January 2009

News from Attorneys General Office

  1. Connecticut Attorney General Richard Blumenthal urged Connecticut lawmakers to establish a “Silver Alert” system in the state. In legislative testimony, Blumenthal urged passage of SB 451 that would amend the Connecticut Amber Alert process by adding a methodology to find missing senior citizens.
  2. New Jersey Attorney General Anne Milgram announced that a Pennsylvania doctor, who had formerly had offices in New Jersey, was indicted for allegedly conspiring to obtain Percocet with false prescriptions. The indictment alleges that Dr. William C. Kropinicki wrote prescriptions for Percocet in eight different fictitious names and gave them to another man, who was also indicted, who then filled them at a pharmacy.
  3. New York Attorney General Andrew M. Cuomo announced the arrests of two healthcare workers for allegedly abusing elderly residents in Rochester-area nursing homes. In one incident, Monique Jones, while employed as a nurse aide, is accused of kicking an 88-year old resident in his ribs. In the other incident, Nellie Weller is accused of immobilizing a 76-year old resident by tying his nightgown around his neck and legs.
  4. Oregon Attorney General John Kroger announced that the owner of a senior care community in Salem, Oregon, pled guilty to two counts of first-degree criminal mistreatment. The home was seized by the Oregon Department of Human Services in 2007 after it found substandard care and allegations of abuse. Marino was also accused of misappropriating more than $58,000 in residents’ funds.
  5. Pennsylvania Attorney General Tom Corbett announced the arrest of a Montour County nurse for allegedly diverting prescription drugs. Traci Lapaglia, according to court documents, obtained controlled substances from Geisinger Hospital by taking more medication from the hospital pharmacy than was needed by patients. General Corbett also announced the arrest of a Blair County podiatrist, Terry Wills, for allegedly writing false prescriptions of controlled medications in the names of family members.

Legislative Developments

  1. The Georgia legislature is considering HB 69, a bill that intends to clarify the law as to when a physician may write a DNR order without consent.
  2. The Hawaii legislature is considering SB 516 that would create a process for a patient to direct end-of-life treatment through a physician orders for life sustaining form (POLST).
  3. The New Hampshire legislature has before it a bill (SB 42) which would establish a committee to report on the feasibility of Medicaid covering hospice cost. Testimony concerning the legislation demonstrated that coverage would actually save taxpayers money since providing care for a dying patient in a hospital setting, instead of a hospice setting, is more expensive.
  4. The Wyoming legislature is considering HB 0164 that would make forgery of a drug prescription a felony. It has been given preliminary approval by the House of Representatives.

Prescription Drug Diversion

  1. An article in Fort Dodge, Iowa’s The Messenger notes that the fastest growing form of substance abuse among Iowans is the abuse of prescription drugs. Accordingto the Governor’s Office of Drug Control Policy, teenagers tend to view these drugs as “safe” and many parents are not aware of the potential for abuse.
  2. Rite-Aid Corporation and its subsidiaries agreed to pay a $5 million civil penalty to resolve violations of the Controlled Substances Act (CSA) in eight states. DEA’s investigation revealed a pattern of violations of the CSA including filling prescriptions for controlled substances that were not issued for a legitimate medical purpose. Other violations included failure to maintain and furnished required records.
  3. Colorado Springs, Colorado, physician Peter W.S. Grigg has been arrested and charged with illegally distributing controlled substances.
  4. Dr. Thomas A Kirk Jr., commissioner of Connecticut’s Department of Mental Health and Addiction Services, wrote an op-ed for the Courant, regarding the state’s effort to fight opioid abuse among young people. The article noted that at least eight young people died in the state last year of overdoses.
  5. A federal grand jury has handed up a 131-count indictment against a Destin, Florida, physician that includes allegations of unlawful dispensing of controlled substances and healthcare fraud. Dr. David Webb and his wife and office manager, Bonnie Webb, operated a medical business known as Destin Primary Care or “Doctors on Call.”
  6. Dr Harry Black, a family practice doctor from Syracuse, New York, was sentenced to four years’ incarceration on his guilty plea to charges of conspiring to distribute and possess prescription drugs and acquiring or obtaining possession of these drugs by misrepresentation, fraud, forgery, deception and subterfuge. Black was also ordered to forfeit his interest in both his home and in his medical office and to pay $38,947.35 in restitution.
  7. Oregon Public Broadcasting ran an article this month concerning federal prosecutions of addicted doctors and other professionals. According to the article, in the past year and a half, 15 western Washington doctors, nurses, and pharmacists have been prosecuted for illegal distribution and abuse of prescription drugs.

