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Report: Morphine overdose contributed to nursing home death

An excessive amount of morphine contributed to the February death of an Alzheimer's patient at a Chapel Hill nursing home, according to a medical examiner's report released late Thursday.

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Britthaven nursing home in Chapel Hill
CHAPEL HILL, N.C. — An excessive amount of morphine contributed to the February death of an Alzheimer's patient at a Chapel Hill nursing home, according to a medical examiner's report released late Thursday.

Nine of the approximately 25 patients in the Alzheimer's unit at Britthaven of Chapel Hill tested positive in mid-February for opiates, a class of controlled substances often used for pain management, officials said. Six of them were hospitalized, and 84-year-old Rachel Holliday, died on Feb. 16.

An autopsy wasn't performed on Holliday, but a medical examiner who reviewed her records determined that she died because of pneumonia-related asphyxiation, according to the medical examiner's report. The report lists "morphine toxicity" as a contributing factor to her death, noting that tests done at UNC Hospitals determined she had a morphine level of more than 50,000 nanograms per milliliter of urine.

Drug testing done in the military and many workplaces considers a morphine level of 2,000 nanograms per milliliter as a positive test result.

Officials have said Holliday and some of the other Alzheimer's patients who tested positive weren't supposed to be receiving any pain medication at Britthaven.

The medical examiner couldn't determine whether Holliday died because of a homicide, an accident or natural causes.

The State Bureau of Investigation and the Medicaid Investigations Unit of the state Attorney General's Office are looking into possible wrongdoing at Britthaven, at 1716 Legion Road. Details of their investigations haven't been made public yet.

A spokesman said the Kinston-based company is cooperating with the investigations.

The state Nursing Home Licensure Section sent a team of inspectors to Britthaven two days after Holliday's death to gather information about drugs administered to Alzheimer's patients there.

Britthaven tested all staff members of the Alzheimer's unit for drugs and placed them on paid leave. The tests came back negative, and the spokesman said some of the staffers have since returned to work.

Britthaven of Chapel Hill now monitors the Alzheimer's unit around the clock, and officials have replaced some medication and eliminated some dietary supplements for patients.

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