INDIANAPOLIS – Lengthy testimony on seven patient deaths highlighted the disciplinary hearing of embattled Fort Wayne pain management Dr. William Hedrick on Thursday before the Indiana Medical Licensing Board.
An expert witness for the state identified what he considered to be evidence of substandard care – from overprescribing powerful narcotics to failing to respond to obvious signs of abuse by patients.
But during cross-examination, Hedricks attorney noted several factual inaccuracies in the witnesses examination of the patient charts and indicated there are differing opinions on some of the treatment.
The board decided to adjourn the daylong hearing after it was clear another eight hours would be needed to conclude the testimony. The case will continue either at the boards regular March meeting or on another date agreed upon by all parties.
Hedricks license to practice medicine remains temporarily suspended. The worst punishment he faces is a full revocation, which lasts for at least seven years and is relatively rare.
The state Attorney Generals Office filed a complaint against Hedrick in December, accusing him of incompetence and recklessly prescribing pain medications.
Hedrick is founder and president of the Centers for Pain Relief, which is based in Fort Wayne but has more than a dozen other locations in northern Indiana. In the past few months, multiple lawsuits have been filed against him, and a number of patients have come forward claiming he got them addicted to controlled substances. There also was a raid on Hedricks offices by local, state and federal authorities.
In opening statements, Deputy Attorney General Jessica Krug said Hedricks practice involved a number of physicians and other employees who failed to concern themselves with patient safety and outcomes.
She alleged Hedrick and others ignored clear evidence of addiction to and diversion of controlled substances. The issues mainly center on opioid therapy – or the chronic use of strong painkillers to control pain.
He contributed to and maintained addiction in patients, Krug said.
She said Hedrick claims he cant be held accountable for actions of other physicians or employees in his practice, but the evidence shows Dr. Hedrick failed to watch the store.
Hedricks attorney, Stacy Cook, first asked the board to ignore the fact that Hedrick sought a settlement of the case last month that would have resulted in a two-year suspension of his medical license.
She said before Thursday the case has been all allegations and speculations, but facts and evidence from patient charts refute the states claims.
Cook described the evidence related to the seven deaths as weak, noting that two of the patients at the time of death had no controlled substances in their system. In two other deaths, Cook said a coroner ruled the death was due to multiple drug toxicity based only on a drug screen – not an autopsy.
She plans to call a number of experts, including a toxicologist, a pain medication specialist and a pathologist. Hedrick is also expected to testify.
The states star witness, Dr. Timothy King, runs a pain management clinic in Crown Point. He reviewed the charts of the seven patients who later died. Krug led the doctor through individual chart notes for hours.
King identified several patterns that he questioned as being proof of substandard care.
First, he didnt believe the patients were candidates for chronic opioid therapy because of other health problems, psychiatric diagnoses and previous abuse history. Next, he found several notations of patients either not taking the medication or taking too much, yet the staff at Hedricks practice continued the prescriptions.
Third, King said there was evidence in multiple cases that the patient was getting additional painkillers from other doctors but the treatment was continued and sometimes increased. Sometimes the patients reported no improvement and yet medication and spinal injections continued.
Lastly, King said a few specific chart notes directed that opiates be stopped but prescriptions were still given.
On cross-examination, Cook used a number of peer-review articles and journals to dispute what King considered to be standards of care. Specifically, King criticized the use of spinal injections by Hedrick, and Cook pointed to differing opinions on the matter.
In addition, she pointed out several inaccuracies in Kings summaries of patients treatment.
For example, one patient was allegedly given an opiate prescription after the chart specifically said it should be discontinued. Cook forced King to examine an inspect report – a state database tracking controlled substances prescriptions – that showed no prescription from the same date of the office visit.
On another case, she forced King to acknowledge that he had left heroine off the list of drugs found in a drug screen of one of the deceased patients.