The family of a Calgary woman who died of a toxic combination of prescription drugs wants physicians to be more vigilant in prescribing medication.

Jodie Bruketa, seen in the pamphlet handed out at her funeral, died of an overdose of prescription drugs when she was 28.
(Bruketa family)

Jodie Bruketa, 28, died in January 2004 from an overdose of the painkiller Percocet — which contains a powerful narcotic called oxycodone — and Zopiclone, a sleeping pill. The amount of oxycodone in her blood was about five times the amount expected in someone taking a regular prescription.

Bruketa, who worked as a marketing assistant, was prescribed hundreds of pills in the two months before her death, primarily from one doctor. In total, she visited five different physicians in less than a year.

A program that has been in place in Alberta since 1986 is designed to flag unusual prescription patterns and catch patient behaviour like Bruketa's, but the College of Physicians and Surgeons of Alberta admits the system failed in her case because it was backlogged.

"You feel sick in the stomach," said Bruketa's mother, Debbie, from her farm southwest of Calgary. "I mean, what's the point of the program if it's only useful after the fact?"

'You feel sick in the stomach. I mean, what's the point of the program if it's only useful after the fact?'

—Debbie Bruketa, mother

Under the Triplicate Prescription Program, copies of drug prescriptions are sent to the college, where they are entered manually into the system by six full-time staff.

The college's assistant registrar, Dr. Janet Wright, said there are simply not enough workers to deal with the million prescriptions processed every year in Alberta.

"If we had a more robust and quicker system, perhaps these doctors would have been notified and had a warning. And they didn't have that," she said.

Wright said the program works in most cases because addictions usually last a long time, which allows unusual patterns to be identified. When the system catches anything unusual, a letter is sent alerting the doctor.

The college sent 1,800 of those letters last year, but Wright said Bruketa's situation escalated so quickly that the program didn't have time to catch it. It's those urgent addiction cases that Bruketa's parents want to prevent.

Overdose surprised parents

Bruketa was diagnosed with diabetes when she was 16. A car accident in 1999 left her with recurring headaches.

Two months before she died, the Bruketas rushed Jodie, who lived alone in Calgary, to the hospital, thinking she had the flu. She was discharged an hour later after a doctor spoke to her.

When Debbie Bruketa confronted the doctor, who is bound by confidentiality restrictions, she was told only that her daughter was taking too much Tylenol. Bruketa's parents believed her illness was caused by a combination of the flu, her diabetes and too much Tylenol.

'It's not so much as blaming as it is to try to make something better from this and try … to make something good out of something that is very tragic.'— David Bruketa, father

"I'm still haunted by this to this day — that I had her in a hospital, and she could have been saved and she wasn't," said Debbie Bruketa.

Two months later, Jodie Bruketa was dead. The Bruketas believed her death was caused by diabetes complications until a phone call from the medical examiner's office told them otherwise.

"She said Jodie did not die of diabetic complications but she had a drug toxicity, that she was given large doses of Percocet — 100 and 200 tablets," said Debbie.

'Wouldn't you ask questions?'

"When you come to a walk-in clinic — a young girl coming to a walk-in clinic for a narcotic — does that not raise a red flag of addiction? Wouldn't you ask questions?

"She asked for it and they gave it to her. And they had to take charge. And I believe some doctors would not have given it to her and she may still be alive. But when you ask and they just give, to me, that's wrong. And it was deadly."

'When you ask and they just give, to me that's wrong. And it was deadly.'— Debbie Bruketa, mother

Debbie and David Bruketa sent an emotional letter to the College of Physicians and Surgeons last month, outlining their concerns about the way Jodie died.

"I do feel that the system failed her because how many cracks are there? OK, maybe you slip once, but do you keep slipping? And we have paid the ultimate price, so the cracks need to be filled," said Debbie.

Parents' plea published in doctors' newsletter

In an unusual move, the college published the parents' plea for change in the way the medical system deals with prescription drug addictions.

Wright said the letter was printed in an effort to capture the attention of doctors, so they would perhaps take a step back and question their prescribing practices.

"We need to be careful. We need to be vigilant," said Wright.

"I would just like to see physicians and patients … work together to address this, for doctors to be thinking that this is a possibility when someone presents to them, so we're not contributing to tragedies like this one."

Doctors need to reassess symptoms: expert

Dr. Raju Hajela, an addictions consultant in Calgary and former president of the Canadian Society of Addiction Medicine, said doctors try to balance prescribing medication for chronic pain and scrutinizing patients for any signs of addiction.

But often doctors are overworked, and the quickest way to deal with patients is to give them the drugs they're seeking.

"Because of the shortage of doctors and the great pressure that doctors are under to see patients quickly, often there isn't enough time available or allocated to do a proper assessment," said Hajela.

College hopes to tap into new database

Instead of hiring more people for the Triplicate Prescription Program, the college hopes to gain access to a new electronic database in Alberta within the next year, Wright said.

Pharmacists currently enter information on drugs they dispense into a computer system. The college plans to connect with that database so it can flag potential problems within a day or two.

"For us, it's not so much as blaming as it is to try to make something better from this and try — just for Jodie's sake — to make something good out of something that is very tragic," said David Bruketa.