A $20,211,025.75 Verdict for Failure to Monitor Opioid Administration
A South Florida jury awarded a $20,211,025.75 verdict to the family of Joshua Hamby, a 54-year-old entrepreneur and loving father who suffered a fatal brain injury after being heavily medicated with opioids without mandatory physiological monitoring. The wrongful death trial was led by attorney Daniel Harwin and the legal team at Freedland Harwin Valori Gander, who held the attending physician accountable for catastrophic patient safety violations. Ultimately, Mr. Hamby’s preventable death was caused by a failure to screen for high-risk respiratory factors and a failure to provide continuous telemetry and oxygen monitoring during high-dose opioid administration.
Written and edited by our team of expert legal content writers and reviewed and approved by Daniel Harwin
- Content last updated on:
- August 28, 2026
Table of Contents
What Went Wrong When Joshua Hamby Entered the Emergency Room for Abdominal Pain?
On May 27, 2020, 54-year-old Joshua Hamby presented to the emergency department at Boca Raton Regional Hospital suffering from severe epigastric pain caused by acute biliary pancreatitis from a gallstone. Upon admission under the care of attending hospitalist Dr. Joshua Glauser, Mr. Hamby was administered multiple doses of powerful intravenous narcotics, including morphine and hydromorphone (Dilaudid), to control his excruciating pain.
Despite placing Mr. Hamby on increasingly heavy dosages of narcotics—ultimately reaching 27 milligrams of Dilaudid over 28 hours, equivalent to 216 milligrams of morphine—Dr. Glauser failed to take a proper medical history, failed to screen him for obstructive sleep apnea, and failed to order continuous cardiac telemetry or pulse oximetry monitoring. Placed alone in an unmonitored room on a general hospital floor, Mr. Hamby suffered opioid-induced respiratory depression, went into cardiopulmonary arrest, and suffered severe, irreversible anoxic brain injury before life support was withdrawn on June 4, 2020.
What Critical Decisions Could Have Prevented This Fatal Outcome?
Tragically, Mr. Hamby presented with a highly treatable underlying condition, and simple, standard patient safety protocols would have saved his life:
- Screening for High-Risk Respiratory Factors: Failing to ask standard admission questions regarding sleep apnea, a condition that exponentially increases the risk of fatal respiratory depression when combined with central nervous system depressants.
- Ordering Continuous Telemetry and Pulse Oximetry: Omitting basic electronic monitoring that automatically transmits live heart rate and blood oxygen levels to central nursing stations, sounding immediate alarms if oxygen saturation drops below safe thresholds.
- Monitoring Following Dosage Escalations: Doubling the dosage of Dilaudid to 4 milligrams without physically evaluating the patient, conducting a hands-on examination, or adjusting monitoring levels to safeguard against cumulative narcotic toxicity.
Should Continuous Telemetry and Pulse Oximetry Monitoring Have Been Provided Sooner?
While in the emergency department, Mr. Hamby was continuously monitored with cardiac telemetry and pulse oximetry. However, once admitted as an inpatient, those life-saving monitors were disconnected. Over the next 28 hours, as escalating doses of Dilaudid accumulated in his system, his respiratory drive was severely depressed without any automated warning system to alert hospital staff.
As a direct result of unmonitored opioid administration and delayed intervention, Mr. Hamby endured severe physiological trauma:
- Opioid-Induced Respiratory Depression: Severe suppression of the brain stem’s automatic breathing signals leading to complete respiratory arrest.
- Cardiopulmonary Arrest and Asystole: Sudden loss of heart function and pulse, requiring emergency administration of Narcan and CPR resuscitation.
- Irreversible Anoxic Brain Injury: Extended periods without oxygen causing total loss of brainwave activity, leaving him dependent on mechanical ventilation until his death.
Mr. Hamby suffered profound brain damage and respiratory failure before medical staff discovered him unresponsive in his hospital room.
Who Was the Dedicated Father Lost Due to Medical Negligence, and Who Did They Leave Behind?
Joshua Hamby was a vibrant, kind-hearted 54-year-old entrepreneur who held an MBA from New York University and possessed a warmth that lit up every room he entered. He met his wife, Marzena, in 2008, bringing together two distinct worlds into a loving, devoted marriage centered on family values, outdoor adventures, and deep mutual support.
Above all else, Josh was a devoted, hands-on father to his seven-year-old son, Jared (J.H.). Josh was present for every milestone, swim meet, and tennis practice, taking night shifts when Jared was a newborn and establishing beloved family traditions. His sudden, preventable loss leaves an irreplaceable void in the lives of his wife and young son, who are left to navigate the future without their provider, protector, and guiding light.
