NJ Attorney General Files Against Doctor After Woman Dies From 'Adverse Effects of Drugs'

The attorney general said the woman died from "adverse effects of drugs."

ByABC News
October 18, 2016, 8:36 PM
Fentanyl Citrate, a CLASS II Controlled Substance as classified by the Drug Enforcement Agency in the secure area of a local hospital, July 10, 2009.
Fentanyl Citrate, a CLASS II Controlled Substance as classified by the Drug Enforcement Agency in the secure area of a local hospital, July 10, 2009.
Joe Amon/Denver Post/Getty Images

— -- The New Jersey Attorney General is seeking to temporarily suspend the license of a doctor who allegedly prescribed the highly addictive painkiller fentanyl off-label to three patients, according to a court filing.

One of the three patients, according to the court filing, is a 32-year-old woman who died from an "adverse effect of drugs" with "significant levels of fetanyl metabolites in her blood at the time of death."

Dr. Vivienne Matalon, an internal medicine doctor from Cherry Hill, has been accused of "allegedly indiscriminately prescribing a powerful spray form of the painkiller fentanyl" by Attorney General Christopher S. Porrino and the New Jersey Division of Consumer Affairs. The complaint was filed with the New Jersey State Board of Medical Examiners.

"Given that opioid overdoses are killing more people in New Jersey than car crashes, it is appalling that a doctor would willfully disregard the federal restrictions placed on this extremely potent drug," Porrino said in a statement.

Fentanyl is an extremely potent synthetic opioid, with very few approved uses. According to the U.S. Centers for Disease Control, it is "approved for treating severe pain, typically advanced cancer pain. It is 50 to 100 times more potent than morphine."

Fentanyl spray, called Subsys, is a powerful, fast-acting formulation of the drug that is absorbed under the tongue and into the bloodstream almost immediately.

"The only federally approved use for ... Subsys, is for the management of breakthrough pain in adult cancer patients who are already receiving, and who are tolerant to, around-the-clock opiod therapy for their underlying persistent cancer pain," according to a press release from the New Jersey Attorney General's office.

The complaint filed with the New Jersey Medical Board last week alleges that Matalon prescribed the spray form of fentanyl to three patients who did not have cancer or "breakthrough cancer pain." The documents filed with the state medical board argue that Matalon was treating the patient who eventually died for chronic pain, diabetes, fibromyalgia and urinary tract infection.

"Dr. Matalon's actions demonstrate a level of professional misconduct that requires immediate intervention to protect the health, safety, and welfare of the public," the statement continued.

Doctors may prescribe a spray opioid since it is more potent than a pill opioid, Joel Saper, founder and director of both the Michigan Headache and Neurological Institute in Ann Arbor, Michigan, and the Head Pain Treatment Unit at St. Joseph Mercy Chelsea in Chelsea, Michigan, told ABC News.

When the drug is absorbed through a spray it enters the blood stream directly and reaches the brain faster than a pill which is absorbed through the stomach and metabolized through the liver before entering the blood stream, he explained. As a result patients using spray opioids can be more at risk for overdose.

"It's a higher risk because you're getting a quicker higher blood level [of the drug]," Saper explained. "It's not metabolized, so it hasn't been neutralized by the liver."

The complaint argues that New Jersey "is suffering from a grave public health crisis: an epidemic of opiate abuse and addiction."

The complaint goes onto argue that "for many, the path to opiate addiction begins with legally prescribed pain medications" and said that fentanyl has "played an exacerbating role in the epidemic."

Matalon has been ordered to appear before the state Board of Medical Examiners on October 26.

Neither Matalon, nor her attorney responded to ABC News' request for comment.

ABC News' Gillian Mohney contributed to this report