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Complaints against Vancouver pain clinic pile up
By Brian Harrah, The Oregonian
March 13, 2009, 8:54PM
A Vancouver pain clinic, under federal investigation for prescribing oxycodone pain pills to a Gresham man who was selling them to teenagers, has been the target of more than 40 complaints since 2006.
Rachel Daggett, an 18-year-old Barlow High School senior, died of an overdose in December after smoking one of the oxycodone pills the clinic prescribed for Ronald T. Zaloznik.
Zaloznik, 33, who faces 30 months in prison, told authorities he sought out the Payette Clinic in Vancouver. Nurse practitioner Penny A. Steers prescribed him oxycodone for a back and neck injury. He became addicted to the medication and was taking more than 1,000 milligrams of the drug a day, court records show.
Just weeks after the teenager's death, the Payette Clinic sent a letter to its pain patients, informing them that Kmart and Rite Aid pharmacies in Vancouver had stopped filling clinic prescriptions. The notice directed patients to fill pain prescriptions at a high-security pharmacy in Gresham, one of the few in Oregon that delivers prescriptions by courier.
In the same notice, the clinic said it expected to grow by 30 percent this year and planned to open a sleep center "for those of you who forget to breathe under the influence of these medications."
State nursing agency will investigate
As a U.S. Drug Enforcement Administration investigation proceeds, the Washington State Nursing Care Quality Assurance Commission says it is continuing to investigate a "bundle" of complaints filed against the clinic since it opened in fall 2005.
Steers, a nurse practitioner who works at the clinic, declined to comment about patients but defended the clinic's procedures in an e-mail to The Oregonian.
"Unfortunately, there will always be a chance that the prescriber is prescribing narcotics to someone who chooses to divert the medications rather than use them," Steers wrote. "We do everything we can to prevent that from occurring."
Steers wrote that the clinic does a physical exam, reviews records, does quarterly urine drug screens and sometimes requires patients to come in for random pill counts to make sure they're taking their prescription appropriately.
Zaloznik told investigators that the clinic had once asked him to come in for a random pill count but that he brushed it off, saying he was unavailable.
Steers faces 22 complaints; Bell faces 19
Steers faces 22 complaints before the state's nursing commission. Clinic owner Kelly M. Bell, also an advanced nurse practitioner, faces 19 complaints. Bell could not be reached for comment.
Clinic co-owner Scott Pecora, a nurse practitioner who focuses on psychiatric pain medication, said Friday that anyone can file a complaint for any reason. "It doesn't mean it's true or rational."
Paula Meyer, the nursing commission's executive director, described the number of complaints as above the norm.
"We're looking at all of them, and they're all being investigated," Meyer said. "While it may appear like it's taking a long time, we have to make sure we've got good solid evidence to make a case."
In its Dec. 29 form letter to patients, the Payette Clinic alluded to the complaints made to the state's nursing board, dismissing them as largely from "pharmacists who are not familiar with chronic pain patients."
The pharmacies that refused to fill prescriptions from the Payette Clinic did not explain why. Other pharmacists and physicians said they found it odd that the Vancouver clinic would direct its patients to fill prescriptions at Assured Pharmacy in Gresham. The clinic's letter, alerting patients of the pharmacy change, described it as a "matter of survival."
"I know that one day we got a call from the clinic. Their pharmacies in Vancouver pulled out, saying, for a while, they had to have escorts to leave the pharmacy. People were getting jumped," said Daniel Peschiutta, Assured Pharmacy's head technician. Peschiutta said Payette's prescription doses are "a little bit higher" but that's not unusual for pain clinics. "I just know the clinic is always under investigation. We've been dealing with them for years."
Assured Pharmacy's head pharmacist declined to comment.
Pecora said the Vancouver pharmacies don't have the security measures in place to carry the doses that his pain clinic prescribes. He said the clinic is "filled to capacity" with patients and decided within the last week or two to limit new patients to referrals.
"Making them go out of state ... seems odd to me"
Christopher Baumgartner, who was developing Washington's Prescription Monitoring Program before funding was cut in February, said directing patients to an Oregon pharmacy is questionable.
"Making them go out of state, to one pharmacy, seems odd to me," he said. "Normally, you don't tell your patients where to go, but to whichever pharmacy is convenient to their home or doctor's office."
Vancouver physicians, Oregon and Washington pharmacists, and former patients complained to Vancouver police, the Washington Department of Health, and Oregon and Washington pharmacy boards last year about the clinic prescribing extremely high doses of painkillers to patients and the large number of clients paying cash for their prescriptions. One pharmacist said he received calls from local emergency rooms about overdoses from the Vancouver clinic's narcotic prescriptions.
A 41-year-old former clinic patient, who asked not to be identified because she is assisting the DEA inquiry, said she had overdosed on medication prescribed by the clinic, only to be put on the same dose after completing residential drug treatment. She also complained that other patients had tried to sell her pills outside the clinic.
Jack Daggett, whose daughter died from the oxycodone overdose Dec. 9, learned from investigators that Zaloznik was prescribed a "tremendous amount" of painkillers.
