KANSAS CITY, Mo. _ Stephanie Price's last phone conversation with her son burns in her memory.
It was Thursday, Aug. 18, 2016. Price's son, Jeromy Bubacz, was about to be discharged from Stormont Vail Health in Topeka after a minor medical procedure.
Bubacz, 29, had been fighting prescription drug addiction for years after he was diagnosed with sarcoidosis, a lung condition that cost him his position in the U.S. Marine Corps.
Price, who lives in Olathe, Kan., had been by his side for most of it, shepherding him toward sobriety.
"I said, 'Jeromy whatever you do, please do not leave there with prescriptions,'" Price said, recalling their last conversation. "(He said), 'I know Mom, I know. It's fine, Mom.'"
Bubacz left Stormont that day with prescriptions for 120 opioid pain pills and 30 tablets of alprazolam, a benzodiazepine anti-anxiety medication commonly called Xanax.
Some time late the next night, Bubacz died of a drug overdose.
Price called it an "astronomical amount of pills" and could not understand why they were prescribed. Bubacz's VA medical records, which she assumed would transfer with him, said he had a history of "opioid dependence." Price said she's not received any explanations from Stormont Vail and she filed a formal complaint with the hospital last month.
In response to calls and emails from the Kansas City Star, Kara Welter, Stormont's director of marketing and communications, said the hospital does not comment on patient care and released the following statement when asked if it was investigating Bubacz's death:
"As a health care facility, we have a process for case review according to Kansas statutes regarding the quality of patient care delivered," Welter said. "By law, results are protected and cannot be disclosed."
The coroner's report determined that Bubacz suffered an accidental overdose of oxycodone and alprazolam, with his advanced sarcoidosis a contributing factor. The report also included photos of the pill bottles that were brought in with him.
In addition to his VA medications, Bubacz had three bottles prescribed by Stormont physician Corbin McIlvain and filled at a Topeka CVS Pharmacy on Aug. 18, the day Bubacz was discharged.
The prescriptions were for 60 pills of 10-milligram OxyContin, 60 pills of 5-milligram oxycodone hydrochloride and 30 pills of 2-milligram alprazolam. After Bubacz died, only 16.5 alprazolam, 11 OxyContin and four oxycodone pills remained.
McIlvain has been licensed to practice in Kansas since 2007 with no disciplinary actions against him.
But Andrew Kolodny, a Massachusetts physician who is the executive director of Physicians for Responsible Opioid Prescribing, said Bubacz's case raised all sorts of questions.
"There's so much wrong here, it's hard to know where to begin," Kolodny said.
Kolodny said Bubacz's addiction history should have been a red flag. But even without that history, Bubacz should have received no more than three days' supply of opioids, if any, after such a minor surgery and should not have been given opioids and Xanax together.
"The combination of opioids and benzos is just absolutely not appropriate," Kolodny said. "That's a very dangerous thing to do."
Kolodny also said that Bubacz should not have been given two opioids at once. He said some physicians prescribe OxyContin, a long-acting opioid, as a baseline for pain management and then add oxycodone to be taken as needed for "breakthrough pain."
But it's not good practice.
"All of that is ridiculous, it's nonsense, it's a practice invented by the (pharmaceutical) industry," Kolodny said. "There should have been no OxyContin."
Bubacz's death was one of a record 60,000 fatal overdoses nationwide last year, according to preliminary data. Compared to most states, Kansas has had few deaths, but the state's opioid problem is growing.
Between 2013 and 2015, Kansas' prescription opioid overdose death rate increased by 28 percent and heroin deaths increased by 71 percent.
Still, Kolodny said Bubacz's death stands out.
"I think this may be an extreme case," Kolodny said. "I sure hope it is."
Price said she doesn't want her son's death to become lost in a sea of opioid headlines. He was not a statistic, she said. He was a Marine. He was funny and creative. He loved music and fashion, especially Air Jordan sneakers. He was her son.
"You put so much energy and time into children who suffer from addiction, and it's only because you want to protect them and save them," she said. "And I couldn't save him."
"He never did heroin. He never did any street drugs. Because he didn't have to. His lungs gave him the ability to get prescriptions. But no doctor that he saw _ no doctor _ ever gave him that amount of prescriptions. Ever."
