By Liz Collin

MINNEAPOLIS (WCCO) — A Twin Cities family believes the system failed to protect their daughter from powerful prescription drugs. Marcy Small Hoffman died of a drug overdose four years ago. But her family’s questions about her doctor’s prescribing practices have gone unanswered.

As police officers, Dave and Karin Small were used to seeing the chaos that addiction can cause.

“It was hard to go to work with Marcy’s issues heavy on your heart and then deal with other people also,” Karin Small said.

“When it’s an everyday occurrence and it’s you, it’s totally different,” Dave added.

Still, nothing could prepare them for the turmoil that unfolded for their daughter. After a life-long struggle with her weight, Marcy had gastric-bypass surgery when she turned 30.

In two years, Marcy dropped more than 200 pounds. But complications from her weight loss followed.

“So they put her on pain medications for that. And that seemed to be the beginning,” Dave said.

Soon Marcy was divorced and her 15-year career as an insurance adjuster ended.

“She got to the point where she couldn’t function anymore at her work,” Small said.

Marcy Small Hoffman (credit: CBS)

Marcy’s family watched as a prescription drug addiction set in. Their daughter said her more recent pain came from a nerve problem with her foot.

“Although, that didn’t cause her to walk with a cane, didn’t cause her to limp or anything else,” Dave said.

“That’s what she was being prescribed all of these pain medications for was some nerve condition in her foot that I don’t even know existed or not,” he added.

Over the years that would pass, Marcy was in and out of treatment and the hospital. Records show she was ordered to remain in the hospital on mental health holds at least twice. As her parents continued to call her psychiatrist and medical doctor for help.

Communication, they say, went nowhere because of Marcy’s age.

“You have no control over them or their medical care,” Karin said.

“I was very upset that this was continuing to go on and they were not addressing this issue at all. Her doctor knew she was a recovering addict and that she had been in treatment numerous times. That was not hidden from her. But she still continued to prescribe pain medications in large quantities,” Dave said.

Marcy died in 2015 at the age of 43 from a mix of methamphetamine and oxycodone abuse. Her family couldn’t believe what they found in her apartment.

In all, Marcy was prescribed four different medications by the same doctor — 481 pills in the last month of her life alone.

“When we saw the medication we thought how could that possibly be? How could anybody prescribe that much pain medication?” her parents questioned.

WCCO is not naming the doctor because she hasn’t been disciplined for doing anything wrong in this case or in the past. Marcy’s parents filed a formal complaint with Minnesota Board of Medical Practice. The watchdog group is charged with protecting the public by keeping tabs on the people who practice medicine. Three years after Marcy’s family filed that complaint, they have yet to receive any answers.

The executive director of the medical board, Ruth Martinez, declined an on-camera interview for this story. Privacy laws keep her from talking about this specific case. But she did say every complaint is taken seriously and that most of the nearly 1,000 complaints a year are resolved in less than a calendar year.

The Board of Pharmacy’s executive director agreed to look at Marcy’s records for WCCO.

“This is the time period that pain became the fifth vital sign,” Cody Wiberg said.

He questioned Marcy’s years-long prescription to Tramadol.

“But the issue does become that tramadol and oxycodone are both opiates. There is some risk if it’s not being prescribed and utilized appropriately that that combination can cause problems,” Wiberg said.

Ultimately, he says Marcy’s case comes down to what her doctor, psychiatrist and pharmacist all knew and when. He believes new laws and more education may have changed what happened here: a program that mandates health care professionals to report prescriptions goes into effect in 2021.

Still, Minnesota doctors checked the prescription monitoring program a quarter of a million times last month. That’s up 80% from the same time last year.

“I think that is having an impact and it could have had an impact in a case like this,” Wiberg said.

Awareness that came too late for the Smalls as they still await a resolution.

“I just want some closure to this whole thing,” Dave said. “I just want someone held accountable for my daughter’s death.”

This isn’t the first time families have questioned the system. Two years ago, a WCCO Investigation into the death of Mike Arens exposed questionable prescribing practices by a Twin Cities psychiatrist. Within months of our story, Dr. Faruk Abuzzahab gave up his license to practice before the medical board ever took any action on the formal complaint the Arens family filed more than a year prior. He has never re-applied for his license.

Liz Collin