Last year, it seemed like Sarah Fuller's dreams were coming true.
Her parents say it was a remarkable turn for the 32-year-old woman who had struggled with an opiate addiction and health problems, most recently chronic pain and fibromyalgia.
"She was getting ready to get married, she was thrilled," said her mother, Deborah Fuller. "She was in pain, but she was taking a non-narcotic painkiller, or Advil."
Then Sarah's prescription changed. Fentanyl, the drug that's made headlines as a deadly, addictive, synthetic opiate-like heroin is also manufactured for use by doctors, to be used only in the most extreme cases.
"The fentanyl was worse," Fuller said. "I mean, she had mood changes with the others, but the fentanyl was definitely worse."
Dr. Joe Contreras, chair of pain and palliative care at Hackensack University Medical Center, says the dangerous drug is stronger than morphine. He sometimes prescribes the medication for cancer patients.
"Fentanyl is 100 times more powerful than morphine," he said. "A very typical type of pain might be due to metastic cancer, for example, that invades the bone and destroys the surface of the bone. That can be excruciatingly painful."
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Sarah Fuller's parents say it was nothing nearly that serious that brought them to the office of New Jersey doctor Vivienne Matalon. They just wanted something to help ease Sarah's chronic pain.
"We went into a conference room," recalled Dave Fuller, Sarah's father. "We sat down and she explained to us, explained to Sarah, both of us, that the medication is for chronic pain and it would help her out better than the other stuff."
A formal complaint filed by the New Jersey State attorney general against Matalon reveals what happened next: inside that conference room was a sales rep for Subsys, the brand of fentanyl Sarah was prescribed. Intially, Dave Fuller didn't think it was strange because he trusted Matalon.
"I assumed the doctor knew what she was doing," he said. "I mean, she went to school for it and you're supposed to trust your doctors."
The Fuller family attorney, Rick Hollawell, disagreed. He called the sales rep's presence "unethical" and "unprecedented."
"I've never heard of a drug rep being in a room with a doctor and a patient at the same time," he said. "So in my experience, unprecedented, completely unethical, and it should have never happened."
Hollawell is preparing to file a civil suit on behalf of the Fuller family, in part against Insys, the company which produces the drug spray that was prescribed. The company is being sued by the state of Illinois for making deceptive and irresponsible marketing claims and entered a settlement with the state of Oregon for marketing off-label uses.
Fuller's fentanyl arrived every month by mail. The boxes of Subsys were left right at her front door. Her parents say Sarah took a dose every four hours.
Tha'ts how it went for a little more than a year. Sarah took nearly a quarter million dollars in fentanyl, all paid for by Medicare, until one morning she was found face-first on the floor of her bedroom. Sarah was dead from an overdose.
"If she were five minutes late for that dose, she would shake, she would get panicky," recalled Deborah. "Had we ever been in the room, there was nothing we could have done."
In a painful twist, the Fullers say they didn't even know Sarah was on fentanyl until she died. Indeed, a state investigation found Sarah and her dad were never told about the risks or dangers associated with the use or misuse of the drug.
"There were so many turns where maybe things could have been done but weren't, so you get angry," said Deborah. "You get angry 'cause it's like she died for nothing. I mean, she died so the pharmaceutical company could make, what, $250,000? Her life was worth a heck of a lot more than that."
A state investigation found Matalon did not diagnose Sarah for cancer or breakthrough pain, and her license was temporarily suspended. She declined to comment for this story.
Repeated calls to Insys, the company that manufactures Subsys, were not returned.