A Northern California doctor is being accused of gross negligence and prescribing excessive amounts of pain pills to six patients who died of overdoses under his care, according to the Medical Board of California.
A 60-page report details the alleged conduct of Dr. Thomas Neuschatz, who has practiced in Chico, Marysville and rural Yuba County. He's accused of prescribing escalating doses of narcotics to patients with addiction problems while taking few steps to substantiate their complaints of pain.
The complaint describes nine patients who died under his care. Six of them, including a 19-year-old who had twice been in residential drug rehabilitation, died of drug poisoning or overdoses of addictive sedatives and opiates that Neuschatz prescribed. The drugs included oxycodone, methadone and Soma.
Prescription pain pills were linked to more than 15,000 U.S. deaths in 2009, or about 41 per day, according to the Centers for Disease Control and Prevention. The CDC has called the problem a national epidemic and tracked escalating prescribing of morphine-based drugs to rising deaths.
The state medical board released its report in May. Neuschatz was seeing patients Wednesday, according to a woman who answered the phone at his Marysville office, but neither the doctor nor his attorney returned calls for comment.
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Doctors facing accusations by the medical board can surrender their license, fight the case at an administrative hearing or seek a settlement with the board.
California Watch reported last week about the medical board’s case against an East Bay doctor, Edward Manougian, who was linked to the deaths of three patients who also were prescribed narcotic pain pills.
Other California doctors have been prosecuted for negligent prescribing of narcotic pain pills, including Dr. Julio Diaz, a Santa Barbara doctor whom some patients nicknamed the "candy man." Diaz has been linked to scores of emergency room admissions and a dozen patient deaths.
In all three doctors’ cases, complaints about the physicians’ practices were filed with the board that oversees physician conduct months or years before the board filed formal accusations.
A Nevada County doctor was among the first to complain about Neuschatz in June 2009, about three years before the board filed a formal complaint. The physician said Neuschatz was prescribing opiates to a patient with a "remote" history of a wrist fracture and a history of addiction.
The patient told a medical board investigator that he went to Neuschatz “because he heard it was easy to get medication from him” and paid $50 to $60 for five-minute visits. The patient also said he woke up in the hospital two days after overdosing on Percocet. He said his addiction to prescription drugs cost him his marriage, house and job.
Later in 2009, the sister of another patient also complained to the medical board, records show. She said Neuschatz was prescribing multiple controlled substances to her 42-year-old sister, even though the woman had a history of substance abuse and had sold drugs prescribed by Neuschatz.
Records show Neuschatz prescribed the woman the equivalent of 1,035 milligrams of morphine a day, a dose far higher than the 100 to 200 milligrams typically given to cancer patients, the board accusation says. The American Pain Society has concluded that 200 milligrams of morphine per day, which is less than two top-strength OxyContin pills, is a "high dose" that merits a closer look.
Soon after the late 2009 complaint, the board began to examine cases in which Neuschatz's patients had died. One was a 19-year-old who was in and out of college and drug rehabilitation before he died in early 2010. Records show Neuschatz was the only doctor the teen was seeing when he was being prescribed methadone, hydromorphone, oxycodone and Xanax.
The patient told Neuschatz that he had a drug-related hospital admission in his past. He also said he had neck pain from a sports injury and two car accidents, but could not recall the names of his doctors or where he got prior prescriptions for oxycodone.
Records show that when the teen went home to San Diego in late 2009 for a residential drug detoxification program, Neuschatz continued to prescribe the patient hydromorphone, sold commercially as Dilaudid, and methadone. Soon after, the teen died while he was prescribed a course of 740 milligrams of morphine per day.
Another patient, a 42-year-old special education teacher, died Dec. 7, 2010, after paying $65 each for 28 visits with Neuschatz. The woman's housekeeper found her dead in her home two days later. She died of acute poisoning from multiple pharmaceuticals, including morphine and methadone.
Records show the patient was on “modest” and “appropriate” doses of hydrocodone and ibuprofen when she began to see Neuschatz. He prescribed her additional opioid drugs.
The patient’s daughter, records show, had called Neuschatz twice during the summer of 2010, concerned about her mother’s functional and mental deterioration. The board accusation says Neuschatz told the daughter to talk to her mother’s primary care doctor.
The board accusation says Neuschatz was grossly negligent by failing to respond to the patient’s complaints about memory loss and sedation before her death.
Several other patients being treated by Neuschatz died of overdoses, including a 61-year-old woman whose Walgreens pharmacist called to warn her of "toxic interactions" between the medications prescribed to her.
The medical board complaint states that family members of other patients reached out to Neuschatz, asking him to limit his prescriptions.
In one case, which did not involve a death, the father of a 19-year-old Chico State University student called, records show, pleading with the doctor to stop prescribing after the teen had a seizure attributed to Xanax withdrawal while home in San Diego in January 2010. Records show that in 2009, the student was being prescribed the equivalent of 1,700 milligrams of morphine per day and repeatedly sought drug refills, saying his medications were being stolen.
After the father asked the doctor to stop prescribing, the medical board complaint says Neuschatz did not document the request in the son's medical record.