King crash driver’s death accidental > Medical examiner: Fryeburg man took overdose of prescribed painkiller

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BANGOR – The driver who nearly killed author Stephen King more than a year ago died in September of an accidental overdose of the painkiller Fentanyl, according to the state Medical Examiner’s Office.

Bryan E. Smith, 43, of Fryeburg was found dead in his mobile home on Sept. 22, the day after the Bangor author’s 53rd birthday. Smith’s family hadn’t heard from him in three days.

His mother, Dorothy Smith, called police for help after her knocks on her son’s trailer door went unanswered.

Smith later was found lying on his bed with a blanket pulled partway up his body, according to Capt. James Miclon of the Oxford County Sheriff’s Department.

“He appeared to be sleeping,” Miclon said in September.

The Medical Examiner’s Office in Augusta received long-awaited toxicology reports on Smith within the last two weeks, although staff members would not confirm that until Friday.

The office now is completing its final report on the cause of Smith’s death before sending it to the state Department of Human Services’ vital records office.

Sheila Thayer, a medical secretary at the examiner’s office, confirmed Tuesday what Smith’s family speculated last month was the cause of his death, that Smith had a reaction to the painkiller Fentanyl, which had been recently prescribed to him.

“It was acute Fentanyl toxicity,” said Thayer, reading from the report Tuesday. “This is the formal cause of death. The manner of death is accident.”

On June 19, 1999, Smith and King’s lives collided when Smith, who was trying to control his Rottweiler in the back seat, drove off Route 5 in North Lovell, striking the author who was walking alongside the road.

King suffered broken bones in his right leg and hip, a punctured lung, broken ribs and a scalp laceration. He underwent at least five surgeries in less than three weeks at Central Maine Medical Center in Lewiston before beginning a more than yearlong rehabilitation process at his Bangor home.

A couple of days after Smith was found dead, King said in a national interview that he believed Smith died on his birthday, Sept. 21. Mail found in Smith’s box, however, was postmarked starting Sept. 19.

The report will not pinpoint on which date Smith died, Thayer said.

“We don’t do that,” she said. “We only list the date that he was found.”

Fentanyl is an addictive, opiate-based drug given primarily to terminally ill cancer patients. It is administered through a transdermal patch that is worn for three days at a time.

The painkiller generally is not prescribed to people with chronic pain unless they are accustomed to taking opiate-based medications.

The painkiller may cause respiratory depression, or hypoventilation, in some patients if it is not administered correctly or its use is not monitored by a physician, according to the manufacturer, Janssen Pharmaceutica.

After consulting with a doctor in the Medical Examiner’s Office, Thayer said that the side effects of Fentanyl are similar to those of morphine. Most people who die from morphine poisoning suffer respiratory depression, she said.

“It wasn’t something that was used to commit suicide,” Thayer said. “It was something new and probably overused. That’s what morphine does.”

Smith’s brother Everett, a Fryeburg police officer, said Tuesday that the report confirms his family’s speculation that the painkiller was to blame for the death.

Last month, Everett Smith questioned whether Fentanyl was the sole cause or whether there was an interaction between the painkiller and the antidepressant Zoloft, which Bryan also was taking.

The Medical Examiner’s Office, however, said it was not because of an interaction, Everett Smith said.

“It was the poison from the patches,” he said. “We don’t know why it happened. We don’t know what he was thinking or what he was doing.”

To cancer patients, Fentanyl is considered a savior, but to the U.S. Department of Justice, it is considered a drug of abuse. Maine is the nation’s fourth-highest consumer of the painkiller, reports the New England office of the U.S. Drug Enforcement Agency. Everett Smith said he does not believe his brother abused the painkiller.

“I don’t think he had time to,” he said. “He was only using it for a few days. It could have been abuse. I don’t know if it was or if it wasn’t.”

One thing the older brother questions is why his sibling was taking the powerful painkiller. Bryan Smith had chronic back pain from work-related injuries and his brother wonders whether the pain was so severe that it warranted a prescription for Fentanyl.

“It’s 50 to 100 times more powerful than morphine,” Everett Smith said. “It slows your respiration down. You have to be cautious when you use it. That’s what I researched on the Internet, and a doctor told me. We don’t know why he was on it.”

Since Bryan Smith was found dead on Sept. 22, the family has refused to believe he committed suicide, despite his girlfriend of two years having ended their relationship two weeks earlier and the prospect that he soon would have to use a wheelchair.

Some King fans speculated that Smith timed his death to coincide with the author’s birthday, but Everett Smith said the death was not planned.

“It’s what we expected,” he said, mentioning the medical examiner’s report. “They ruled it accidental. They didn’t think it was anything else.”