MORGANTOWN — Mon Health System and WVU Health System have joined with hospitals across West Virginia and Kentucky to sue opioid manufacturers, wholesale distributors and pharmacies to seek redress for the damages done by the opioid epidemic.
The 27 West Virginia hospitals and 10 Kentucky hospitals filed suit Tuesday in Marshall County Circuit Court against 55 defendants.
Mon Health comprises three hospitals: Mon Health Medical Center, Preston Memorial and Jackson Memorial. WVU Health System comprises nine: Ruby and Children’s jointly under WVU Hospitals, Camden-Clark, Charles Town, City Hospital, Potomac Valley, Reynolds Memorial, St. Joseph’s and United Hospital Center.
The defendant manufacturers include Purdue, Jannsen, Abbott and Endo. The distributors include Cardinal Health and AmerisourceBergen. The pharmacies include CVS, Walgreen’s, Rite Aid, Walmart and Kroger.
The 331-page suit opens with a long preface about how the epidemic has harmed West Virginia and its hospitals. Everything cited is form the complaint.
From 2001-2015, 7,209 people in West Virginia died of overdoses. The annual number quadrupled form 2001 (212) to 2016 (884). The percentage of deaths involving at least one opioid rose form 70% in 2001 to 87% in 2015. In 2015, the state’s cost per capita was the nation’s highest: $4,378.
From 2005-2016, Cardinal Health shipped 366 million doses to West Virginia; McKesson shipped 299 million; AmerisourceBergen shipped 248 million.
For the hospitals, “the opioid crisis has taxed their resources and threatened their ability to provide quality health care to anyone in need.”
Much of the 331-page suit overlaps allegations made in about 1,400 suits, collectively known as National Prescription Opiate Litigation, being heard in Ohio federal court. They have been reported here before can be briefly summarized.
Before the mid-1990s, opioids were recognized as suitable for short-term treatment of acute pain. Beginning in the mid-1990s, drug manufacturers launched deceptive marketing campaigns — including paid physicians and medical front groups — to minimize and dismiss opioids’ addictive qualities and to promote opioids for long-term chronic pain.
Among their claims: addiction risk was low; people exhibiting addictive behavior such as clock watching and doctor shopping were experiencing “pseudoaddiction” and needed more drugs; opioid doses can be increased without limit.
Distributors and pharmacies, in turn, flaunted federal and state laws intended to discover, track and prevent suspicious orders, which include orders of unusual size, orders deviating substantially from a normal pattern, and orders of unusual frequency.
The suit contains some additional highlights. Among them, hospitals are financially burdened treating opioid overdoses and addiction, hepatitis C and HIV in intravenous users, neonatal treatment of addicted newborns and psychiatric treatment for addicted patients, and surgical and other medical care made more complex via opioid usage.
As early as 1995, Purdue and Abbott targeted the nation’s 1,200 cancer centers, 1,200 teaching hospitals and 2,500 community hospitals with more than 100 beds to market opioids. “The importance of targeting hospital emergency rooms was illustrated by a study that demonstrated that patients who receive an opiate prescription within 7 days of surgery are 44% more likely to still be using the medication one year after surgery than patients who do not receive an opioid prescription.”
Abbott called its opioid sales reps knights and royal crusaders. The four leaders were called Wizard of OxyContin, Supreme Sovereign of Pain Management, the Empress of Analgesia and the King of Pain.
At Purdue, “representatives who failed to get enough patients on opioids were placed on probation, put on performance improvement plans, and they would be threatened with loss of their jobs if they did not generate more opioid sales. Those unable to generate more sales were fired.”
The manufacturers manipulated hospitals by targeting the Joint Commission of Healthcare Organizations, which accredits more than 21,000 organizations. Through the Joint Commission, it published a book dismissing addiction as a problem for opioid pain control.
One of the industry front groups established the commission’s pain control standards and hospitals that offered insufficient pain management faced accreditation risks.
Further down the chain, distributors and retailers saw substantial profits by ignoring suspicious orders. They “funneled far more opioids into communities across the United States than could have been expected to serve legitimate medical use and ignored other red flags of suspicious orders.”
The hospitals are seeking punitive and compensatory damages, along with disgorgement of “unjustly acquired profits.”
Stephen Farmer, of Farmer, Cline & Campbell, is one of the lead attorneys and represents the WVU system hospitals.
‘It’s really amazing how outrageous the conduct has been in the last 15 years by these companies,” he said.
He and his colleagues will fight having the case transferred to federal court with all the others, he said. They don’t believe there’s and justification for removal, and the hospitals want to have their cause heard here, where the problem is the worst in the nation. They don’t want their voices drowned out in the national forum.
The problem has devastated all 55 counties, he said. This case, I think, is the most important case I’ve been involved in as a lawyer in my career.”
WVU Health System supplied this statement: “We the hospitals of WVU Medicine believe this case has the potential to create critically needed resources for the thousands of people who have been affected by the opioid crisis – many of whom live right here in West Virginia, which has been hit exceptionally hard by this epidemic.
“At WVU Medicine, our mission is to improve the health of West Virginians and all we serve through excellence in patient care, research, and education. One of the ways we do that is through our pioneering work in medication assisted therapy for substance use disorder.
“While this lawsuit may not result in financial gain for us, we hope to be included in the conversation about potential solutions and opportunities for meaningful change, including building treatment facilities, increasing the availability of Narcan Nasal Spray, and expansion of programs for babies born with neonatal abstinence syndrome, should the suit make funds available to do so.”
Mon Health System referred questions to its attorney in the case, who could not be reached in time for this report.
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