"I'm questioning the system," Daggett said. "Why was he being overprescribed?"
http://www.oregonlive.com/news/index.ssf/2009/03/complaints_against_vancouver_p.html
By Brian Harrah, The Oregonian
March 13, 2009, 8:54PM
A Vancouver pain clinic, under federal investigation for prescribing oxycodone pain pills to a Gresham man who was selling them to teenagers, has been the target of more than 40 complaints since 2006.
Rachel Daggett, an 18-year-old Barlow High School senior, died of an overdose in December after smoking one of the oxycodone pills the clinic prescribed for Ronald T. Zaloznik.
Zaloznik, 33, who faces 30 months in prison, told authorities he sought out the Payette Clinic in Vancouver. Nurse practitioner Penny A. Steers prescribed him oxycodone for a back and neck injury. He became addicted to the medication and was taking more than 1,000 milligrams of the drug a day, court records show.
Just weeks after the teenager's death, the Payette Clinic sent a letter to its pain patients, informing them that Kmart and Rite Aid pharmacies in Vancouver had stopped filling clinic prescriptions. The notice directed patients to fill pain prescriptions at a high-security pharmacy in Gresham, one of the few in Oregon that delivers prescriptions by courier.
In the same notice, the clinic said it expected to grow by 30 percent this year and planned to open a sleep center "for those of you who forget to breathe under the influence of these medications."
State nursing agency will investigate
As a U.S. Drug Enforcement Administration investigation proceeds, the Washington State Nursing Care Quality Assurance Commission says it is continuing to investigate a "bundle" of complaints filed against the clinic since it opened in fall 2005.
Steers, a nurse practitioner who works at the clinic, declined to comment about patients but defended the clinic's procedures in an e-mail to The Oregonian.
"Unfortunately, there will always be a chance that the prescriber is prescribing narcotics to someone who chooses to divert the medications rather than use them," Steers wrote. "We do everything we can to prevent that from occurring."
Steers wrote that the clinic does a physical exam, reviews records, does quarterly urine drug screens and sometimes requires patients to come in for random pill counts to make sure they're taking their prescription appropriately.
Zaloznik told investigators that the clinic had once asked him to come in for a random pill count but that he brushed it off, saying he was unavailable.
Steers faces 22 complaints; Bell faces 19
Steers faces 22 complaints before the state's nursing commission. Clinic owner Kelly M. Bell, also an advanced nurse practitioner, faces 19 complaints. Bell could not be reached for comment.
Clinic co-owner Scott Pecora, a nurse practitioner who focuses on psychiatric pain medication, said Friday that anyone can file a complaint for any reason. "It doesn't mean it's true or rational."
Paula Meyer, the nursing commission's executive director, described the number of complaints as above the norm.
"We're looking at all of them, and they're all being investigated," Meyer said. "While it may appear like it's taking a long time, we have to make sure we've got good solid evidence to make a case."
In its Dec. 29 form letter to patients, the Payette Clinic alluded to the complaints made to the state's nursing board, dismissing them as largely from "pharmacists who are not familiar with chronic pain patients."
The pharmacies that refused to fill prescriptions from the Payette Clinic did not explain why. Other pharmacists and physicians said they found it odd that the Vancouver clinic would direct its patients to fill prescriptions at Assured Pharmacy in Gresham. The clinic's letter, alerting patients of the pharmacy change, described it as a "matter of survival."
"I know that one day we got a call from the clinic. Their pharmacies in Vancouver pulled out, saying, for a while, they had to have escorts to leave the pharmacy. People were getting jumped," said Daniel Peschiutta, Assured Pharmacy's head technician. Peschiutta said Payette's prescription doses are "a little bit higher" but that's not unusual for pain clinics. "I just know the clinic is always under investigation. We've been dealing with them for years."
Assured Pharmacy's head pharmacist declined to comment.
Pecora said the Vancouver pharmacies don't have the security measures in place to carry the doses that his pain clinic prescribes. He said the clinic is "filled to capacity" with patients and decided within the last week or two to limit new patients to referrals.
"Making them go out of state ... seems odd to me"
Christopher Baumgartner, who was developing Washington's Prescription Monitoring Program before funding was cut in February, said directing patients to an Oregon pharmacy is questionable.
"Making them go out of state, to one pharmacy, seems odd to me," he said. "Normally, you don't tell your patients where to go, but to whichever pharmacy is convenient to their home or doctor's office."
Vancouver physicians, Oregon and Washington pharmacists, and former patients complained to Vancouver police, the Washington Department of Health, and Oregon and Washington pharmacy boards last year about the clinic prescribing extremely high doses of painkillers to patients and the large number of clients paying cash for their prescriptions. One pharmacist said he received calls from local emergency rooms about overdoses from the Vancouver clinic's narcotic prescriptions.
A 41-year-old former clinic patient, who asked not to be identified because she is assisting the DEA inquiry, said she had overdosed on medication prescribed by the clinic, only to be put on the same dose after completing residential drug treatment. She also complained that other patients had tried to sell her pills outside the clinic.
Jack Daggett, whose daughter died from the oxycodone overdose Dec. 9, learned from investigators that Zaloznik was prescribed a "tremendous amount" of painkillers.
"I'm questioning the system," Daggett said. "Why was he being overprescribed?"
http://www.oregonlive.com/news/index.ssf/2009/03/complaints_against_vancouver_p.html
