The Texas Medical Board recently disciplined two Austin-area doctors and referred the case of an emergency medicine doctor accused of numerous patient care violations to an administrative hearing.

The board alleges that Dr. Thomas Joseph Curvin, who has practiced emergency medicine in various locations, including Cedar Park, violated the standard of care in treating eight patients and prescribing dangerous drugs and controlled substances to two friends and a relative.

The board’s complaint to the State Office of Administrative Hearings also accuses Curvin of unlawfully removing patient charts and medications from a clinic and appearing to work while impaired on alcohol or drugs.

The case was sent to an administrative law judge last month because the board and Curvin could not agree on settling the complaint.

No date for the trial-like proceeding has been set.

At its April meeting, the board also ordered Dr. Robert P. Wills of Austin, who specializes in pain management and anesthesia, to complete courses in record-keeping and risk management.

The board said Wills did not keep sufficient records on a patient who experienced a complication and is now quadriplegic though it did not say the record keeping was related to the patient’s care or outcome.

The board also ordered Dr. James Edward Stevens of Westlake to pay a $1,000 fine and take classes in immunology, treatment of fibromyalgia, risk management and communicating with patients.

The board said Stevens did not keep adequate records on a patient or complete courses it required in 2010.

Stevens could not be reached, and the board’s website said he is no longer I in practice.

State disciplines 2 doctors requests hearing for third is a post from: Accident & Injury Law in Texas

Federal health officials added new safety alerts Tuesday to the prescribing information of statins, cholesterol-reducing medications that are among the most widely prescribed drugs in the world, citing rare risks of memory loss, diabetes and muscle pain.

It is the first time that the Food and Drug Administration has officially linked statin use with cognitive problems such as forgetfulness and confusion; although some patients have reported such problems for years. Among the drugs affected are such huge sellers as Lipitor, Zocor, Crestor and Vytorin.

But federal officials and some medical experts said the new alerts shouldn’t scare people away from statins.

“The value of statins in preventing heart disease has been clearly established,” said Dr. Amy Egan, deputy director for safety in the FDA’s division of metabolism and endocrinology products. “Their benefit is indisputable, but they need to be taken with care and knowledge of their side effects.”

Diabetics and even those who develop diabetes while taking statins should continue taking the medicines, said Dr. Steven Nissen, chairman of ardiovascular medicine at the Cleveland Clinic. Nissen has studied the medicines extensively.

“These are not major issues, and they really do not alter the decision-making process with regard to statins,” Nissen said.
Last year, nearly 21 million U.S. patients were prescribed statins, making the drugs among the most widely used.
The FDA also said that routine monitoring of liver enzymes in the blood, once considered standard procedure for statin users, is no longer needed because the liver injury associated with statin therapy is so rare.

Reports about memory loss, forgetfulness and confusion cover all statin drugs and all age groups of patients, the FDA said. There have been dozens of well-controlled trials of statins, but they have offered few hints that the drugs cause any kind of cognitive impairment, Egan said. Still, the FDA has received many reports that some patients felt unfocused or “fuzzy” in their thinking after taking the medicines.

Officials within the FDA debated whether such reports were truly worrisome, Egan said. But in recent years, the FDA – criticized for waiting too long to issue some safety alerts — has become much more willing to be public about its uncertainty.

“We are trying to be as transparent as possible with our alerts and labeling,” Egan said, even though the alert on the possibility of fuzzy thinking “is not overly helpful.”

FDA warns of cognitive problems linked to anti-cholesterol drugs is a post from: Accident & Injury Law in Texas

The owner of a Texas medical service provider was among seven people indicted in an extensive health care fraud scheme that allegedly bilked Medicare and Medicaid of nearly $375 million, authorities announced Tuesday.

The federal indictment accused Jacques Roy, a doctor who owned Medistat Group Associates in DeSoto in North Texas, of leading a scheme that billed Medicare for home health services that were not medically necessary or were not done.
Also indicted were Roy’s office manager as well as the owners of three home health agencies. A federal indictment unsealed Tuesday accuses the agencies of using Roy to rack up millions of dollars in false claims.

The indictment alleged that from January 2006 through November 2011, Roy or others certified 11,000 Medicare beneficiaries for more than 500 home health services — more patients than any other medical practice in the U.S.

Investigators for the U.S. Health and Human Services department noticed irregularities with Roy’s practice about one year ago, officials said.

Roy had “recruiters” finding people to bill for home health services, said U.S. Attorney Sarah Saldana, the top federal prosecutor in Dallas. Some of those alleged patients, when approached by investigators, were found working on their cars and clearly not in need of home health care, she said.

Medicare patients qualify for home health care if they are confined to their homes and need care there, according to a federal indictment.

