BC Coroners Service – Preventable Death Bulletin – August 2014

A 37 year old man died at home approximately 10 hours after discharge from a rural emergency department following a 90 minute stay for the treatment of a methadone overdose.

On review of the case it became clear the facility did not have a protocol for the management of suspected methadone overdoses, including an adequate period of observation.

In follow up the Health Authority has committed to review the case and institute clinical guidelines for the management of overdoses.

This is important as methadone use for opiate substitution and chronic pain management is in place throughout the province, including in many small communities where such events may be uncommon.

FINAL Methadone Overdose – BC Coroner Preventable Death Bulletin For Distribution August 2014