death in this case was a combined overdose of methadone and (alcohol)
Overdose death leads to reprimand for Minnesota physician
The 2014 overdose death of a patient has led to a local physician being fined and reprimanded by the Minnesota Board of Medical Practice.
Dr. Timothy L. Burke, an infectious-disease specialist for Essentia Health-Duluth Clinic at the time of the incident, was cited for “unethical and unprofessional conduct,” said a news release from the state board earlier this month.
Burke’s medical license, issued by the board in 1995, has been placed on conditional status and he must complete a series of steps for it to be restored. He was also fined a civil penalty of $2,500.
Neither Burke nor his attorney, Steven Schwegman of St. Cloud, could be reached for comment.
A July 2015 internal publication for Essentia Health, Daily Dose, featured a story announcing Burke’s retirement. While retired from practice with Essentia Health, he “still works occasionally as a casual physician,” said Essentia spokeswoman Maureen Talarico in an email. She declined elaboration by adding, “Matters between the Minnesota Board of Medical Practice and the physicians it licenses are separate from the physicians’ relationships with Essentia Health.”
Executive Director Ruth Martinez told the News Tribune the state board has the authority to reprimand its licensed physicians, suspend licenses, invite someone to voluntarily surrender a license and even revoke licenses. The reprimand is a part of a physician’s record forever, she said.
According to a stipulation agreed upon by the board and Burke, filed by the state board, Burke had treated the male patient since 2006, authorizing controlled substances for the patient, including concurrent prescriptions for methadone and clonazepam, “based on the patient’s claims of pain or other symptoms.” The stipulation listed the patient with multiple health issues, including “chemical dependency, polysubstance abuse, mental health issues and personality disorder.”
Burke, the stipulation said, failed the patient in numerous ways related to the medications, including failing “to conduct routine biological fluid screens to monitor” the patient’s compliance with his medication regimen or use of additional drugs and alcohol.
The patient had been living in a group home and when he decided to leave the group home, Burke “explained to the patient that he had a number of reservations” about the patient’s decision based on the his history of alcohol misuse and medication noncompliance.
Upon the patient’s release from the group home, Burke performed an exam and requested the group home release medications to the patient.
The patient was “later found dead,” the stipulation said. An autopsy by a medical examiner determined ” ‘death in this case was accidental and secondary to a combined overdose of methadone and (alcohol).’ ” Chronic obstructive pulmonary disease was also listed as a contributing factor in the man’s death, the stipulation said.
The state board first received a complaint about Burke’s treatment of the patient in August 2014, the stipulation said. The stipulation does not indicate who filed the complaint.
In addition to failing to perform body fluid screenings for medication levels, the stipulation said Burke failed to “document objective clinical findings to support the need for initiating or renewing the medications, failed to explore non-narcotic treatment options, failed to document an overall treatment plan, and failed to provide referrals or establish care,” for the patient with a primary care physician, a psychiatrist or other specialists to coordinate the patient’s overall health care.
While he was in the group home, “the group home maintained control” of the patient’s medications to ensure proper administration, the stipulation said. Burke then “failed to monitor the efficacy of the medications” and “failed to implement a controlled substance contract,” the stipulation said.
In December 2015, Burke appeared before the state board and acknowledged he prescribed the narcotics for the patient, who “had a history of chronic pain, depression, anxiety and alcohol use,” the stipulation said.
In order to petition for the reinstatement of his license unconditionally, Burke is required to read policy for pain control and a clinical guide for responsible opioid prescribing, as well as complete courses on chemical dependency awareness and chronic pain management.
Upon completion of the readings and coursework, he will need to write a paper describing what he learned, how he might treat the patient of the investigation differently, and how he will implement that knowledge into his practice.
Burke is listed in the stipulation as having been born in 1953, with a birthday this month, putting his age at 62 or 63.
According to the story of Burke’s retirement published in the Essentia’s Daily Dose, Burke “was the physician epidemiologist at St. Mary’s Medical Center from 2000 to 2013. He served as chief of the Department of Medicine from 2005 to 2010 and was the chief of Medical Staff from 2011 to 2014.”
Burke wrote columns for the News Tribune during the H1N1 flu crisis in 2012-13 and was often cited as a source for News Tribune stories during flu season. In the Daily Dose publication announcing his retirement, Dr. Rajesh Prabhu described Burke as ” ‘an excellent clinician and universally well respected colleague.’ “
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