Saldana said Roy used the home health agencies as “his soldiers on the ground to go door to door to recruit Medicare beneficiaries.”

Roy, 54, is charged with health care fraud and conspiracy to commit health care fraud. He and the other defendants have been taken into custody.

The Centers for Medicare and Medicaid Services also announced the suspension of an additional 78 home health agencies associated with Roy. The agencies were collecting about $2.3 million a month, said Peter Budetti, CMS’ deputy administrator for program integrity.

Until recently, HHS could not effectively track data to identify the kind of fraud now linked to Roy, who was billing beneficiaries “off the charts” for more than five years, officials said. The department’s inspector general, Dan Levinson, told reporters the department’s technology “has not come online as quickly as we’d like to see.”

7 indicted in Texas health care scheme is a post from: Accident & Injury Law in Texas

A new study provides what independent researchers call the best evidence yet that colonoscopy — perhaps the most unloved cancer screening test prevents deaths. Although many people have assumed colonoscopy must save lives because lt is so often recommended, strong evidence has been lacking until recently.

A team of researchers led by Dr. Sidney Winawer, a gastroenterologist at Memorial Sloan-Kettering Cancer Center in New York City, followed 2,602 patients for as long as 20 years. In that group, the death rate from colorectal cancer was cut by 53 percent in those who had the test and whose doctors removed precancerous growths, known as adenomatous polyps, the researchers reported Wednesday in The New England Journal of Medicine. The test examines the inside of the intestine with a camera-tipped tube.

Colorectal tumors are a major cause of cancer death in the United States and one of the few cancers that that can be prevented with screening. But only about 6 in 10 adults are up to date on getting screened for colorectal cancer, according to federal estimates.

Cancer screening tests have come in for greater scrutiny recently. A government panel recommended in October that men no longer get the PSA blood screening test for prostate cancer after concluding it did not save lives. The new study on colonoscopy has limitations — it is not a randomized clinical trial — but some experts say it nonetheless was well done and helps answer questions about the effectiveness of the procedure.

Colonoscopy is expensive, costing hundreds or thousands of dollars, depending on whether polyps are removed and on the part of the country where it is done. It also carries small risks of causing bleeding or perforation of the intestine. And it requires sedation and taking strong, usually foul-tasting laxatives to clean out the intestines so that the doctor can look for polyps.

Study says colonoscopy cuts risk of death from colon cancer is a post from: Accident & Injury Law in Texas

The number of overdose deaths from powerful painkillers more than tripled over a decade, the federal government reported recently — a trend that a US. health official called an epidemic, but one that can be stopped.

Prescription painkillers such as OxyContin, Vicodin and methadone led to the deaths of almost 15,000 people in 2008, including actor Heath Ledger. That’s more than three times the 4,000 deaths from narcotics in 1999.

The overdose deaths reflect the spike in the number of narcotic painkillers prescribed every year — enough to give every American a one-month supply, said Dr. Thomas Frieden, director of the federal Centers for Disease Control and Prevention in Atlanta, which issued the new report.

Such painkillers “are meant to help people who have severe pain,” Frieden said. “They are, however, highly addictive.”

Prescriptions have risen as doctors aimed to better treat pain and as new painkillers hit the market.

The report shows nearly 5 percent of Americans ages 12 and older said they’ve abused painkillers in the past year — using them without a prescription or just for the high.

In 2008-09 surveys, Oklahomans reported the highest rate of abuse at 8.1 percent while the lowest was in Nebraska and Iowa at 3.6 percent. The national average was 4.8 percent.

Texas was below the national average for people who’ve abused painkillers in the past year at just 4.6 percent.

New Mexico had the highest overdose death rate with 27 deaths per 100,000 residents, while Nebraska had the lowest at 5.5 deaths per 100,000 residents. The national rate was 11.9 per 100,000 people.

Texas’ death rate was well below the national average at 8.6 per 100,000 residents, making it the state with the ninth-lowest rate of such overdose deaths.

Sales of prescription painkillers are highest in the Southeast and Northwest.

States oversee prescription practices and can rigorously monitor prescriptions and crack down on “pill mills” and “doctor shopping” by patients, Frieden said.

Doctors should limit prescriptions — giving only a three-day supply for acute pain, for example — and look for alternative treatments, he said.

“For chronic pain, narcotics should be the last resort,” he added.

Overall, there were 36,450 fatal overdoses in 2008, including accidental cases and suicides involving illegal drugs such as heroin and cocaine along with prescription medicines. About three-quarters of the deaths from prescriptions involved narcotic painkillers.

The report notes that fatal overdoses were more likely in men, middle-aged adults and whites and American Indians.

