A Tucson neurologist has been placed on probation after mismanaging the pain treatment of eight patients, including one who died.
That physician, Dr. Mitchell Halter, was one of several Tucson doctors disciplined for "unprofessional conduct" last week by the Arizona Medical Board. The disciplinary records were released Monday.
Another neurologist, Dr. Carol Henricks, was reprimanded for her failure to properly diagnose and treat a spinal injury, resulting in the patient's paralysis and disability.
Two other doctors were cited for improperly prescribing narcotic pain-killing drugs, resulting in their patients' addiction and, in one case, an acute but not fatal overdose.
Here are details of the cases and the medical board's disciplinary actions:
Dr. Mitchell Halter
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The board's investigation of the neurologist and pain specialist was launched after Halter was suspended by Northwest Medical Center due to concerns about his patient infection rate, lack of sterile technique and his competency, according to board documents.
The board found serious problems with eight patients treated for pain by Halter. One of those patients, a 77-year old woman suffering from metastatic breast cancer, went into acute distress when Halter left her "unattended and unmonitored" after infusing her with an anesthetic epidural to control her bone pain. She then suffered cardiac arrest and died three days later.
Halter told the board he thought the patient's sudden decline was likely due to a blood clot to the lungs brought on by her lengthy bedridden state.
Halter violated the standard of care for failing to monitor the patient's vital signs during and after the pain procedure, and for doing the procedure without skilled nursing or resuscitation equipment and drugs immediately available, the board found.
Another patient in his care, a 57-year old woman with diabetes and lung disease, twice suffered respiratory failure after he implanted her with a drug-infusing pump to administer a muscle relaxant and morphine, trying to control pain and twitching from a recent leg amputation.
The board cited Halter for giving the frail patient morphine unnecessarily, for improperly dosing her, and failing to recognize her overdose.
In the cases of five more patients, Halter was cited for failing to properly treat infections that developed after he implanted them with pain control devices, board documents say. And in another patient, he unsuccessfully tried to implant a pain device without good medical reason or sufficient training to do so, the board found.
In testimony before the board, Halter said he is the doctor other doctors send their sickest and most difficult pain patients to. He added he "has only had the interest of providing the best, most cutting edge, effective treatment for people who very often have no other hope," board documents say.
"These are very, very complex cases," said Halter's attorney, Daniel Jantsch. "We dispute a lot of the evidence that was presented, virtually all of it, but we decided it was not worth the time, effort or expense to fight this legally any further."
Placed on two years' probation, Halter is forbidden to implant pain control devices until he undergoes further training that satisfies the medical board's demands. He also was issued a letter of reprimand, the medical board's mildest form of discipline.
Dr. Carol Henricks
The Tucson neurologist also was given a letter of reprimand for her treatment of a patient who went to the ER complaining of numbness and tingling in the legs.
After a series of tests, Henricks failed to diagnose a spinal cord injury due to a herniated disc. The delay in treatment caused the patient to develop pressure sores, inflammation and paralysis, resulting in "permanent spinal cord injury and disability," the board found.Efforts to contact Henricks on Monday were unsuccessful.
Dr. Susan Fleming
The Tucson pain specialist was put on one-year probation after prescribing huge amounts of the narcotic painkiller oxycodone, as well as anti-anxiety drugs, over a one-year period to treat chronic back pain and dental problems in a 48-year old man.
Fleming was cited for failing to adequately examine the patient before prescribing those drugs, for prescribing too much, and for failing to recognize and monitor the patient's "aberrant drug-seeking behavior" and addiction, according to the board's probation order.
Fleming was issued a letter of reprimand and ordered to undergo further training in prescribing medications.
Telephone calls to Fleming and her attorney were not returned Monday.
Dr. Darrell Jessop
The Tucson family physician also was placed on a yearlong probation for poor pain management of a patient.
The board cited Jessop for rapidly increasing dosages of the narcotic painkiller OxyContin to treat the patient's chronic back pain, then adding "excessively high" doses of methadone, also a narcotic, for a painful infection, causing the patient to overdose.
The patient voluntarily entered treatment to detox from prescription narcotics.
Given a letter of reprimand, Jessop also was ordered to undergo training in pain management.
Efforts to contact Jessop on Monday were unsuccessful. A voice message at his office said his family practice was "permanently closed."
