An expert witness testifying Thursday on behalf of the estate of a man who died while recovering from ankle surgery at St. Charles Bend told jurors the combination of pain and anxiety drugs given to Stephen Brenn was a deadly cocktail.

“In my opinion, you take anyone in this courtroom, and if they were given the equivalent of 59.7 milligrams of morphine and 4 milligrams of Ativan in this time frame, they would all end up in the same position as this unfortunate patient,” Seattle pharmacist Dan James said.

But other testimony Thursday in Deschutes County Circuit Court raised questions about the drugs in Brenn’s system when he died. Test results did not show OxyContin or Ativan — medications given to Brenn for pain — in his blood.

Brenn, 47, a Jeld-Wen vice president and married father of two, died in April 2006, seven hours after Dr. Anthony Hinz, a friend of Brenn’s, performed elective ankle surgery.

After the surgery, Brenn was awake and alert. He complained of severe pain for several hours as nurses gave him several doses of pain medication. Just before 8 p.m., they provided him with doses of OxyContin, Dilaudid and Ativan, and Brenn was discovered dead around 10 p.m.

Brenn’s estate filed a lawsuit against St. Charles’ parent company, Cascade Healthcare Community, and Hinz, an orthopedic surgeon.

Cascade settled with the estate earlier this year.

The estate is now seeking $9.7 million from Hinz in compensation for lost wages and other damages.

Hinz’s lawyer contends the hospital staff members who administered the drugs were responsible for Brenn’s care after surgery and are responsible for his death.

James, the pharmacist who testified on behalf of the estate, said he believed Hinz’s quadrupling of Dilaudid and Ativan after the original doses didn’t work was dangerous.

And he also said OxyContin is not recommended for postoperative situations, particularly on patients who were not previously on the narcotic.

But on cross-examination, James said he didn’t know Brenn was taking Vicodin for ankle pain before surgery and that he hadn’t seen some of Brenn’s medical records, which indicated he had a high tolerance for pain medication.

Deschutes County Medical Examiner Chris Hatlestad also testified that he originally listed Brenn’s cause of death as respiratory repression caused by an overdose of pain and anxiety medications, based on hospital records.

But he changed the cause of death on Brenn’s death certificate to cardiopulmonary arrest when a toxicology screen came back four months later with no indication of those drugs in Brenn’s system.

The toxicology report took months, Hatlestad said, because it was sent to a Pennsylvania lab to determine the drug amounts in Brenn’s blood, rather than simply whether drugs were present.

“There was no concrete evidence in the toxicology to show he had high levels of medication in his system,” Hatlestad testified. “It didn’t confirm my as- sumptions.”

After the toxicology report came back, Hatlestad met with the state medical examiner to determine the final cause of death. The state medical examiner determined it was cardio-pulmonary arrest, and Hatlestad said Thursday he agreed with that finding.

But in a May deposition, Hatlestad gave different testimony. At that time, he said he disagreed with the state medical examiner’s opinion.

During testimony Thursday, however, Hatlestad said he couldn’t find his files on Brenn’s death when he was deposed. He found them Wednesday evening, he said.

One thing Hatlestad couldn’t answer was why the drugs Brenn received didn’t show up in his toxicology report, and why there was a small amount of ethanol, a grain alcohol used for drinking, in the patient’s blood.

Hatlestad believes the ethanol may be a contaminant, he testified.

The trial, which is expected to go through Aug. 21, continues today.

The estate’s lawyers are expected to call family members, work partners and other medical experts to testify.