A federal drug plan announced this year calls for state programs to track prescriptions. All but two states — Missouri and New Hampshire — have approved them.

U.S. sees epidemic of prescription painkiller deaths is a post from: Accident & Injury Law in Texas

The Texas Supreme Court overturned a $32 million jury award to the family of a Texas man who died after briefly taking Vioxx, a painkiller the drugmaker later pulled from the market.

A jury in Rio Grande City in 2006 made the award to the family of 71-year-old Leonel Garza. He had heart disease for 23 years and died in 2001 after less than a month on Vioxx.

The award — originally $25 million in punitive damages, plus $7 million in compensatory damages — was reduced to about $7.75 million under the state’s damage caps.

A Texas appeals court later overturned the verdict because of jury misconduct and ordered a new trial.

Merck, the world’s second-largest drug-maker by revenue, stopped selling Vioxx in September 2004, amid evidence it doubled risk of heart attack and stroke.

Texas high court overturns award in Vioxx case is a post from: Accident & Injury Law in Texas

Medical procedures and surgeries on the wrong patient and wrong body part have declined stantially at Veterans Affairs hospitals nationwide, while reports of close calls have increased, according to a study that credits ongoing quality improvement efforts, which encourage better reporting and communication at hospitals. The study, published online in the Archives of Surgery, is based on reports from mid-2006 to 2009; they were compared with data from the previous five years.

Fewer surgical errors at VA hospitals is a post from: Accident & Injury Law in Texas

The Texas Medical Board last month disciplined seven Austin-area doctors, including two alternative practitioners.

The two are Dr. Russell Roby of Austin, who is known for his infomercials, and Dr. Philip Zbylot, a preventive medicine practitioner in Austin and Wimberley and chief medical official for Austin/Travis County in the mid-1980s.

The board said that Roby, 70, who gives allergy medication under the tongue rather than through injections as is usually done, failed to inform a patient that the treatment was not approved by the Food and Drug Administration and that anaphylactic shock could occur.

The board reprimanded Roby in 2004 for inadequate patient consent and disciplined him again in 2007 for inadequate disclosure, requiring him to tell patients that his treatments, therapies and formulas were not FDA-approved and had not been tested for their effectiveness. Roby failed to follow the 2007 requirements and did not disclose the ingredients in his formulation to patients, the board’s current order says.

The board also said it found that Roby had a sexual relationship with a patient who also was an employee.

Earlier this month, the board issued a public reprimand of Roby, a relatively light form of discipline, and ordered him to take courses in professional boundaries, recordkeeping and ethics; pass a medical jurisprudence exam; submit all of his advertisements to board staff for review; pay a $3,000 fine; and continue his treatment for bipolar disorder.

“He skated,” said Dena Buckley of San Antonio, a former patient who said her complaint prompted the order. “It cost him $3,000, and he has to take classes. I have $25,000 in medical bills I am still paying.”
Buckley, 48, said the drops Roby gave her in 2009 caused her to go into anaphylactic shock and be hospitalized.

Roby disputed that the drops caused a severe reaction. He treated Buckley, who is not named in the board’s order.

Dr. Gary Albertson said he worked for Roby from 2004 until he quit in Apri1 2010. Albertson said that he didn’t recall any severe reactions but that he no longer uses drops as treatment because he does not consider them as effective as injections.

Roby said the main issue was using an outdated form that lacked the FDA disclosure. As for the inappropriate relationship, Roby said he stopped treating the woman once they became intimate. She became an employee and lived with him for seven years but fell out with him over a joint venture, the Roby Institute in Brazil, he said.

Zbylot, who the board said is 63, was medical director of Holistic Health Care Center in Boerne, which was inspected m March 2009 by the Department of State Health Services after a complaint that it did colon irrigation as a treatment for cancer without medical supervision, the order says. Zbylot said he became the medical director later that month, unaware of the states involvement.

Zbylot said he also was unaware that the medical board required patients to have physician orders for the treatment and added that because he was 60 miles away, he saw his job as developing protocols, not being on site to supervise.

“I didn’t understand that the board understood this to be part of the practice of medicine,” Zbylot said.

The board said Zbylot’s failure to consult with a lawyer or state authorities after he took the job “demonstrated indifference regarding the law by relying on nothing other than the statements of (the center’s) owners?’

Owner Michele O’Donnell said there were no requirements that doctors write orders for colon irrigation and “the medical board makes up the rules as they go.”

That matter is in litigation. The board ordered Zbylot not to supervise or delegate medical tasks to others. His practice also must be monitored by another doctor, and he must take a jurisprudence exam and a recordkeeping course and pay a $3,000 fine. Zbylot said he agreed to the punishment rather than undergo the expense of litigation.

