Pain Management

Fattah, M.D. v. State Medical Board of Ohio, 1994 WL 73903 (Ohio App. 10 Dist.). Physician appeals from a judgment affirming Board's revocation of physician's license to practice medicine and surgery. The Court ruled that physician's acts and omissions constituted a failure to use reasonable care and discrimination in the administration of drugs or failure to employ acceptable scientific methods in the selection of drugs or other treatment. Physician violated Ohio Administrative Code which prohibits a physician from utilizing a controlled substance without considering the drug's potential for abuse or if the patient will use the drug for non-therapeutic use.

Brown, M.D. v. Louisiana State Board of Medical Examiners, 637 So.2d 1113 (La. Ct. App. 1994). Psychiatrist sought review of Board's decision to suspend his license for four months to practice and permanently revoke his ability to prescribe medication. The psychiatrist had charged undercover agents $80 to write prescriptions for controlled substance, without conducting physical or mental examinations. The Court of Appeals stated the majority of the sanctions were not excessive, considering the psychiatrist behavior. However, the Court required the Board to remove a provision that permanently prohibited the psychiatrist from ever applying for a controlled substance permit again. Amended and affirmed.

Thompson v. West Virginia Board of Osteopathy, 442 S.E.2d 712 (W.V. Ct. App. 1994).Petitioners, decedent's family, were entitled to compel Board to fulfill legal duty to consider and adopt formal findings of fact and consideration of law but not to compel the Board to take disciplinary action against physician who doubled patient's pain medication, which may have resulted in patient's heart attack and death.

People v. Schade, 30 Cal. App. 4th 1515 (Cal. App. 1994). Physician appealed conviction on 13 counts of prescribing illegal prescriptions for a controlled substance and 1 count of involuntary manslaughter. Physician defended all of his prescriptions as necessary for "pain treatment."  However, evidence showed the doctor prescribed high levels of drugs. In addition, the physician routinely failed to give physical exams, conduct background checks, order lab work, and refer patients to other doctors. Despite this evidence, the Court of Appeals dismissed all counts ruling that the trial court erred by failing to instruct the jury on the definition of the technical term ‘addict." Involuntary manslaughter affirmed.

United States v. Tran Trong Cuong, M.D., 18 F.3d 1132 (1994). Physician was convicted of distributing controlled substances by prescription outside the usual course of medical practice. Evidence was presented that patients faked pain symptoms, yet physician wrote prescriptions and suggested they be filled at different pharmacies. Patient records indicated a charge of $35 for issuing prescriptions; and patients were kept on narcotics for years when complaints were merely for headaches, backaches and other subjective ailments. However, because of improper introduction of reputation evidence by the government, these convictions are being reversed for a new trial.

Hollabaugh, M.D. v. Arkansas State Medical Board, 861 S.W.2d 317 (Ark. Ct. App. 1993).  Physician appealed the Court's approval of the Board's suspension of her license for prescribing excessive amounts of controlled substances. Physician defended her prescription habits with detailed evaluations and expressed her belief that the pain resulting from most medical conditions is not adequately treated by most physicians. The Board's primary evidence consisted of pharmacists' testimony regarding the types, amounts and frequencies of the prescriptions. The Court of Appeals ruled that the Board failed to present standard of care and sufficient substantive evidence to support its findings. Reversed.

Eaves v. Board of Medical Examiners, 467 N.W.2d 234 (Iowa 1991). Physician appeals an order upholding the Board's decision imposing discipline for excessively prescribing controlled drugs. His patients complained of severe and chronic pain. The State's witness testified that narcotic pain medication should not be used for long-term treatment in the absence of a terminal disease. Physician was found violating Iowa law in prescribing excessive dosages of medication in five of the seven patients investigated. The Board imposed a three-year probation, $1000 fine, additional medical education classes, prohibition against continued prescription of addictive drugs for chronic pain and submission of new treatment plans for his patients. Affirmed.

Hulse v. Sheriff of Clark County, 498 P.2d 1317 (Nev. 1972). Physician wrote numerous prescriptions for extremely large number of controlled substances. The Court found that since there was a genuine physician-patient relationship, that physician's prescription of the drugs was in good faith, that there was nothing to suggest the physician was concerned with anything except treatment of a genuine physical ailment and relief of pain, it was improper to hold the physician over for trial on charges of unlawfully prescribing narcotic drugs. Reversed.

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