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A Chicago jury ruled on November 17, 2008, that subsidiaries of Johnson & Johnson must pay $16.6 million to the family of a woman near Chicago who died of a drug overdose after using a defective Duragesic patch as a pain killer.

The woman, 38, died in February 2004 because the patch she was wearing delivered a fatal dose of the narcotic fentanyl, the main ingredient in the Duragesic patch, a jury said.

The patch manufactured by Alza Corporation, a company based in Mountain View, California, owned by Johnson & Johnson. The product was distributed by another unit of the company, Janssen Pharmaceutica.

In 2007, The patches generated $1.16 billion in sales.

Last month, a jury in Sanford, Fla., awarded more than $13 million to the family of Susan Hodgemire, who died after using a Duragesic patch in 2002. The companies have faced several other lawsuits related to the patch.

Janssen recalled one lot of the patches because of improper sealing a day after the victim passed away.

On October 29, 2008, a Seminole County jury in Florida granted $13.3 million to family whose mother died when a pain patch failed, flooding her system with too much medicine. The victim had been in the process of recuperating from back surgery when she put two Duragesic patches on her arm June 7, 2002.

The very next day, she passed away.  She overdosed on fentanyl, the medicine in the patch. Fentanyl is a powerful opiate which functions similar to heroin in the body. Patients who overdose on the drug may experience weak, shallow breathing (hypoventilation), low blood pressure, unconsciousness, and other life threatening symptoms.

The plaintiff’s family sued the maker of the patch, ALZA Corp., and its distributor, Janssen LP, alleging the patch was defective.

Health officials in the United States announced on July 24, 2008 that at least 1,013 people died of overdoses in several U.S. cities from 2005 to 2007 after illegally injecting the highly potent painkiller fentanyl.

The fentanyl, at least some of which came from Mexico, was sold illegally by drug dealers on U.S. streets, sometimes mixed with cocaine and heroin, according to a report issued by the U.S. Centers for Disease Control and Prevention.

The Chicago area had the most deaths with 349, followed by Philadelphia with 269, the Detroit area with 230. Additional deaths were reported in St. Louis, Missouri, and the states of Delaware and New Jersey.

Emergency medical personnel reported finding some victims with the needle still in their arms, not having completed the injection because the drug was so powerful, said retired CDC public health service officer Dr. Stephen Jones, who wrote the report.

The fentanyl caused perhaps hundreds of other deaths not reflected in the official tally of 1,013 deaths, Jones said in a telephone interview.

“I think this is an extraordinary episode of fatal drug overdoses. But it’s got to be recognized as part of the bigger problem of the increasing numbers of drug overdose deaths in the United States.”

The number of deaths from drug overdoses and other cases of unintentional drug poisonings jumped from 11,155 in 1999 to 22,448 in 2005, the CDC noted, with powerful painkilling drugs playing an important role.

The fentanyl used in Chicago and Detroit was believed to have come from an illicit production facility in Toluca, Mexico that was shut down by authorities in May 2006, the CDC said.

Fentanyl is used medically to treat pain in cancer patients and others but also is abused for recreational use.

“One gram of pure fentanyl can be cut into approximately 7,000 doses for street sale. Manufacture of (fentanyl) requires minimal technical knowledge, and recipes for making (fentanyl) are available on the Internet,” according to the report.

“The unknowns of what somebody can obtain on the streets and misuse are a very obvious message from this outbreak,” Nick Reuter of the U.S. Substance Abuse and Mental Health Services Administration said in a telephone interview.

Jones said the recent deaths marked the worst known outbreak of U.S. fentanyl deaths. An earlier series of deaths in the 1980s included at least 110 fatal overdoses, he said.