A West Australian coroner has recommended restricting the prescription and use of fentanyl patches after a 54-year-old woman overdosed in hospital from the pain treatment.
Marjorie Joy Jarick was given various opioids to treat chronic post-operative pain at Rockingham Kwinana District Hospital in July 2013, but nursing staff didn't realise she'd been given too much until it was too late.
Her doctor over-estimated her level of opioid tolerance, based on calculations of what she'd been exposed to before surgery, Coroner Sarah Linton said in findings released late on Thursday.
Medical experts told Ms Jarick's inquest earlier this year that fentanyl patches were overused for chronic pain treatment in Australia.
There have been about 550 fentanyl-related deaths nation-wide since 2010, most of them unintended due to the use or misuse of transdermal patches.
Professor David Joyce said they had a "beguiling appearance" - tiny bits of skin-coloured plastic - and preconceptions about the skin's ability to prevent toxins entering the body, as opposed to injecting or ingesting a drug, provided a false reassurance they were benign.
"The dose is in micrograms, which sounds very little but is because fentanyl is so potent," Prof Joyce said.
The coroner deemed the woman died by misadventure, saying closer monitoring of the patient might have alerted hospital staff that she was succumbing to respiratory depression, but the signs had been subtle.
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