Bill would help track deaths caused by prescription drug abuse

For once, Nevada's dishonorable top-of-all-bad-lists position is beat out by another state. Florida is the state with the most pill mills, not the Silver State.

That doesn't mean some Nevada doctors aren't handing out painkillers like M&Ms.

The Nevada Board of Osteopathic Medicine recently settled two complaints against one doctor involving overprescribing opiates, as detailed in Saturday's column.

But there are two unresolved complaints against Dr. Paul Chen, a pain management doctor who also has been sued in a wrongful death case involving opiates. The lawsuit against Chen, 49, is pending. His attorney David Mortensen didn't return calls for comment.

Annette and Rudy Rosado, parents of the late Rudy Rosado , sued Chen and the Advanced Pain Management and Family Care Associates alleging malpractice, breach of contract and wrongful death.

Their son became Chen's patient in August 2008, according to the lawsuit filed in November. Like most pain management patients, Rudy signed a contract saying that, if he broke their agreement, Chen would stop providing pain-control medications.

Rudy's toxicology screening in February 2009 showed the security guard had taken drugs outside of what Chen was prescribing, so Chen had a duty to taper off and stop prescribing pain medications, according to the contract. But he didn't.

Rudy died of a drug overdose on Nov. 15, 2009, a combination of methadone and oxycodone intoxication. He was 24.

The two complaints filed against Chen by the Osteopathic Board on Feb. 2 started after the families of two patients complained about the doctor to the board.

Patient A is a young woman who underwent knee surgery in 2007, fell on it a year later and became Chen's patient in November 2008. He treated her exclusively with painkillers, and she paid cash for the visits over seven months. The complaint said that within a month of Chen's treatment her dosage went from 5 mg of oxycodone to 30 mg. She was also seeing another doctor who was prescribing painkillers.

A toxicology screening showed she didn't have benzodiazepines or Soma in her system, which Chen had also been prescribing. That violated the doctor/patient contract, because it indicated she could have been providing the painkillers to others.

The complaint contends Chen overprescribed dangerous drugs and is unfit to practice osteopathic medicine, especially in pain management, and committed gross malpractice.

Patient B is a young man who said he had a sports injury in 1997 and was in a car accident in 1998. Two other doctors stopped treating him and in their records said he had an addiction problem.

Chen's treatment began in January 2007 for "vague pain" rated a 2 out of 10. Later, the patient told Chen he was getting methadone from a friend, a violation of the patient agreement, yet Chen continued to give him prescriptions.

Both complaints said Chen should undergo a medical competency exam and allege he is guilty of malpractice and unethical behavior.

The board's executive director and general counsel, Dianna Hegeduis, said overprescribing painkillers is a national epidemic, "but in Nevada, I think we are out front." The state's various licensing boards have been aggressive about this type of abuse, she said.

Unlike Florida, Nevada has an online database of patients and prescriptions available to doctors and pharmacists, making it difficult to obtain multiple prescriptions of painkillers by doctor shopping.

Senate Bill 168, sponsored by Republican Sens. Joe Hardy and Don Gustavson, would help track deaths caused by prescription drug abuse by requiring that such deaths be reported and that the Board of Medical Examiners investigate to see if the conduct of the physician contributed.

The sponsors overlooked including the Board of Osteopathic Medicine in the bill, but that can be fixed, and help keep Nevada from looking like Florida, where an estimated seven people a day die of prescription drug abuse.

Jane Ann Morrison's column appears Monday, Thursday and Saturday. E-mail her at Jane@reviewjournal.com or call (702) 383-0275. She also blogs at lvrj.com/blogs/morrison.