The sudden death of a 2-year-old boy from Deerfield has prompted national alerts about accidental exposure to adhesive patches containing a powerful painkiller that can stick to children's skin or be swallowed if not disposed of properly.
"This should never happen to another family again," said Melissa Seamonson, whose son Blake died in November.
The toddler ingested a fentanyl patch two or three days after coming into contact with it at Nazareth Health and Rehabilitation Center in Stoughton, Seamonson and her husband, Brian, allege in a lawsuit against the nursing home.
Blake might have put the clear, tape-like patch in his Halloween candy bucket or run over it with his toy truck while visiting the center, Seamonson said.
The U.S. Food and Drug Administration and the Pennsylvania-based Institute for Safe Medication Practices issued alerts about the danger in April, largely in response to Seamonson's complaints about Blake's death.
The alerts, which cited 26 known cases of accidental exposure to fentanyl patches among children in the past 15 years, said young children are particularly at risk.
"Their mobility and curiosity provide opportunities for them to find lost patches, take improperly discarded patches from the trash, or find improperly stored patches, all of which may result in patches being placed in their mouths or sticking to their skin," the FDA alert said.
The Seamonsons — from Deerfield, about 20 miles east of found their son lifeless when they went to wake him up Nov. 4, according to the lawsuit filed this month in Dane County Circuit Court.
Blake and his family visited Nazareth Nov. 1 to see his great-grandmother, who was on fentanyl patches.
An autopsy found the patch in the boy's throat, which caused his death from "acute fentanyl intoxication," according to the death certificate.
'An unsafe environment'
Nazareth employees told Dane County Sheriff's detectives they have occasionally found patches on the floor, according to a sheriff's report.
A state inspection of the nursing home in February, which Seamonson said was prompted by a complaint from her, found a patch on the bedside table of a resident who had removed it from her body.
State inspectors said the facility's practice of folding used fentanyl patches in half and throwing them in garbage cans in residents' rooms "created an unsafe environment."
The patches should be folded and flushed down the toilet, according to the FDA.
Nazareth told the state and the State Journal its staff is now doing that.
"Providing a safe environment is a top priority, whether it's for residents, visitors or employees," said Carol Russell, a communications consultant from Minneapolis working with Nazareth.
She said the nursing home had no comment on the lawsuit.
While Melissa Seamonson is convinced Blake picked up the fentanyl patch at the nursing home, detectives asked the Seamonsons about pain medication Brian takes for a back injury, according to the sheriff's report.
The detectives found no patches in the house but couldn't rule out the house or another location as the source of the patch found in Blake, Sgt. Mark Olson said.
Melissa Seamonson said Brian used fentanyl patches for a week six years ago but switched to another pain medication, which she declined to name. They disposed of Brian's fentanyl patches, which looked different from the one found in Blake, when Brian stopped using them, she said.
Design, disposal changes
Blake's death is among 10 deaths and 16 other accidental exposures to fentanyl patches reported among children since 1997, according to the FDA.
The FDA alert said the patches, designed to release pain medication over three days, can retain more than 50 percent of the narcotic after that period.
The agency is exploring design changes that could make the patches safer, said Dr. Douglas Throckmorton, deputy director of the FDA's Center for Drug Evaluation and Research.
But some proposals to make them more noticeable, such as coloring the patches or putting a skull and bones on them, could make them more attractive to children, Throckmorton said.
He said the federal government is designing a collection and disposal system for narcotic medications, including fentanyl patches, that could give nursing homes and other places a safer way to get rid of them.
"It might prevent some of these tragedies," he said.
'Being a little boy'
Michael Cohen, president of the Institute for Safe Medicine Practices, a nonprofit organization in Horsham, Pa., said disposal methods for fentanyl patches vary.
Some health care facilities incinerate the patches and others place them with needles and syringes in "sharps" containers, he said.
"There's really a lot of confusion about what to do," Cohen said.
The institute's alert gave some details about other cases of accidental exposure to the patches: a 4-year-old boy died after placing a fentanyl patch used by his mother on his body; a girl sat on a patch, leading it to stick on her leg; a boy put on a patch he removed from his grandmother while she was sleeping.
Seamonson said she's still recovering from the shock of seeing her lively son dead. He was a rambunctious boy who loved to dig in the dirt with his toy dump trucks, she said.
At the grocery store, he would comment on beautiful flowers for sale. At dinner, he would say, "This is so delicious."
"He really, really enjoyed the beauty of life," Seamonson said.
She hopes raising awareness of the danger can prevent other children from dying or being harmed.
"My son wasn't doing anything he shouldn't be doing," she said. "He was just being a little boy."