Prescribing doctor faces SA inquest

Lee-Anne Atkins hopes an inquest will find out why her husband was overdosed on opioids in hospital.A doctor who prescribed opioid painkillers to a man who died in Adelaide’s Flinders Medical Centre has told an inquest he should have consulted a pain specialist before doing so.

Dr Christos Marantos treated Stephen Atkins, who died in March 2015 after he was administered Fentanyl and Oxycodone to manage his chronic neck pain.

His cause of death at autopsy was Fentanyl and Oxycodone toxicity, but there is some dispute between professionals as to the accuracy of the finding.

In the South n Coroners Court on Wednesday, Dr Marantos said in addition to the two opioids he also prescribed Oxycontin, a slow-release form of Oxycodone.

He told the inquest he had commonly seen the three drugs prescribed together during his training, but said guidelines released by the American College of Physicians in 2017 suggested the combined use of the drugs was “potentially unsafe” and the dosages become difficult to adjust.

The doctor also admitted he should have consulted the hospital’s acute pain service before prescribing the drugs.

He accepted Mr Atkins’ wife, Lee-Anne Atkins, and one of their sons had approached him the day before the death and told him Mr Atkins was “very groggy and seemed out of it”, but he said he did not go back and check on him.

“I didn’t get the impression that I needed to go back and see the patient,” he told the inquest.

“Retrospectively, in hindsight, yes I should have gone back and seen Mr Atkins.”

On Tuesday, counsel assisting the coroner Kathryn Waite said the hospital had failed Mr Atkins on two levels.

She said staff administered him potentially lethal opioids without closely monitoring him, and said there were also questions as to whether the medication should have been prescribed.

The inquest continues before Deputy State Coroner Jayne Basheer.