Sample Case Evaluation Reports - Pain Therapy Expert Witness


Pain Therapy: Medical Doctor Prescribing Narcotic Pain Medications Like a Drug Dealer.

At age 33 this patient saw Dr. John on 3/26 as a "self-referral", complaining of chronic pain. Page 1 of the typed office notes are missing.

The written notes do not fully reveal what is contained in the typed notes such as on 6/25: "not to take too much medication", and 9/17 the next year: "I told the patient that I shall not give him any more prescription (sic) for this medication and that if it continues to have these problems he needs to see a Specialist, probably Orthopedic Surgeon".

However, that was 18 months after his first visit. Dr. John was negligent in not performing a complete physical examination as it relates to the complaints of headaches, neck, shoulder and back pain. Negligent in not obtaining x-rays of his head, neck and low back as well as CT Scans or MRI's to rule out operative pathology. He never once mentioned it in his records, nor documented any refusal of his patient for any such evaluations. He was also negligent for not obtaining basic diagnostic laboratory tests for arthritis, and general laboratory tests because of the chronicity of his complaints and lack of response to home physical therapy. He also was negligent in not obtaining the EMG (Electro-Myogram) an NCV (Nerve Conduction Velocity) electrical studies to aid in the diagnosis.

There are huge amounts of narcotics being filled at 8 different pharmacies, including 4 Pharmacies of one chain. These are grossly in excess of standard doses, and most dates do not coincide with the limited office visits. You must obtain a copy of the actual narcotic prescriptions (and bottles with labels if available), to be sure that they all came from Dr. John and not other doctors, too, and that they were not forged.

If all these are from Dr. John, then he is grossly negligent and no different than any drug dealer. How did Dr. John earn money on all those prescriptions? What was his motive, if he actually wrote and signed each of them?

FYI: Lorcet is hydrocodone (a narcotic, too).

If the chain pharmacy had all their regional pharmacies on a central computer system, the pharmacy hopping behavior typical of addicted patients would (should) have been obvious, and they would have a duty to contact Dr. John and possibly the police or the State Board of Medicine. If they had that program in operation and failed to use it, then they too would be negligent.

Why did Dr. John close his office? Obtain police, DEA (Drug Enforcement Agency) records, and records from the State Board of Medicine. He would have a DEA license to prescribe narcotics.

Have the patient seen by a local Psychologist to examine him and perform the standard psychological tests to document the extent of his emotional damages from the addiction. A local economist could document his lost wages and expenses.

We recommend Medical Experts in Physical Medicine and Rehabilitation, Orthopedic Surgery, Neurosurgery, and Addiction Medicine.

Punitive damages are justified.

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