The Tenth Circuit has ruled that a jury must decide whether a car accident proximately caused the insured's subsequent overdose and resulting death. (Photo by John Moore/Getty Images)
A jury must decide whether a car accident proximately caused the insured's subsequent overdose and resulting death, ruled the U.S. Court of Appeals for the Tenth Circuit, reversing a district court's decision.
The case
In August 2013, an underinsured motorist allegedly failed to yield to the vehicle in which Cynthia Thompson was a passenger. The resulting collision broke Thompson's neck. For the next several months, Thompson's doctors prescribed oxycodone and diazepam to alleviate her pain.
Six months later, Thompson died at home. The physician who performed the autopsy, Dr. Robert Kurtzman, concluded that she died after overdosing on prescription drugs. Dr. Kurtzman detected no oxycodone in her blood. Instead, he discovered a fentanyl patch on her back and both fentanyl and diazepam in her blood. Dr. Kurtzman opined that the combination of fentanyl and diazepam caused an accidental overdose that resulted in her death.
Thompson had a history of neck pain, and years before the August 2013 accident, Thompson's doctors prescribed fentanyl to treat and alleviate her neck pain.
According to Thompson's son, Derek Thompson, her medical records revealed that she last received a prescription for fentanyl in 2010. Mr. Thompson explained that Ms. Thompson used a leftover fentanyl prescription as a substitute for the oxycodone because the oxycodone caused extreme nausea. But because she was no longer a regular fentanyl user, she lost her tolerance to it, and the combination of fentanyl and diazepam proved deadly. It appeared that Ms. Thompson died from an attempt at self-medication.
After Ms. Thompson passed away, Mr. Thompson sent a demand letter to her insurer, State Farm Mutual Automobile Insurance Company, claiming his mother's underinsured motorist (UIM) benefits.
State Farm refused to pay benefits, reasoning that the car accident had not caused her overdose and resulting death.
Mr. Thompson sued State Farm and sought a declaration of his entitlement to UIM benefits.
In a summary judgment motion, State Farm argued that Ms. Thompson's self-medication, not the car crash, had proximately caused her death. In other words, State Farm argued that her self-medication intervened to break the chain of causation. State Farm claimed it could not foresee that a car accident might cause Ms. Thompson to overdose on a medication that doctors last prescribed in 2010 — some three years before the accident.
Mr. Thompson countered that it was foreseeable that an injured person such as Ms. Thompson would use a leftover medication, especially because Ms. Thompson had previously used that same medication to treat a similar type of pain.
The U.S. District Court for the District of Colorado agreed with State Farm, concluding as a matter of law that Ms. Thompson's fentanyl use constituted an unforeseeable intervening act that severed the chain of causation between the accident and her death.
The dispute reached the Tenth Circuit.
The Tenth Circuit's decision
The Tenth Circuit reversed.
In its decision, the circuit court explained that reasonable minds could disagree as to whether Ms. Thompson's overdose on pain medication was foreseeable. It pointed out that Mr. Thompson's expert opined that Ms. Thompson's manner of death was "consistent with that of an accident via what appears a self-directed attempt to control her pain to prolonged healing of traumatic cervical spine injury."
The circuit court added that Mr. Thompson also presented evidence that Ms. Thompson had a prior prescription for fentanyl, that she used fentanyl patches to treat neck pain for many years before the car accident, and that Ms. Thompson replaced the oxycodone with a leftover fentanyl patch because the oxycodone had caused her to experience extreme nausea.
The Tenth Circuit explained that the district court accepted Mr. Thompson's evidence but concluded that Ms. Thompson's use of a dangerous narcotic was unforeseeable as a matter of law. The Tenth Circuit then ruled that, in reaching this conclusion, the district court "failed to adequately consider the context of the situation and draw all inferences in [Mr. Thompson's] favor."
The circuit court reasoned that a reasonable jury could conclude that, based on her medical history and prior use of fentanyl patches, "it was reasonably foreseeable that she would use a leftover patch to treat her resurfaced neck pain after the accident."
The Tenth Circuit concluded that a jury should decide proximate causation in this case and that a reasonable jury could find that Ms. Thompson's accident-related pain had proximately caused her overdose.
The case is Thompson v. State Farm Mutual Automobile Ins. Co.
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