF-Voyeristic practices, it’s been clear for about 8 years of Monthly trauma and poisons that “They” want to slowly kill me. Destabilize, forced insomnIn, now Fractured and Buckled Teeth. Thyroid and Brain Deterioration, among Countless Other Covert Attacks. This Abuse and Sadism must End. Obscene And Perverse, Nonconsensual and uninformed, I RecRef to live in Hell. I’m not a labrat and they will have to kill me before forcing any Vaccines. Violation of Every Single Right. Juried Toxicologists ASAP including Massive Courageous Law firms who believe in the Constitution. I’m About To Rid Myself of these Toxic Frankenmeds. The majority of people are more ignorant than I Ever believed possible. Thrreats in NY to Force Vaccine Against our will. When Will This Nightmare End

  2. Regarding your statement:

    “The medical records that a prescriber keeps on a pt should document this cause/effect of the pt’s pain management meds being lowered/discontinued. Likewise, those same records should document what the prescriber did – if anything – to try to lower the pt’s blood pressure.”

    My pain clinic is cutting my meds by 80% from a stable dosage. At each visit, I tell my doctor how much worse I am doing, and I present medical facts that pretty much make the clinic’s rationalization/justification for cutting my meds Null & Void! For example, my clinic doctor and the clinic owner/doctor have both stated that this med cut is to conform to the 2016 CDC Guidelines. I point out that in June of 2019, the authors of those guidelines stated in the New England Journal of Medicine that the Guidelines should never be used to justify reducing the meds of a chronic pain patient. But, my statements of the facts are ignored. I have even taken a typed 2-week pain log to my clinic doctor, but it never entered my records.

    Not only are my statements ignored, but my presentation of my increased pain is also ignored. I have also documented my higher blood pressure, my weight loss, and my lowered immunity when at these visits. BP & Weight might show in the medical records, but w/o comment that it is due to my reduction in meds. NONE OF MY PRESENTATION OF THE FACTS goes into my medical records at any visit. There is no attempt by the pain clinic doctor to adjust my BP medicine. If anything, they expect that to be the job of one’s PCP, not the clinic even though they are the ones causing the high BP.

    The only thing one will see when looking at those records of the visit is a “plain vanilla” report that states “patients reduction of his meds to 90 MME continues”. The clinic/doctor are not going to enter anything such as, “medical records that a prescriber keeps on a pt should document this cause/effect of the pt’s pain management meds being lowered/discontinued.” Doing so would have the potential of putting the doctor/clinic in possible future legal jeopardy. Therefore, they avoid putting anything in those medical records that might have even the slightest chance of incriminating them.

  3. I was pulled off of my break thru pain med and anxiety med at the beginning of last year and slowly my blood pressure went up and up then my pcp didn’t want to prescribe any pain meds so went to pain clinic that Dr told me to stop taking my muscle relaxed & CBD products I got what I thought was a migraine but it was my blood pressure! I had a small stroke luckily I don’t have any lasting side effects but I’m scared that the 2 blood pressure meds I now have to take aren’t going to matter because my pain level from massive adhesions from surgeries for endometriosis and my interstitial cystitis/ painful bladder disease is outta control to make it to Dr apts I have to numb my bladder or I can’t stand to be driven to the appointment car rides make my pain worse and I also have a nerve that’s pinched some where in my pelvis area….
    Encased within all that wonderful scar tissue….

  4. That is EXACTLY what has happened to me My blood pressure was always 120/80 Until my pain medication was reduced to a 1/3/ of what I had been taking. Im on 2 different B.P. medications now and Im not even sure if it is working At times my pressure is sky high or it will be 115/60 I have told my Dr Im being “under medicated” and he looks at me like I have 2 heads. He claims what Im taking is “high dosage” I firmly believe my B.P. problems are all related to my meds being dropped to a 1/3 of what I was taking to deal with my pain

  5. THANK YOU STEVE! Yep, I’ve experienced pretty much all the damages from having meds cut off cold-turkey 1.5 years ago. My body has seemed to be shutting down now from such severe intractable pain. I’m doing my best to hang in there.

    You are such a blessing.

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