UR Nation is Tracking the Case of Brian Koon v. Dr. Henry Walden

| | Evidence Based Medicine, Physician Peer Review, Utilization Review

Toms January 2017 Article Koon v Walden
UR Nation is tracking a new Missouri case. The case is called Brian Koon v. Dr. Henry Walden. Brian Koon, a city parks employee, injured his back while working as a mechanical maintenance engineer. Over the course of several years Koon’s primary care physician, Dr. Henry Walden, prescribed Koon ever increasing doses of opioids.

Koon’s opioid consumption peaked when he was taking Oxycontin, Vicodin and Oxycodone, all at the same time. The most recently released CDC guidelines call for no more than 100 milligrams of morphine-equivalent per day. During the peak, Brian Koon was taking 1,555 milligrams of morphine-equivalent per day. According to the trial testimony, Dr. Walden had prescribed in excess of 37,000 opioid pills over the course of 5 years. That’s more than 20 pills per day.

Not surprisingly, Koon became addicted and eventually entered a drug rehab center. His relationship with his wife also spiraled downward, as family members described him as “a zombie.” Koon’s wife eventually filed for divorce.

As a result, Brian Koon sued Dr. Walden for medical malpractice. At trial, Koon’s attorney, Tim Cronin, elicited the testimony of expert witness Dr. Paul Genecin, director of Yale Health. He looked at the prescribing pattern and called the doses prescribed by Dr. Walden to Brian Koon “colossal and reckless.”

Tim Cronin asked the jury to find that Dr. Henry Walden had been reckless in his prescribing. He asked the jury to return a big verdict, and they did just that. The jury awarded Brian Koon $1.4 million in compensatory damages and awarded Koon’s wife $1.2 million. In addition, Tim Cronin asked the jury to send a message to Dr. Walden and St. Louis University. The jury agreed to the tune of $15 million in punitive damages. You may recall that punitive damages are designed to punish the defendant.

I have recently been in contact with Tim Cronin’s office and have learned that Dr. Walden’s attorney, Paul Venker, has filed an appeal. Looking at the Missouri Court of Appeals docket for the Eastern Appellate District, I verified that the notice of appeal has been filed. No briefs have been filed yet.

I don’t want to speculate as to what arguments Dr. Walden’s legal team will make in their opening brief, but it will be interesting to see what they argue. For example, to what extent does Brian Koon share in the responsibility with respect to his opioid addiction? Was the punitive damage verdict excessive? Should Koon’s wife have been able to recover $1.2 million when there were likely multiple causes for the divorce?

While the outcome is uncertain, one thing is clear. This case should send a strong message to prescribers that they need to be extra careful when prescribing opioids. Otherwise, a medical malpractice lawsuit could be waiting at the end of the opioid trail of tears.

Tom Swiatek

Tom Swiatek

As Assistant Vice President of Regulatory Services, General Counsel, and Editor in Chief of UR Nation, Tom Swiatek draws on his experience as an insurance attorney on both the general liability side, as well as on workers’ compensation matters. As a California Workers’ Compensation Section Member, Tom is leading the discussion with respect to the regulatory challenges and opportunities facing the workers’ compensation system.