RALEIGH -- A patient at a state-run drug-treatment center in Butner died after workers gave him a lethal overdose of methadone.
Jeffrey S. Harbin, 42, died Aug. 15 following a brief stay at the R.J. Blackley Alcohol and Drug Abuse Treatment Center. An autopsy report completed in February showed Harbin had methadone in his blood at twice the level considered toxic.
It was the second time Harbin had received a methadone overdose at the center in less than a year, though he did not need the drug at all.
The death prompted federal regulators to find that patients at the center were in "immediate jeopardy." Violations were issued in four major areas.
Despite the findings, which imperiled the center's ability to receive federal funding, officials at the state Department of Health and Human Services would not release the full report or basic information about the death - including Harbin's name.
Methadone is a synthetic opiate often prescribed to addicts to blunt the painful effects of heroin withdrawal.
Harbin, who lived with his grandmother in Mebane, had struggled with drugs and alcohol since he was a teenager. When admitted to Blackley Aug. 12, Harbin told a doctor he had been using a gram of heroin a day, according to his medical records.
The doctor prescribed methadone without waiting for the results of a urine test to confirm the addiction. The results of that test showed Harbin had been using cocaine and marijuana but was negative for heroin.
However, doctors at Blackley failed to review those results, or the results of subsequent urine tests, before increasing Harbin's dosage of methadone, according to the federal report.
Harbin's family said he abused cocaine but they never knew him to use heroin.
"Jeff had his problems, but he went there for help," said Donna Shelton, his mother. "He shouldn't have died from drugs they gave him."
Renee McCoy, spokeswoman for DHHS, said Tuesday she could not comment on how Harbin died.
Unknown causes cited
Blackley, which has 75 beds, serves male and female patients from a 26-county area in central part of the state, including the Triangle.
On Aug. 13, the night after Harbin was admitted, he complained he didn't feel well and appeared drowsy, his medical records say. He was later seen unconscious in his room by a staff member, who assumed he was sleeping.
Shortly after midnight, a fellow patient found Harbin on the toilet, his head between his legs and blood dripping on the floor from his mouth and nose, according to his medical records.
Harbin was taken to Durham Regional Hospital but never regained consciousness.
Though records show that state doctors quickly suspected that Harbin died of a methadone overdose, the information was not shared with his family. His death certificate initially said he died of unknown causes.
The autopsy report on Harbin, completed Feb. 9, determined that his recent cocaine use triggered a harmful reaction to the high dosages of methadone, causing his heart to stop.
Federal regulators went to Blackley on March 4, nearly seven months after Harbin died, and determined the facility had failed to adhere to basic policies and procedures for administering the dangerous opiate.
In a 24-page report issued March 18, the investigators cited their interview of the facility's medical director, who suspected a methadone overdose within hours of Harbin's death.
"The interview revealed he had concerns when he saw the (urine test result) was negative for opiates (heroin) and positive for cocaine," the report said. "The interview revealed giving methadone to a patient with cocaine in their system was serious since the two drugs should not be given together."
The report also says that Harbin's doctor failed to review the results of the patient's urine tests before prescribing methadone, though that information was available.
The names of the state doctors involved are not disclosed in the federal report. It was not immediately clear Tuesday whether any state workers were disciplined following the death, though the facility has stopped using methadone to help detox heroin addicts.
The first OD
Harbin's medical records show that the August incident was not the first time Blackley's staff gave him too much methadone.
During a stay there in November 2008, Harbin's heart stopped after he was given large doses of the drug. Harbin was revived with CPR. After recovering in the Durham hospital, he was returned to Blackley.
Harbin's mother, who lives in Little River, S.C., said she is still haunted by the loss of her son. But she finds some comfort in knowing the true cause of his death.
She knew nothing of the federal investigation or the violations cited against the facility until she was contacted by The News & Observer.
"What happened to my son needs to be known so it doesn't happen to anyone else," Shelton said. "I want them to acknowledge what they did and own up to it."
