Dr Christos Marantos told the inquest he did not consult a specialist about Mr Atkins’ medication. (ABC News: Rebecca Opie)
The doctor for a Flinders Medical Centre patient who was allegedly given a lethal dosage of painkillers has admitted he should have consulted an acute pain specialist and reduced the medication.
Stephen Robert Atkins died suddenly in the hospital in March 2015, just three days after being admitted to undergo tests for chronic neck pain.
The inquest before deputy state coroner Jayne Basheer has heard he was subjected to a “disastrous pain management regime” which involved the strong opioid medications fentanyl and oxycodone.
It has heard Mr Atkins was not closely monitored as he should have been given the combination of medications, and that there were no assessment notes from the last few hours before his death.
On Wednesday, Dr Christos Marantos was called to give evidence and admitted he did not consult a specialist about Mr Atkins’ medication.
“With the benefit of hindsight I should have had a conversation with the acute pain service or discussed the pain management with [another doctor],” he said.
Dr Marantos said he also now believes he should have reduced the medication.
“In retrospect I should have stopped the fentanyl and just stuck to the one opiate and oxycodone only,” he said.
The inquest heard Dr Marantos had only recently undergone specific training in acute pain management as a result of gaining employment at the Royal Adelaide Hospital.
He said he now knows that an opioid medication should not be administered to a patient within an hour of another opioid drug and that the patient should be closely monitored for symptoms.
“I wasn’t aware of these things at the time, I hadn’t had the education,” Dr Marantos said.
‘Nothing changed’ after concerns were raised, lawyers says
Stephen Atkins, who died at Flinders Medical Centre, with his wife Lee-Anne. (Supplied: Atkins family)
Dr Marantos said he was also now aware of new guidelines which would have changed the way he handled Mr Atkins’ case.
“There [have] been recent guidelines published to say that slow-release opiates shouldn’t be used in acute pain,” he said.
“The American College of Physicians released new guidelines … in 2017 to state that they shouldn’t be used because they are difficult to triturate and potentially unsafe.”
Mr Atkins’ wife Lee-Anne Atkins told the inquest on Tuesday that she reported to medical staff that her husband was feeling groggy, struggling to breathe and feeling sick after being administered the drugs.
The inquest heard symptoms of sedation are a significant warning sign which should be considered when prescribing opioid medications.
Under cross-examination, Dr Marantos said being told someone is “groggy” was not as significant as if the family had specifically told him that Mr Atkins “couldn’t stay awake”.
“I didn’t get the impression that he was sedated from our conversation, and he definitely wasn’t sedated when I saw him,” he said.
“I didn’t get the impression that I needed to go back and see the patient.”
The lawyer representing Mr Atkins’ family, Josie Atkins, said the family made their concerns known and “nothing changed”.
“Doctor, I suggest to you that the very fact family came to see you about their concerns should have been enough to make you go back and review Mr Atkins,” she said.
Dr Marantos said in hindsight he accepts that he should have gone back and re-examined Mr Atkins.
–Top Twitter To Follow: