Rescuers and hospital workers in western Illinois might have saved Prince from a first opioid overdose, but a new lawsuit is questioning whether they did enough to try to prevent the second one that killed the superstar singer a week later.
Prince's six heirs filed a wrongful-death lawsuit in Illinois on Friday, one day ahead of the deadline in that state for submitting the claim, against Trinity Medical Center in Rock Island, Ill. The lawsuit was made public Monday in Cook County Circuit Court in Chicago.
The suit questions the roles of a doctor and pharmacist at the hospital on April 15, 2016, when Prince suffered an overdose on a flight home from a concert in Atlanta and needed emergency medical attention.
Prince died April 21, six days later, from a second overdose in his Paisley Park estate in Chanhassen. Pharmacy chain Walgreens also is named in the suit because it dispensed opioid medications in the name of Prince's longtime friend and Paisley Park manager Kirk Johnson that actually were meant for Prince.
"We will have much to say when the time is right," said John Goetz, the attorney who filed the suit on behalf of the family. "We have client interests to protect at the moment, including our theory of the case. What happened to Prince is happening to families across America. Prince's family wishes, through its investigation, to shed additional light on what happened to Prince."
Investigative records, released last week after state and federal authorities closed their criminal inquiry into Prince's death, showed the early morning in Illinois to be tumultuous. Prince declined medical testing and treatment, even as he and friends came to understand the risks and potency of the drugs he was taking to manage pain.
"It's like my soul left," he said, according to an account about the overdose that musician Judith Hill later provided to investigators. "I could hear you. I could hear everybody talking and I kept saying, 'how am I going to get back to my body?' and it was the hardest thing."
According to investigative records:
When Prince's plane made an emergency landing in Moline, Ill., Johnson carried him from the plane. He was breathing about four breaths a minute, paramedics told investigators. They scrambled to revive him on the tarmac with an initial dose of 2 milligrams of the opioid antidote naloxone — twice what it takes to revive a "casual narcotics user," they said. Yet Prince barely responded, so they gave him a second dose, and he gasped for air.
Paramedic Justin Fredericksen asked Johnson what Prince had taken. Johnson responded that he sometimes takes Percocet, an opioid painkiller, after a show. (Johnson's physician had given Prince a prescription for Percocet under Johnson's name the day of the concert.)
Donald "Ed" Wright II, the primary nurse who treated Prince at the medical center, told investigators that Dr. Nicole F. Mancha had requested a "standard set" of tests for an overdose, which would have included an electrocardiogram (EKG), a blood draw and a urine toxicology screening. Prince repeatedly refused the tests.
Doubting that Percocet alone could have caused such a severe overdose, Mancha pressed Prince and Johnson to disclose other drugs that might have been involved.
Hill, who was in the hospital room with Prince, later told investigators that the medical staff told Prince they could not let him leave unless they knew what he'd taken, "because you could die depending on what it is." Johnson looked in a bag Prince carried and found nothing suspicious, she said.
"Prince was awake and more conscious. He says … to us, 'There is something else,' " Hill recalled. He directed Johnson to a Bayer aspirin bottle containing white, oval pills marked "Watson 853."
Wright said Prince told him that "someone gave it to him to relax," but Prince never said where he got it.
A pharmacist at the hospital inspected one of the pills, confirmed that it appeared to be prescription Vicodin — a combination of hydrocodone bitartrate and acetaminophen — and returned it to Prince.
The pills actually were counterfeits that contained hazardous levels of fentanyl, a synthetic opioid 50 times more powerful than heroin.
Investigators didn't confirm that until days after the singer's death. An autopsy confirmed that Prince died at age 57 of a fentanyl overdose.
The lawsuit does not specify how the Illinois doctor or pharmacist failed, other than that they "failed to timely and appropriately investigate the cause of opiate overdose."
A spokesman for the hospital's parent company, UnityPoint Health, said in a statement Monday that the system was "unable to comment on pending legal matters."
Refused urine drug screen
Emergency room leaders in Minnesota said it would have been unusual to go beyond a visual pharmacy examination of the pills Prince had been taking — though it was technically possible to test them. A urine drug screen could have led medical authorities to the realization that Prince had overdosed on fentanyl — or certainly a more potent substance than he thought he was taking — but the singer refused the test.
Tammera E. Banasek, a partner with the HeplerBroom law firm in Chicago with experience in medical malpractice and wrongful-death cases, said the standard of care in Illinois is what a reasonable doctor would do under similar circumstances.
"Whether or not these doctors [at Trinity] are reasonable or not, that's to be litigated," she said.
Banasek did not want to comment specifically on the Prince case. She said all patients have the right to refuse medical care, a fact that could be a possible defense for the defendants.
According to the investigative records, Hill told investigators that she tried to persuade Prince to agree to the medical tests. She said he told her that he was concerned, too, but just couldn't take them in Illinois and would do so when he returned home. She figured that he was concerned about the publicity.
Investigators later concluded that Prince did not know the pills from his Bayer bottle contained fentanyl. Even without that knowledge, friends the following week were making arrangements for him to receive addiction treatment.
Authorities last week closed the death investigation, saying they were unable to identify the source of the fatal fentanyl. No one was arrested or criminally charged in the case.
Dr. Michael T. Schulenberg, a Twin Cities doctor, agreed to a $30,000 federal settlement for allegedly prescribing Percocet (not fentanyl) to Prince in Johnson's name.
The statute of limitations for filing the wrongful death suit in Illinois expires two years after a death — in this case, April 21.
Staff writer David Chanen contributed to this report. Jeremy Olson • 612-673-7744 Dan Browning • 612-673-4493