The board also:

• Accepted the voluntary surrender of the license of Dr. Venkat Reddy Akkanti, a Bastrop pediatrician. The board accused him of prescribing large amounts of promethazine with codeine to numerous patients without showing it was necessary or documenting it. Akkanti denied the allegations but decided to retire at age 59, the order says.
• Ordered Dr. Rhonda Lee Anderson, an Austin psychiatrist, to pay a $1,000 fine and take courses in record keeping and drug-seeking behavior.  It said said she failed to use diligence in prescribing narcotics to a soldier who was an admitted drug abuser and was found dead in his barracks in 2008.
• Ordered Dr. Anthon Wolfe Shallin, a Georgetown internist, to pay a $3,000 fine and take courses in record keeping and urinary tract infections. The board said Shallin failed to meet the standard of care which led to a delay in diagnosing bladder cancer in a patient.
• Ordered Dr. David C. Riedel, a Liberty Hill psychiatrist, to take courses on record keeping and risk management after the board said he prescribed medicine to five relatives without examining or diagnosing them or keeping records.
• Ordered Dr. Robert Edward Cantu, an Austin psychiatrist, to pay a $1,000 fine and take a course in record keeping because of inadequate records.

State Medical Board disciplines 7 Austin-area doctors is a post from: Accident & Injury Law in Texas

A panel of cancer experts has ruled for a second time that Avastin, the best-selling cancer drug in the world, should no longer be used in breast cancer patients, clearing the way for the government to remove its endorsement from the drug.

The unprecedented vote Wednesday by the Food and Drug Administration advisory panel comes less than a year after the same panel reached the same conclusion.

In three unanimous votes, the six members of the FDA oncology drug panel voted that Avastin is ineffective, unsafe and should have its approval for breast cancer withdrawn.

“I think we all wanted Avastin to succeed, but the reality is that these studies did not bear out that hope,” said Natalie Compagni-Portis, the lone patient representative on the FDA panel.

The vote is not binding. FDA Commissioner Margaret Hamburg will make the final decision. The drug is approved for multiple cancers and will still be available for breast cancer, though most insurers are expected to drop coverage if it loses FDA approval.

The FDA began steps to remove Avastin’s breast cancer approval in December, but drugmaker Roche took the rare step of appealing that decision and lobbied the agency and Congress for a second hearing.

The dramatic, contentious tone of the two-day hearing underscored the difficulty of removing an option for cancer patients, even when backed by scientific evidence.

After the vote, patients erupted in shouts against the FDA and its panelists. “What do you want us to take? We have nothing else!” shouted Christi Turnage of Madison, Miss. She said her cancer has been undetectable for more than two years since starting therapy with Avastin.

A spokesman for the Abigail Alliance, which pushes for patient access to experimental medicine, said the vote should be overruled. “This was a kangaroo court,” said Steven Walker, the group’s co-founder. “There wasn’t one dissenting thought up there, let alone one dissenting vote.”

Assuming the FDA follows through on the withdrawal, Roche could lose up to $1 billion in revenue for its bestselling product, which generates more than $6 billion per year. Avastin is FDA-approved for various types of colon, lung, kidney and brain cancer, which are not part of the debate. Without insurance, a year’s treatment of Avastin, including administration fees, can cost $100,000.

Panel urges end of using drug to treat breast cancer is a post from: Accident & Injury Law in Texas

Three Austin doctors were among 75 disciplined this month by the Texas Medical Board, including Dr. James Edward Hansen, a neurologist, who surrendered his medical license after closing his practice.

The board’s order said Hansen suffered a spinal injury while biking and was unable to practice. It said the discipline is authorized when a doctor cannot practice skillfully and safely because of “mental or physical condition” and when the board is seeking to resolve a complaint or contested case against the doctor.

The board also ordered Dr. Dennis Barson Jr., a general practitioner, to take a course in patient boundary issues after allegedly providing false information about a court-ordered drug test for a close friend. The order said Barson did not admit guilt but signed the order to avoid litigation.

The board also ordered Dr. Lloyd Elvin Arnold Jr. to pay a $500 fine for allegedly closing his practice without giving proper notice to patients so they could get or transfer their records.

UPDATE:  I received a nasty letter from one of the doctor’s lawyers threatening a defamation lawsuit because of comments made by other people based on this article were allegedly untrue.  It’s definitely a shame some doctors and lawyers feel they can bully people who exercise their free speech rights.  While I definitely feel I can’t be held liable for someone else’s comments on this site – I’m too busy working on client files to deal with the hassle .  So I’ve removed all the comments.

Board disciplines three doctors is a post from: Accident & Injury Law in Texas