Other Items of Interest

  1. An article in Maine’s Portland Press Herald details the state’s pilot program for disposing of unwanted medications in an eco-friendly manner. Pharmacists across the state are distributing special leak proof mailing envelopes in which unwanted drugs, both prescription and over-the-counter, can be returned to the University of Maine Center on Aging where they will be incinerated. The legislature may soon be considering a bill that would require drug manufacturers to pay for a permanent disposal program for their unused products.
  2. Texas Child protective Services filed a motion in a Dallas County court asking that doctors be allowed to remove 6-month old David Coronado from life support. That motion was withdrawn after doctors assessed a change in the baby’s condition. The child has been diagnosed with 42 skeletal injuries, bruises, and human bite marks. His parents have been charged with criminal child abuse.
  3. Another court in Texas considered the case of 21-month-old Brianna Williams, a child that arrived at the hospital with severe head trauma, bruises on most of her body, and signs of strangulation. Brianna’s parents are facing child endangerment charges and the court awarded guardianship to the state. The parents agreed to a DNR but, at the hearing, the mother changed her mind and the court ruled that the DNR should be removed.
  4. The President’s Council on Bioethics recently released a white paper on brain death. Titled Controversies in the Determination of Death, the paper concludes that the neurological standard remains valid, but noted that there was disagreement among the panel members.
  5. A half-hour documentary, 203 Days, chronicles the daily life of a family that is caring for a terminal elderly parent. The video illustrates the stress that both the care-giver and her mother face and the many decisions that need to be made.
  6. The Guam Board of Medical Examiners met recently to discuss a complaint filed with it concerning the treatment, which resulted in death, of a patient at Guam Memorial Hospital. Ms. Borja was admitted to the hospital with a broken arm. She evidently did not receive the medications she needed and, in the process of being treated for various problems that then evolved, her family noticed that there was a DNR order on her chart. The DNR order evidently did not comport with Ms. Borja’s living will.
  7. PBS ran a segment this month dealing with the ethical dilemmas in the care of patients with Alzheimer’s disease.
  8. Yoshiko Colclough, a nursing professor at Montana State University, has received a grant from the Lance Armstrong Foundation to research the needs of dying patients on the Blackfeet Reservation.
  9. The second annual Oklahoma Bioethics Conference produced a number of videos which are available online from the Oklahoma Palliative Care Resource Center. These include presentations on ethical issues involving transplantation and doctor/patient communication, medically futile care, and determining mental capacity.
  10. An op-ed in the Washington Post, written by a Minnesota physician, details his experience with treating elderly patients who are near the end of their lives. The article is titled, “The Dying of the Light: The Drawn-Out indignities of the American Way of Death.” He concludes, “At some point in life, the only thing worse than dying is being kept alive.”
  11. California advocates are lobbying the legislature to pass a Silver Alert program in the state. They point to statistics from North Carolina and Florida to cite the success of the programs in those states. North Carolina found 99 people alive out of the 108 Silver Alerts issued in 2008. Florida’s program, which began in October of last year, has led to safely recovering all 32 of the reported missing seniors.
  12. Judge Edward Reibman, a Lehigh County, Pennsylvania, judge, convened a panel this month, gathering together doctors, layers, religious leaders, and court-appointed guardians, to discuss the difficult end-of-life choices he oftentimes oversees. He noted that the number of guardianship cases has increased nearly 25% over a two-year period and that the issues in a time of advancing medical technology and shifting social realities have become far more complex.
  13. A report from the United Kingdom’s Daily Mail told the story of a woman who apparently changed her mind, according to her children, about her instructions in her “living will”; however, her inability to communicate these wishes to her physicians left the family at odds with the medical establishment.
  14. The Pain and Policy Studies Group, University of Wisconsin has recently completed a preliminary review of the UN Office on Drugs and Crime model drug control laws to determine whether the model language ensures adequate availability of opioid analgesics for those in pain. The review found that the current language was not adequate. The PPSG then developed preliminary recommendations based on the Single Convention on Narcotic Drugs, as amended. The recommendations are available on the PPSG website.
  15. A study published in the January issue of the Journal of the American Geriatrics Society reported that black and Asian patients with terminal cancer were less likely than their Hispanic or white counterparts to enroll in a hospice program. They were also more likely to die in the hospital and be admitted to intensive care units near the end of their lives.
  16. Exercise to help relieve chronic back and neck pain is under utilized, according to an article in the February issue of Arthritis Care & Research. Exercise can improve physical function, decrease pain, and minimize disability caused by lower back and neck pain.

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