Incident 39995

i. Patient J.C.’s history and diagnosis included surgical treatment for fracture of the Herrington Rods in his back in September 2014. Respondent prescribed high doses of controlled substance to J.C., including monthly prescriptions for Diazepam 10mg #90, Oxycodone 80mg #180, Duragesic 100mg #15, Oxycodone 30mg #240, and Carisoprodol 350 #90. The expert opined that this combination of a tranquilizer, amphetamines, sleeping pills, and muscle relaxants increases the risk of respiratory depression and death.
ii. The medical history beginning in December 2014 for patient R.B. included chronic fatigue, anxiety disorder, restless leg syndrome, and plantar fasciitis. Respondent provided R.B. with monthly prescriptions for Methylphenidate 20mg #120, Oxycodone 30mg #180, Clonazepam 2mg #120, and Lorcet 10/325 #180. The expert opined that it is recommended that patients on chronic opioid therapy should receive random drug screens on a regular basis and also sign an opioid contract. The expert’s review of R.B.’s medical records did not detect any discussion of drug screens, an opioid contract, or pill counts.
iii. The expert also stated Respondent did not maintain comprehensive patient medical records. The expert’s review of Respondent’s medical records revealed patients were primarily seen by a nurse for monthly visits for controlled substance prescription refills. History of present illness for patients was recorded as “return for visit” only. There were no discussions of control of pain, possible side effects of controlled substances, or any attempt to reduce controlled substance prescriptions. The expert opined that this documentation failure fell below the standard of care