METHADONE CLINIC CAN BE HELD LIABLE FOR PATIENT ACTION

Court Says Doctor Will Remain Part Of Lawsuit Over Wreck

Physicians who treat addicts with methadone have a duty in some cases
to protect the public from harm from their patients, the Alabama
Supreme Court ruled last week.

The justices agreed 7-0 that an Etowah County circuit judge should not
have dismissed a lawsuit a wreck victim filed against a Gadsden
methadone clinic operator. Methadone is a synthetic narcotic used to
help addicts withdraw from heroin.

"There is now a deterrent to keep doctors from abusing or
over-prescribing methadone," said Huntsville lawyer Joe King.

In February 2001, King filed a lawsuit for Lola Ann Taylor of Gadsden,
severely injured in a car wreck in Marshall County, against the
Gadsden Treatment Center Inc. and its administrators, including Dr.
Kenny E. Smith. The suit alleges Glenda Ennis of Grant, Smith's
patient, was impaired when she caused the wreck on Sept. 8, 2000.

A spokeswoman for the clinic Thursday declined to comment about the
lawsuit. The Birmingham lawyer for Smith, Joe Miller, was not
available for comment.

According to the suit:

Ennis drove 90 minutes every day from Grant to Gadsden for a dose of
methadone, then drove back home. She received a dose of methadone
about an hour and a half before the wreck.

The center had performed 12 urinalysis tests between April and
September 2000 to monitor Ennis' drug use. She tested positive 11
times for marijuana and other drugs, including Xanax and Valium.

A test two days before the wreck found she had used benzodiazepines,
including Xanax and Valium. "When they noticed the presence of other
drugs in (Ennis') system, they were supposed to take her off the
methadone," King said.

The center's clinical notes indicated Ennis was not attending group
counseling sessions and reported no desire to stop using illicit drugs.

On Sept. 8, 2000, Ennis received methadone about 6 a.m. and drove
away. At 7:23 a.m. on Marshall County Road 5, she crossed into
oncoming traffic and collided with Taylor.

Dr. Nathan R. Strahl, medical director at the Raleigh (N.C.) Methadone
Clinic, said Ennis' treatment records should have drawn the concern of
the medical director of the Gadsden clinic.

"The combination of methadone with benzodiazepines and marijuana can
greatly impair the mental and/or physical abilities required for the
safe performance of potentially hazardous task, such as driving a
car," Strahl said in an affidavit.

Considering the distance Ennis had to drive after receiving methadone
and her use of illegal drugs, the possibility of a wreck was
foreseeable, Strahl said.

Smith's lawyers contended that Smith was not liable under medical
malpractice laws for Taylor's injuries. Circuit Judge Donald W.
Stewart agreed and dismissed Smith from the lawsuit.

But Justice Thomas A. Woodall, writing for the court, said Smith is
liable under the common law regarding negligence. Woodall noted that
the plaintiff conceded that if Smith's treatment of Ennis met the
standard of care, he should not be held liable.

"The policy considerations cited by Dr. Smith," said Woodall, "do not
justify the risk of releasing a dangerously medicated patient upon the
highways of Alabama without potential liability to the physician who
directly administered the medication."

The other six justices concurred. The case is expected to go to trial
late this summer, King said.