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Grieving parents lobby for research into opioids’ fatal effects on breathing

SHARE Grieving parents lobby for research into opioids’ fatal effects on breathing

SALT LAKE CITY — Parents crushed by their 21-year-old son's untimely death following a tonsillectomy, as well as the doctor who says the painkiller he prescribed to the young man likely killed him, asked lawmakers Tuesday to support a measure formally calling for research into opioids' respiratory side effects.

Yvonne Gardner said the group made the trip from Vernal because they want to spare other families from the searing pain caused by the abrupt loss of her son, Parker Stewart.

"We're hoping that other lives will be saved and ... my son won't have died in vain," Gardner told the Senate Health and Human Services Committee.

The committee voted unanimously to recommend the measure, which would officially recognize the assertion that "opioids have been known to affect the part of the brain that regulates breathing, resulting in respiratory depression and death, particularly in patients who are recovering from a surgical operation."

The nonbinding resolution also calls on "hospitals and academics ... to collect more data about the risks of taking an opioid after surgery." It declares that "deaths from opioid-induced postoperative respiratory depression are often misdiagnosed as pneumonia and are therefore under-reported."

Gardner, who shared the story of her son's death in depth with the Deseret News last month, said Tuesday she was bewildered by the autopsy that concluded Stewart died of pneumonia, since he hadn't shown any symptoms of the illness.

"He wasn't coughing, he wasn't sick, he hadn't shown any signs of disease," said Gardner, who had seen her son the night before as he dropped off Christmas presents. "So to me that didn't make any sense."

Stewart, who his family described as the picture of health, was found not breathing by his wife of only three months on the morning of Dec. 4, 2016. Gardner said it's estimated "he had already been gone for two hours."

Dr. Michael Catten, the ear, nose and throat specialist who performed Stewart's tonsillectomy and prescribed opioids to handle the resulting pain, was rocked by his patient's sudden passing. After examining the details surrounding Stewart's death, Catten has previously said, he was alarmed as he concluded that the opioid he had prescribed him likely caused the young man's sudden respiratory failure.

"One of the main side effects ... is respiratory depression," Catten told the committee. "It can make (patients) not breathe as deeply as they should."

Gardner said she discovered after Stewart's death that he was taking just half his prescribed dose.

There is some existing research into respiratory depression deaths related to opioids, but Sen. Kevin Van Tassell, the sponsor of the resolution, hopes it will promote the collection of more robust data examining the issue in Utah as tangible solutions are sought.

"Hopefully we can gather enough information that we can create protocols that will be effective and save lives in the future," the Vernal Republican told the committee.

Intermountain Healthcare said last month that researchers there were involved in three separate studies examining the feasibility and effectiveness of using different types of at-home breathing monitoring devices on patients.

One of the goals of the studies was to examine whether sending such devices home with patients on a large scale would be doable, according to the hospital system, which has also previously expressed support for Van Tassell's resolution.

Catten, who has been sending patients home with an oximeter when prescribing them opioids ever since Stewart's death, told the committee he is in favor of seeing that practice expand in the medical community.

"The fact is, it's hard to predict beforehand who will have these problems, but we quite simply have the technology to monitor ... these patients... for two to three days after surgery," Catten said.

Sen. Brian Zehnder, R-Holladay, asked Catten whether he believed sending home a monitoring device was advisable and worthwhile for all post-operative patients who are prescribed opioids.

"I'm wondering, for the person that's otherwise completely healthy, who has no conditions, you're suggesting that even those people would benefit from having a pulse oximeter for a few days?" Zehnder asked.

Catten replied by comparing the safety measure to the requirement that everyone wear a hard hat in a construction zone, in which the risk of a worst-case scenario is comparatively low but "the intervention is so easy ... that it shouldn't be an issue."

"We have the technology (to do it) and it's not an expensive technology," he said.

The text of the resolution states that "the use of a low-cost, in-home monitoring device to alert a caregiver of low oxygen saturation would have prevented many ... needless deaths" related to opioids.

Greg Gardner, Stewart's stepfather, told the Deseret News the resolution doesn't provide everything the family was originally shooting for at the Legislature — they were initially hoping for a bill — but that it's a good first step and that "we're excited for the response we've received."

"They've been very receptive from the get-go," he said of legislators. "It's kind of really a no-brainer ... if we can save lives."

Yvonne Gardner said she was encouraged to see medical professionals like Catten look into the issue, which she said lends a layer of credibility to the painful story she is sharing with lawmakers. She thinks that will make the issue all the more a priority at the Legislature long term.

"It's not just (a) mom who lost her son," she said.

The resolution also calls on the Utah Department of Health to "convene a multi-stakeholder, cross-sector group" that would examine best practices as it pertains to preventing respiratory depression deaths resulting from opioids.

It also recommends that health care professionals in general be educated about the risks faced by patients prescribed opioids following surgery and that a copy of the resolution be distributed at the Department of Health as well as to members of the Utah Medical Association.

Both of those organizations testified briefly to the committee in favor of the resolution.

Michelle McOmber, CEO of the Utah Medical Association, told the Deseret News her organization is supportive of the measure because of its call for more research into the fatal incidents families such as Stewart's have described.

"Let's do things based on data. and let's make sure we know what the data is. ... We would like to see what (the) results are," McOmber said.

Dr. Marc Babitz, deputy director of the Utah Department of Health, said his agency was appreciative of the initiative and that "we've already recognized this issue (and) already had discussions with our opioid overdose groups" about how to address it.