Fatal Combination Of Drugs Can Result In Finding Of Line-Of-Duty Death

Written on 12/10/2022

In 2014, Philadelphia Police Officer Raymond Diaz was injured in a motor vehicle accident in the course of his employment, sustaining a concussion and injuries to his neck and back. Diaz never returned to work and collected Heart and Lung Act benefits as part of Pennsylvania’s workers’ compensation system.

Diaz was prescribed pain medica­tion, including a fentanyl patch. He had difficulty standing straight, could not focus his eyes, exhibited poor memory, and developed balance issues. Despite using a cane when walking, Diaz’s poor balance caused him to fall quite often.

In 2016, Diaz fell, tearing his left bicep. In advance of surgery, and as directed, Diaz stopped taking his pre­scribed pain medications and removed the fentanyl patch. Surgery was done on September 6, 2016, and Diaz was discharged the following day, with a prescription for hydromorphone to treat his post-surgical pain. The following day, September 8, 2016, Diaz appeared fine. However, on September 9, 2016, Diaz was found unresponsive and died at the hospital.

The City’s medical examiner reported that the cause of death was Diaz’s “intoxication by the combined effects of hydromorphone, oxycodone and fentanyl therapy for chronic and postsurgical pain.” Other factors con­tributing to Diaz’s death included sleep apnea and hypertensive heart disease.

On behalf of Diaz’s widow, the City applied for line-of-duty death benefits under state law. The State’s Bureau of Finance and Risk Manage­ment denied the application, reasoning that “the circumstances surrounding Diaz’s death are too far removed from the service-related injury he sustained.”

Pennsylvania’s Commonwealth Court found that Diaz’s widow was entitled to the benefits. The Court found that the line-of-duty law requires a “causal relation between death and performance of duties, and it is to be construed liberally in favor of its intended beneficiaries. However, it is not intended to function as a general life insurance policy.

“Here, Diaz was involved in a motor vehicle accident while in the performance of his official duties, sustaining a concussion and injuries to his head and neck. Diaz was prescribed medication for his work injury pain, including oxycodone and fentanyl. His widow’s evidence established that the work injury also left Diaz with ongoing gait and balance problems, necessitat­ing his use of a cane for walking. On July 19, 2016, Diaz lost his balance and fell, injuring his left arm, which fall the City accepted as work-related.

“The surgery to treat Diaz’s left arm was followed by a prescription for hydromorphone. Two days later he died. The death certificate determined the cause of death to be intoxication by the combined effects of hydromor­phone, oxycodone, and fentanyl. The City Police Department determined that Diaz’s death was service related.

“This evidence established a causal connection between Diaz’s work injury and his death. But for the work injury, Diaz would not have been prescribed pain medication or experienced ongo­ing balance problems that led to his fall in 2016. But for that fall, he would not have needed surgery or been pre­scribed hydromorphone. Regardless of whether the fall resulted from his post-concussive syndrome, it is undis­puted that but for Diaz’s work injury, oxycodone and fentanyl would not have been present in his bloodstream when he took the hydromorphone, and their fatal combination with hydro­morphone would not have occurred. Thus, Diaz’s death was a direct result of the injuries he sustained in the per­formance of his official duties.

“The Department argues that because Diaz did not die from the cervical or lumbar injury or from post-concussive syndrome, the link between the service-related injury and the ultimate cause of death was bro­ken. Under the law, the only relevant inquiry is whether death comes as a result of the performance of an officer’s duties. But for Diaz’s work injury, the fatal combination of drugs prescribed for his work injury with the hydro­morphone would not have occurred.”

Diaz v. Department of General Services, 2022 WL 3363663 (Penn. Cmwlth. 2022).

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