Martin GasparianRehab facilities often like to project a strong sense of safety and competency. This is particularly common with facilities that offer 24/7 monitoring.
The emphasis in all their advertising is on safety and the promise that you or your loved one will be able to just focus on recovery.
Unfortunately, overdose injuries and deaths happen more frequently than you might expect at rehab locations, with fentanyl being a particularly notorious problem.
Let’s look at why overdose deaths happen at facilities despite their promises. Also, you will learn about who may bear responsibility for overdose deaths and injuries during rehab. Finally, we will discuss how you can pursue justice for yourself or a loved one.
How Often Do Rehab Overdose Deaths Occur?
Hard statistics on the number of overdose deaths in California rehab facilities are difficult to come by. However, reporting by the Orange County Register indicates that a person dies inside a licensed rehab in California about once every two weeks. Even the state itself admits the real number is hard to determine because “oversight is not always timely or thorough.”
The number only includes properly investigated deaths in licensed facilities. If a death occurs at an unlicensed rehab, it doesn’t count toward the number. Deaths that occur after discharge don’t count. Uninvestigated deaths also don’t count.
Worse, even licensed facilities rarely face meaningful penalties when a death occurs. Facilities rarely face shutdowns, and fines may be less than $1,000 per death.
Mandatory Reporting
Notably, California requires reporting of all unusual deaths in facilities. While this might not lead to justice through fines and regulation, it may give an injury attorney a strong starting point for a wrongful death case.
Rising Overdose Rates
California saw overdose deaths statewide rocket between 2019 and 2023, with non-heroin opioid deaths tripling. Fentanyl was the major driver of the rise. Especially when it comes to illegally manufactured fentanyl, the fatally risk is high. The drugs are often laced with other chemicals without the user’s knowledge. For example, the sedative xylazine often appears in illegal fentanyl.
How Drugs Enter Supposedly Secure Rehab Centers
Like any location where there is demand for drugs, rehab centers have people willing to take the risk to traffic them into supposedly secure buildings. Potential vectors for drugs to enter a rehab include:
- Incoming patients
- Staff members
- Visitors
Rehab facilities build their business model on attracting patients, not pushing them away. Consequently, they may refrain from sufficiently thorough bag and body searches of both patients and visitors.
Likewise, facilities often hire people who’ve had substance use disorders because they understand the rehab experience. However, such a person is also at risk of relapse and may begin bringing drugs into the facility. Similarly, a facility may just not perform a thorough enough background check.
The Duty of Care: What Facilities Owe to Patients
Under the California Civil Code, rehab facilities have a duty of care for their patients. Legally, this means they must take all reasonable steps to provide a safe environment for recovery. For example, a duty of care means a facility needs to screen every employee for the risks they might pose to patients. If a facility hires someone with a prior drug trafficking conviction who then supplies drugs to a patient, the facility has violated its duty of care.
Most importantly for surviving family members, this means the facility may be legally liable if a loved one overdoses while under the facility’s care due to that negligence. Facilities need to be mindful of potential dangers, such as:
- Improperly securing confiscated drugs
- Hiring known offenders
- Placing high-risk patients in the same wing as low-risk patients
- Failing to secure legal prescription-only drugs, such as benzos, within the facility
- Ignoring patient red flags
- Not maintaining enough staff
- Failing to properly train staff
- Not stocking naloxone for suspected opioid overdoses
Also, facilities need to be clear about their treatment protocols for when a patient is at the facility and afterward. This means a rehab needs to:
- Perform a full patient assessment during intake
- Individualize treatment plans and update them regularly
- Medically supervise high-risk detoxes
- Provide aftercare planning
- Document all services and incidents
California Code
Notably, California Code specifically outlines requirements for a safe rehab environment. This starts with having safety and security protocols in place. Likewise, there needs to be enough staff members to make the protocols work. Particularly, California requires rehabs to maintain a drug- and alcohol-free environment for recovery.
Staff member training has to address a variety of scenarios that will eventually happen in a rehab. These include events like:
- Misuse of prescribed medications
- Medical reactions to treatments
- Patient relapse
Predatory Rehab Facilities
California has found that its licensing regime hasn’t been sufficient to prevent predatory and unethical practices at rehabs. In 2023, the state passed a law that includes a client bill of rights. This requires facilities to provide clear, accurate, and complete information about their services. Likewise, they must treat patients with respect, honesty, and dignity. To this end, they must be clear about the facility’s business name, its location, the level of care available, and what specific services are available.
The reason the law is necessary is that many facilities, including licensed ones, have lied about their level of care. Facilities are especially keen to advertise that they provide things like 24/7 monitoring, on-site security, and medical intervention in case of reactions. They often don’t deliver on these promises.
The law gives patients and surviving relatives better grounds for demanding compensation. You can bring a claim against anyone who aided or participated in the violations that led to a loved one’s overdose.
Who Is Liable When an Overdose Happens in a Rehab?
Facilities must properly supervise at-risk patients. If they promise 24/7 monitoring, then they should deliver. Likewise, they can’t legally promise high levels of monitoring if they don’t actually provide them.
Even if a facility doesn’t advertise round-the-clock monitoring, the staff still has to perform a reasonable number of wellness checks at regular intervals. This includes room checks for contraband. Likewise, there should be enough security to prevent unauthorized entries or exits. The facility should also screen and monitor visitors, including search requirements for admission.
Note that California has laws against improper discharge. Sober living arrangements need to be in place, including involvement with trustworthy family members, friends, or professionals. The patient may not leave the facility if they are:
- Medically unstable
- At high risk of a relapse upon release
- Lack the necessary support system to safely and securely pursue recovery
Failure on any of these fronts puts liability squarely on the facility or its staff members. Liability often falls on the corporation that owns or operates the rehab. Administrators may be liable, too. Similarly, licensed professionals like doctors and nurses may be liable.
Proving Fault
The basic elements of an injury or wrongful death case involving an overdose are:
- Duty of care
- Breach of that duty
- Direct causation of the injury or death
- Damages for patient harm
The duty of care is the previously discussed legal expectation that the facility take appropriate safety steps. The breach is the failure to do that. Causation means that a specific action led to the injury or death. For example, failing to stock naloxone at a facility with known opioid users might constitute cause in an overdose death because naloxone is highly effective in reversing overdoses quickly.
Damages involve all of the harms that come from a patient’s injury or death. Suppose a person suffered brain damage following an overdose and required advanced care before they passed. The surviving family members would be able to demand compensation for those costs. Beyond medical bills, other potential damages include:
- Lost wages
- Pain and suffering
- Loss of marital companionship
- Funeral expenses
- Loss of enjoyment of life
Documenting Negligence
Claimants must document negligence and show how the facility or its staff failed to meet the duty of care. Documentation may include autopsy and toxicology reports, hospital records from off-site care, visitor logs, security videos, admission assessments, and treatment plans. Also, lawyers often like to present testimony from:
- Other patients
- Former facility employees
- Current staff
- Medical experts
Negligence Per Se
California considers a documented violation to be strong evidence of liability. This significantly improves the odds of winning a case because claimants only have to show the state’s record of the violation. A history of citations also strengthens the case against a facility, even if there wasn’t a documented violation in a specific overdose case.
Getting Justice
You can sue a rehab center in California but you must file a claim within two years of the injury or death to have the right to pursue compensation. Surviving spouses and children often have the best claims under California law. Other parties, like surviving parents, other family members, or the deceased’s estate, may pursue a case if there isn’t a spouse or child alive to make a claim.