Pain clinic doctor practiced for years after first death complaint
http://www.tampabay.com/news/courts/criminal/pain-clinic-doctor-practiced-for-years-after-first-death-complaint/2213638
TAMPA — Dana Kittler turned to the Florida Board of Medicine after her 26-year-old son overdosed on painkillers in 2009. She blamed a Pinellas Park doctor who, according to state records, had prescribed him 3,360 oxycodone pills in the year before his death.
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But Dr. Edward Neil Feldman’s patients kept dying of overdoses and a grieving mother found no peace.
“They didn’t do anything about Dr. Feldman,” said Kittler, a pharmacy technician now living in Tennessee. “Not at all.”
Three times in the past three years, a Board of Medicine panel has accused Feldman of malpractice, charging that he prescribed excessive, unjustified quantities of oxycodone and other medicines to patients he didn’t adequately screen, examine, treat, or drug counsel.
He still has his state medical license. He still has a federal Drug Enforcement Agency license to prescribe controlled substances.
He could still be on the job, except for a federal judge’s temporary order to stay home and steer clear of doctoring while awaiting trial in an alleged $6 million drug conspiracy.
One of his attorneys, Warren Pearson of Tallahassee, said he has seen no evidence that Feldman directly caused the death of Kittler’s son.
Libor Mark Kittler of Seminole died March 6, 2009, when Feldman was 69. The mother filed a complaint Dec. 6, 2010, when Feldman was 71. This year, the doctor turns 76, and the complaint continues to grow old.
Department of Health spokesman Ryan Ash said the agency is preparing to forward the complaint and two others to the state Division of Administrative Hearings for a final hearing.
Feldman signed a settlement agreement in two state cases, including Kittler’s, in April, neither admitting nor denying guilt, but accepting a $40,000 fine and agreeing to sanctions, including enrollment in a drug prescribing course at the University of Florida.
However, as the full Board of Medicine was set to vote on the agreement, Pearson withdrew it.
“It’s in negotiations,” Pearson said. “We’re having a back and forth with the Department of Health regarding his case.”
In the meantime, records reviewed by the Tampa Bay Times show that at least 16 other people in possession of Feldman prescriptions have died of overdoses since the death of Kittler, who came to the United States from the Czech Republic with his family as a boy.
Three deaths from 2010 and 2011 landed in a Dec. 10 federal grand jury indictment, unsealed last week, that accuses Feldman of dispensing drugs outside the usual course of professional practice for reasons that weren’t medically legitimate.
He and his wife both face charges of drug conspiracy and money laundering, but the doctor could spend the rest of his life in prison if he is found to have caused the deaths of patients identified only by the initials “J.M,” “R.G.” and “S.W.”
Under a 2014 Supreme Court ruling that arose from a heroin dealer’s appeal, Burrage vs. United States, the government would have to prove that without the Feldman-prescribed drugs, the deaths would not have occurred.
It’s sometimes a steep threshold because abusers might combine different drugs from multiple sources, tainting toxicology studies. For many of Feldman’s patients, the cause of death was “multidrug toxicity.”
Prosecutors can make a case that a drug cocktail caused a death, but only if dangerous elements of the cocktail were all dispensed by the same doctor.
In the case of Kittler, the Pinellas-Pasco medical examiner found methadone, oxycodone and Xanax. Public records in the case do not explain the source of the methadone.
Health officials allege in an administrative complaint that Feldman prescribed oxycodone and Xanax unnecessarily even as he recommended that Kittler enter an in-patient drug rehabilitation program.
His mother knew he abused drugs but assumed they came from the street, not doctors, she said. She could tell when he was high. She would kick him out of the house to keep him from being around his young nephew.
It stunned her, after the death, to see how much oxycodone her son had been prescribed, she said. She knows now he was doctor shopping. She opened the bills later. But she saw a list of a half a year’s worth of pills, she said, and many were from Feldman.
“His prescription, I gave that prescription to police, those detectives that came to my house,” she said. “That prescription was written for oxycodone, 30 milligrams, 240 pills. Can you picture that?”
Amid federal charges in the other cases, the DEA asked Feldman to relinquish his license. He has not yet done so, DEA spokeswoman Mia Rowe said this week.
The agency is aware that Magistrate Judge Anthony Porcelli made abstention from medicine a condition of Feldman’s pretrial release. He was released on an unsecured bond, in part because the government had tied up the family’s real property by announcing it might be forfeited.
The U.S. Attorney’s Office, which filed charges based on a DEA investigation, seeks forfeiture of the couple’s Ballast Point home and a clinic on Park Boulevard.
Feldman, at various times, had offices in Tampa, St. Petersburg and Pinellas Park.
Kittler’s mother recalls the sea of emotions that nearly propelled her to visit a clinic and confront the doctor in person.
“Once, I called and I was pretty cold and mean and nasty,” she said. “But I didn’t get to talk to the doctor. They didn’t put him on the phone.
“I was asking if they know the doctor was prescribing oxycodone and other narcotics to young kids like my son. I told them my son died because of Dr. Feldman.”
He is not criminally charged in Kittler’s death. He faces possible licensing sanctions.
The Board of Medicine, whose members are appointed by Gov. Rick Scott, operates under the Department of Health, which regulates and licenses health professions.
In disciplinary actions, the department acts as prosecutor and the board serves as an independent, quasijudicial arbiter, deciding if a professional has violated the law and determining punishment.
Asked if Department of Health cases normally take this long, Feldman’s attorney declined to answer.
“I’m not going to criticize the department, as a former employee and somebody opposite them in the current case,” Pearson said.
Radha V. Bachman, a health care lawyer for the firm Carlton Fields Jorden Burt isn’t involved in Feldman’s cases.
Speaking generally, she said delays sometimes work in favor of doctors who are in the wrong, allowing them to continue to practice.
Bachman speculated that the Department of Health might be allowing federal authorities to take the lead, yielding to agencies with greater investigative powers and resources.
“Whatever happens with regard to that case could put his license in jeopardy, baseline, aside from the fact that there’s a complaint.”
Times news researcher John Martin and staff writers Jimmy Geurts and Michael Auslen contributed to this report.
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