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A WOMAN died from a cocktail of prescription drugs after she got away with “doctor shopping”.

In the space of a year, Milica ‘Mary’ Minchev visited about 30 doctors at 12 different clinics around Melbourne, attending a consultation almost daily.

She received prescriptions from every doctor, and the drugs she was taking was a deadly mix.

The 48-year-old woman became drug dependent after suffering from epilepsy, depression, anxiety and some self-harm following the breakdown of her 31-year marriage.

She also had a mild stroke and had swelling in her leg.

A coroner has looked into how Ms Minchev managed to get prescriptions frequently from a large number of health professionals.

She was found dead on the floor on February 26 2013 in her uncle’s home in Thomastown in Melbourne’s north.

In the coroner’s report into her death, Ms Minchev was described as likeable and outgoing but she did seek treatment for health conditions she did not have.

She was seeing a health professional at The Melbourne Clinic, who tried to restrict her prescriptions, but Ms Minchev was also seeking help from Epping Plaza Medical and Dental Centre, where she saw a number of different doctors.

She was a known ‘doctor shopper’ but about a week before her death, she was given a number of prescriptions.

According to the coroner’s report, she visited a doctor at the Epping Plaza Medical and Dental Centre and told him she was going to New South Wales for a holiday and he prescribed her three weeks’ worth of different medications.

Just four days before her death, Ms Minchev revisited the same doctor and said she would instead be away for five weeks and he prescribed drugs to treat anxiety and pain relief.

On the day she died, she went back to the same doctor, requesting more drugs, the coroner’s report said.

The doctor told the coroner’s court he struggled to get Ms Minchev and her son out of the consultation room so prescribed her 20 more capsules.

He then told Ms Minchev he did not want to consult her anymore and referred her to another doctor in the clinic.

The Coroners Prevention Unit reviewed Ms Minchev’s medical records and found in the 12 months leading up to her death she was prescribed strong drugs by Epping Healthcare 18 times, 12 times by The Melbourne Clinic, 24 times by Epping Plaza and four times from Reservoir Medical Centre.

Between February 2012 and 2013, Ms Minchev was prescribed drugs by Epping Plaza nine times, and once from the Lyndarum Family Clinic, Alpha Medical Clinic and The Northern Hospital.

In the year before her death she was prescribed strong drugs by Epping Plaza on 64 occasions and was sometimes given more than one prescription on the same day or within one day of getting her last prescription.

She was prescribed drugs 21 times by Epping Healthcare, 16 times by Reservoir Medical Centre and six times at The Northern Hospital.

She also managed to get strong drug prescriptions from Lyndarum Family Clinic, Wantirna Medical Clinic, Lalor Plaza Medical Centre, Knox Private Hospital and the TriStar Medical Group.

The coroner’s report said it was impossible to know who prescribed the drugs leading to her death.

The review into her death found there were a number of issues with the delivery of health services to Ms Minchev.

On her patient summary at Epping Healthcare, there was a note on top of her file that said “Dr Shopper, please do not prescribe anything to her esp (sic) alprazolam/oxy”.

Those reading her file were then told to see notes from April 2012, that spoke about a doctor having contact with a pharmacist who said Ms Minchev was doctor shopping.

There were also records at Epping Plaza that suggested she was a doctor shopper.

There was a note in her file from 2007 from the Medicare Australia Prescription Shopping Program, that said she was a doctor shopper.

The coroner’s report said the review found Epping Healthcare, Epping Plaza and Reservoir Medical Centre did not try to identify other prescribers and communicate with them to care for Ms Minchev.

According to the coroner, the health professional from The Melbourne Clinic was the only one who tried to communicate with another doctor treating Ms Minchev.

In 2009 he wrote to a doctor at Epping Plaza, letting him know she was drug dependent.

There was also a note in her file from 2008 that said Ms Minchev’s use of pharmaceutical opiods was consistent with drug dependency.

Another document at Epping Healthcare, which was written in 2003, said Ms Minchev was drug dependent and lying about her drug use.

According to the coroner’s report, if a health professional suspects a patient is abusing drugs, they need to alert Drugs and Poisons Regulation at the Department of Health and Human Services.

The review found most doctors knew about her drug dependency, but only two alerted the DPR.

In Victoria, doctors also need to be given a permit by DPR to prescribe very strong drugs.

Doctors at the Epping Plaza Medical and Dental Centre prescribed the drug despite being refused permits on two occasions.

In statements to the court, doctors said they believed Ms Minchev’s medical concerns were genuine and her needs for medication were legitimate.

Some doctors worried stopping medication would cause her to have seizures.

Coroner Audrey Jamieson said most doctors who gave statements said they were following on clinical strategy started by another health professional.

One doctor claimed he did not think it was his role to change or adjust Ms Minchev’s medication.

“This appeared to be a strategy that several doctors adopted, as they believed they were not Ms Minchev’s principal general practitioner,” Coroner Jamieson said.

“Given Ms Minchev’s propensity for doctor shopping, it could be argued that none of the clinicians were her primary doctor. However, regardless of whether a patient is generally managed by one doctor or not, other practitioners must perform their own clinical assessment before prescribing.”

Seven of the doctors who gave statements in relation to Ms Minchev’s death were not certain Ms Minchev was doctor shopping and none knew to what extent she was going to.

“I note that a lack of information and communication appeared to be central undermining features of treatment rendered to Ms Minchev by clinicians, and the circumstances of her death evince the need for Real-time Prescription Monitoring,” Coroner Jamieson said.

“There appears to have been clear evidence that Ms Minchev was engaged in prescription shopping, but doctors did not identify the behaviour or intervene to prevent her access to medication beyond her therapeutic need.”

Real-time Prescription Monitoring was announced by the Victorian government earlier this year to prevent people from dying from prescription medicine overdoses.

In 2015, there were 330 Victorians who overdosed on pharmaceutical drugs.

That’s more than the 217 deaths caused by illcit drugs.

Real-time Prescription Monitoring is computer software that allows pharmacies to lodge medicines they are dispensing and the records are transmitted to a centralised database that can be accessed by doctors and pharmacists.

“It is anticipated that with the advent of Real-time Prescription Monitoring, doctors in Victoria will be assisted to monitor their patients’ medication with far better oversight and attentiveness than was rendered in Ms Minchev’s case,” Coroner Jamieson said.

If you need help, call Lifeline on 13 11 14 or visit www.lifeline.org.au/gethelp

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