November 1, 2011

Our research regarding physician medical malpractice and physician disciplinary actions taken against doctors throughout the United States has brought to our attention the fact that many of the physicians whose medical licenses are revoked, suspended, or surrendered get in  trouble due to their negligent or intentional wrongdoing involving “pain management” and, in particular, the use and management of controlled substances such as narcotic drugs for chronic pain patients and others. (Too often the “others” are people who do not need multiple and ongoing narcotics for chronic pain management and either use the narcotics inappropriately or illegally sell the controlled drugs to others (referred to as “diversion”)).

As an example, a physician who was board-certified in family medicine and had held a medical license in Maryland since April 14, 1970, surrendered his medical license on August 1, 2011 to the Maryland State Board of Physicians (“Board”). The Board had received three complaints that the doctor had excessively prescribed controlled dangerous substances (“CDS”). In response, the Board acquired twelve random patient records from the doctor. The twelve patient records were then forwarded for an independent expert review. Subsequently, the Board filed formal charges against this doctor for alleged violations of the Maryland Medical Practice Act.

For one of the doctor’s patients, it was charged that the doctor had prescribed Klonopin and Darvocet-N 100 but failed to document a pain management plan and failed to document urine toxicology screening to confirm that the patient had been taking the prescribed medications and/or to check for any illicit drugs.

For another patient, the doctor prescribed alprazolam, lorazepam, Darvocet-N 100, and other controlled dangerous substances without documenting an adequate pain management plan, without adequately attempting or documenting non-CDS treatment modalities, without adequately documenting the efficacy of the medications, without documenting attempts to taper the patient’s medications, without documenting any consideration of CDS abuse or diversion, etc.

Click here to read the specific and extensive allegations against this doctor regarding his prescribing CDS to his patients whose records were independently reviewed on behalf of the Board.

The Board set forth what it considers to be the Standard of Practice Relating to Pain Management Patients:

1. An appropriate initial history should be elicited including any substance abuse history;

2. An appropriate physical examination should be conducted related to the pain;

3.  If complaints of pain are related to past events, patient records should be requested from other providers to substantiate relevant diagnostic and medication history;

4. Documentation of patient visits for pain management should include an interval history of the problem and reassessment during every visit, even if succinct,  and an assessment of the problem, any objective findings and a treatment plan;

5. The patient should be referred for appropriate evaluation of pain including testing and/or consultations with specialists when indicated;

6. If there is any suspicion of diversion, toxicology screening should be considered to confirm the patient is taking the prescribed medication and to check for any illicit drugs;

7. Consideration should be given and documented to appropriate treatment with non-opioid alternatives and adjunctive therapies such as physical therapy and psychotherapy;

8. If CDS are prescribed in an ongoing fashion, there should be a documented plan for management of pain; and,

9. There should be documentation of periodic reevaluation of the need for the medication and if applicable, attempts to wean a patient off the medication.


If your pain management doctor’s treatment of you caused injury or other harm, visit our website to be connected with medical malpractice lawyers in your state who may be able to assist you with a medical malpractice claim based on the negligent treatment you received. You may also call us toll free at 800-295-3959.

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