An opioid was prescribed for Sarah Fuller, a former certified nurse's aide in New Jersey in January 2015. Fourteen months later, she was dead.The Drug is Subsys and it has only been approved by the Federal Drug Administration for catastrophic cancer pain.

The first thing you have to know about Sarah Fuller is that she did not have cancer - what she had was neck and back pain as a result of two auto accidents. Doctors had prescribed painkillers for her that ended up damaging her kidneys and resulted in an addiction she had to beat cold turkey. So when she visited a new doctor in August 2014 and told the doctor of her past history, she received prescriptions for oxycontin, percocet and eventually Subsys.

Documents filed in a lawsuit in New Jersey Superior Court indicate Fuller ended up with the wrong doctor and a fatal prescription. The doctor's license was suspended in October 2016 because of the Fuller case and two other cases in which she had prescribed Subsys for patients who did not have cancer.

Drug deception captured in call

The fate of Sarah Fuller is hard enough to deal with when the facts are written in the cold, gray legalese of a lawsuit petition. This week for the first time, thanks to an investigation by Sen. Claire McCaskill, D-MO, the exact words that allegedly led to the 32-year-old's death can be heard. McCaskill released an audio recording on YouTube in which a representative of InSys, the Arizona company that manufactures SubSys, can be heard using misleading information to obtain the prescription for the deadly opioid.

At two points in the conversation, the InSys representative says she is "from the doctor's office." At another point, when she is told that SubSys can only be prescribed for catastrophic cancer pain, the woman says the patient has "catastrophic pain," omitting the word cancer.

For the next 14 months, Sarah Fuller sprayed the medication under her tongue every four hours, six times a day.

The insurance company paid $336,000. On March 25, 2016, 14 months after Sarah Fuller began using SubSys, her fiance found her dead on the floor of their apartment.

InSys is not the only company being investigated by Sen. McCaskill, but the Sarah Fuller story has become a focus of the probe and the New Jersey woman has become the symbol for an opioid crisis that has grown at a meteoric pace over the past few years.

Drug Company response

As for the company that manufactures Subsys and has found itself the subject of lawsuits, criticism, and scorn, InSys' public posture is that it "is taking appropriate steps to ensure appropriate policies and procedures are in place."That carefully worded statement does not cut it with those who say pharmaceutical companies' greed is at the heart of the opioid epidemic. The Insys approach to maximizing profits is highlighted in a segment of the McCaskill report:

"Employees, for example, reportedly falsified medical histories for prospective Subsys patients, “fraudulently assert[ing] that a patient had a cancer diagnosis regardless of the patient’s history and regardless of whether the prescriber had prescribed Subsys® for a different diagnosis.”

According to the McCaskill report, it is an approach that raked in obscene profits for the company and drained millions from taxpayers. For Sarah Fuller and who knows how many other patients, that alleged fraud appears to have cost them their lives.