How Did the Plaintiffs Prove Medical Negligence?
Daniel Harwin demonstrated that:
- FDA Prescriber Guidelines Were Violatively Ignored: The FDA black box warnings for Dilaudid explicitly instruct physicians to monitor patients closely for respiratory depression, particularly within the first 24 to 72 hours of initiating therapy or increasing doses.
- Fundamental Patient Screening Was Omitted: Standard medical practices require screening patients for sleep apnea prior to prescribing heavy narcotics, an obligation the defendant physician completely failed to perform.
- Continuous Electronic Monitoring Would Have Prevented Death: Had pulse oximetry or telemetry been attached, central station alarms would have alerted nursing personnel to declining oxygen levels in time to administer Narcan and prevent brain death.
Crucial expert testimony supported these claims, establishing that the administration of high-dose narcotics without objective physiological monitoring fell directly below the accepted standard of care. Media outlets highlighted the significance of the verdict, including detailed reporting by the Palm Beach Post Coverage, CVN, and WPBF.
How Does Expert Testimony Establish Causation?
The defense claimed:
- The patient’s cardiac arrest was caused by an underlying, unknown heart condition rather than narcotic toxicity.
- Periodic nursing checks every few hours constituted sufficient monitoring for a patient receiving high-dose opioids on a standard floor.
The jury disagreed.
How Do Defendants Defend Failure to Monitor Opioid Patients?
In medical malpractice litigation involving narcotics, defense counsel often attempts to attribute sudden patient collapses to unpredictable cardiac events or argue that standard floor nursing care satisfies legal requirements. In this trial, the defense argued that hospital capacity pressures during the COVID-19 pandemic justified placing the patient on an unmonitored floor, and that nursing staff adequately checked on Mr. Hamby.
However, Daniel Harwin dismantled these assertions by presenting uncontroverted medical records, autopsy findings, and EKG data proving that Mr. Hamby’s heart was structurally healthy and that his collapse was purely respiratory. The jury determined that hospital logistics do not excuse a physician from following basic drug safety mandates, assigning full legal fault to the attending physician for failing to mandate telemetry and pulse oximetry.
The $20,211,025.75 Award
The damages reflected both the patient’s suffering and the family’s loss:
- $211,025.75 for medical and funeral expenses incurred by the estate
- $9,000,000.00 for Marzena Hamby for the loss of her husband’s companionship and protection, and for her pain and suffering
- $11,000,000.00 for J.H., the minor child, for the loss of parental companionship, instruction, and guidance, and for his pain and suffering
- Total: $20,211,025.75
This substantial verdict underscores the catastrophic emotional and economic toll inflicted on a family when medical professionals disregard basic drug safety rules.
Why Do Failure to Monitor Cases Set Powerful Legal Precedents?
Opioids like hydromorphone are invaluable tools for acute pain management, but they carry well-documented, life-threatening risks of respiratory depression. When healthcare providers administer these heavy medications without utilizing standard, widely available monitoring tools like pulse oximetry and telemetry, they strip away a patient’s ultimate safety net.
This multi-million-dollar verdict sends an unmistakable message to hospitals and attending physicians across the nation: patient safety protocols cannot be treated as optional. Time, communication, continuous monitoring, and proactive risk screening matter, and medical professionals must act decisively to protect vulnerable patients under their care.
How Does a Verdict Deliver Justice?
Through relentless courtroom advocacy, Freedland Harwin Valori Gander brought the complete truth of Joshua Hamby’s final hours to light. By uncovering systemic breakdowns in care, proving the direct line of causation between unmonitored opioid administration and respiratory arrest, and defeating defense attempts to blame pre-existing conditions, the firm secured crucial financial security for Mr. Hamby’s surviving wife and young son.
While no verdict can restore a beloved husband and father, holding negligent providers accountable provides answers, restores dignity, and compels health systems to enforce rigorous safety standards for future patients. When the system fails, justice must be delivered.
About Freedland Harwin Valori Gander (FHVG)
Freedland Harwin Valori Gander is a nationally recognized medical malpractice, personal injury, and consumer justice law firm based in South Florida. With over $2.6 billion recovered for our clients, our partners—Michael Freedland, Daniel Harwin, Raymond Valori, and Deborah Gander—are committed to holding powerful defendants accountable. When you need a team with the resources and fortitude to take on big corporations, hospitals, and insurance companies, we are here for you. Contact us today at (954) 467-6400 or fill out our contact form for a free consultation.
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