Death Certificate Project Lists Doctors Cited for Narcotic Overdoses
Eleven more physicians are facing “Death Certificate Project” accusations involving overdoses from the Medical Board of California, filed over the past month because a patient for whom they had prescribed narcotics died. The project was launched three years ago and begins with the board’s review of death certificates from 2012 and 2013 listing overdose of a prescription drug as a cause. The state agency then cross-checks California’s prescription drug database to identify which physicians prescribed controlled substances to those patients up to three years before their death.
So far, 23 physicians are facing new disciplinary actions. Their names and practice locations are as follows:
Ashmead Ali, MD, California City, Kern County; Michael S. Basch, MD, Temecula, Riverside County; Jose Rosendo Cesena, MD, El Cajon, San Diego County; Daniel George Clark, MD, Auburn, Placer Counter; John Courtney Dozier, MD, Susanville, Lassen County; Frank Gilman, MD, San Diego, San Diego County; William Lee Matzner, MD, Simi Valley, Ventura County; Mahyar Okhovat, MD, Agoura Hills, Los Angeles County; Ronald David Richmond, MD, Mission Viejo, Orange County; Bruce M. Stark, MD, Toluca Lake, Los Angeles County; Charles Yang, MD, Huntington Beach, Orange County.
These physicians have been accused of the following (not an all-inclusive list):
Prescribing controlled substances for family members with whom he did not have a patient-physician relationship; Prescribing dangerous medications to an alcoholic without referring patient for alcoholism treatment; Prescribing hydrocodone for an undercover police officer after a “perfunctory medical examination”; Failing to appropriately sever the doctor-patient relationship; Writing “illegible” notes; Failing to order drug tests to ensure patient was not abusing other substances; Prescribing ultimately lethal doses of fentanyl patch to a patient known to be taking benzodiazepines.
Gilman’s case is an especially notable one and includes 63 investigatory pages in total. Six pages list controlled substance prescriptions for a single patient, most of them prescribed by him. The document notes that two of his patients died of drug overdoses. Gilman failed to screen one of his patients for aberrant drug behavior and did not check the prescription drug database or coordinate prescriptions he wrote with care given by other prescribers.
Many physician organizations have denounced the project’s methods, claiming it is unfair for the board to reach as far back as it is to consider overdoses and to prescriptions written before a patient overdosed in 2012, because the extent of the opioid epidemic was far less well-known at the time. Many have also objected to being blamed for the death of a patient who had been prescribed a legitimate analgesic for pain if the patient’s life ultimately ended because of a street drug overdose.
“We have asked [the board] to look to using an outside agency to survey whether their techniques and investigations are improperly or irregularly focusing on specialties or geographic areas, and therefore skewing the investigations’ outcomes,” Theodore Mazer, MD, California Medical Association’s (CMA) immediate former president and a San Diego based otolaryngologist, said.
Mazer added, “in Northern California, there’s a specific area that feels they’re being focused on, improperly targeted, and it’s both a geographic and specialty concern.”