A Brainerd methadone clinic and its CEO have agreed to be found negligent in a wrongful death lawsuit filed by the families of two Carlton County workers killed in a traffic collision caused by a patient under the influence of the drug in October 2012.
Pinnacle Recovery Services and Dr. John Stroemer have agreed to an $8.55 million settlement with the families of Mitchell Lingren and Zachary Gamache, according to a stipulation filed in State District Court.
The settlement comes ahead of a high-stakes jury trial that was set to begin this week in Duluth.
"I think it makes a statement," said Phil Sieff, an attorney for the families. "If you are going to be involved in the treatment of opioid-dependent people, you can expect that members of the public will seek to hold you accountable. A lack of accountability is not going to be inconsequential."
Unlike most agreements in civil cases, Sieff said it was important to the Lingren and Gamache families that the terms of the settlement be made public and that a finding of negligence be entered in the public record.
"This case shows us that significant reform remains to be accomplished," he said. "Methadone treatment, in a vacuum, is fine. But it has to be done correctly. If done incorrectly, people get hurt and people die. Until significant reform is made, that is going to continue."
Lingren, 29, and Gamache, 25, were killed in a multi-vehicle crash along Minnesota Highway 210 near Wright on Oct. 1, 2012. Investigation revealed that Vanessa Brigan had crossed the centerline, striking their truck which then careened across the highway and was struck by a large truck hauling construction equipment.
Brigan had received methadone treatment at the Pinnacle clinic in Brainerd earlier in the day. She also admitted to injecting a take-home dose of the drug intravenously before beginning a 100-mile drive back to her home in Cloquet.
Brigan, now 30, is serving a six-year prison sentence after pleading guilty to criminal vehicular homicide charges.
Legal action against Pinnacle was initiated by the families more than three years ago. Sixth Judicial District Judge Sally Tarnowski in August 2014 denied the clinic's motion to dismiss the case, finding that it has a duty to protect the public from actions taken by its patients. Sieff said that ruling was the first of its kind for a methadone clinic in Minnesota.
Attorneys for the families subsequently alleged that Stroemer never conducted a physical examination of Brigan or even looked at her medical records prior to prescribing her a take-home dose of the narcotic.
Gregory Bulinski, an attorney for Pinnacle, said in pretrial motions that Stroemer had relied on the opinions of an experienced team of professionals before prescribing Brigan the take-home dose. He also argued that the clinic could not expected that the patient would get behind the wheel after receiving treatment.
However, defense attorneys acknowledged in the settlement agreement that Pinnacle and Stroemer face a "significant risk" of being found liable for a substantial judgment if the case goes to trial.
"Lengthy and detailed opinions from highly qualified experts in the field of methadone treatment have been disclosed in this case and there would be credible testimony at trial that Pinnacle and Stroemer were negligent in their dealings with Brigan and that Pinnacle and Stroemer's negligence played a substantial part in Brigan's intoxication on October 1, 2012, and the resulting fatal crash," the stipulation states.
The agreement calls for judgments of $5.7 million against Pinnacle and $2.85 million against Stroemer.
The plaintiffs have agreed to seek damages only from West Bend Mutual Insurance Company and the Minnesota Joint Underwriting Association, the liability insurers for Pinnacle and Stroemer, respectively. Both insurers have denied coverage, but suits have been filed in district court seeking to force payment.
"The families have been unwilling to back down or be intimidated," Sieff said. "They're going to continue to do that."
Pinnacle is one of a number of for-profit methadone providers in Minnesota that have come under fire in recent years. The Lake Superior Treatment Center in Duluth was finally shuttered by authorities last summer, nearly three years after the state revoked its license due to dozens of violations.
Stroemer, 65, is Pinnacle's president, registered agent, CEO and former medical director, according to court documents. He has had repeated run-ins with regulatory authorities dating back to his work as a obstetrician in the 1980s.
The Minnesota Board of Medical Practice in 2014 temporarily revoked his medical license, finding that he "routinely prescribed excessive quantities of controlled substances, but failed to assess his patients for their risk of chemical dependency, toxicity, diversion or suicide."
Stroemer prescribed suboxone - which, like methadone, is used to treat opiate addiction - to 92 clients, despite being authorized to prescribe the drug to 30 patients, according to the report. In one case, a patient with a history of drug abuse and prescription forgery was prescribed the drug.
Bulinski, the attorney who has represented Pinnacle and Stroemer, retired from law practice last week and could not be reached for comment. Attempts to reach other representatives of the clinic and Stroemer on Tuesday were unsuccessful.