Dangerous doctors: Pain pill physicians keep prescribing, despite state charges
As Florida emerged as the epicenter of the nation’s prescription drug crisis nearly a decade ago, when pain clinics popped up in neighborhoods and loose rules let people sweep up painkillers by the score, state lawmakers vowed to crack down.
Despite the tough talk, Florida health regulators have allowed doctors they accuse of improperly prescribing painkillers to keep doling out pills for years.
The South Florida Sun Sentinel identified at least 50 doctors who remain free to prescribe while state cases against them linger, some for as long as eight years.
These unresolved cases reveal some of the state’s most confounding doctor regulation issues.
Though state law requires prosecutors with the Department of Health to expedite cases that are older than a year, the cases against each of these doctors are more than
a year old. They include doctors who have racked up new charges while their initial cases sat untouched. And they make up some of the health department’s oldest unresolved cases against doctors.
The findings are the latest in a Sun Sentinel investigative series that has exposed a system that is slow to punish doctors accused of endangering patients, reluctant to suspend them after charges are filed, and quick to let them off the hook with settlement deals.
“I am very concerned about the issues your investigative reporting has uncovered,” state Sen. Dana Young, R-Tampa, who heads the Senate’s health policy committee, said in a statement about the series. “I have raised this issue with the Department of Health and have asked them to provide options to us where we can put more teeth into the enforcement apparatus.”
Four cases, all unresolved
The Department of Health has spent eight years building four cases against Dr. Fred Liebowitz, but has yet to resolve any of them.
All the while, he’s continued to write prescriptions from his Fort Myers pain clinic.
The state’s cases accuse Liebowitz of mishandling painkiller prescriptions for 13 patients. One of them was Michael Moore, 51, who was found dead on the floor of a Fort Myers hotel room, near methadone pills and a prescription from Liebowitz. A medical examiner ruled his 2009 death an accidental overdose by methadone and clonazepam, used to treat anxiety.
Liebowitz prescribed oxycodone, methadone and clonazepam to Moore, despite records showing his patient had a history of drug abuse and that he was likely taking more medication than he was supposed to, the health department said when it charged the doctor.
The state’s prosecution of Liebowitz raises questions about the health department’s urgency in prosecuting doctors — even for those who have racked up multiple allegations.
State health regulators have said cases take time because of the difficulty of tracking down witnesses and navigating complicated medical issues. But the state waited more than two years to ask Liebowitz to correct incomplete paperwork. Once they did, he addressed the issue within three weeks.
That was in May. Still, the cases against Liebowitz sit idle, waiting to be sent to the Florida Division of Administrative Hearings, said Brad Dalton, a health department spokesman. Cases are sent there to be heard by a judge when a doctor disputes the state’s allegations. Dalton did not answer questions about why the cases have not yet been sent to the division for a formal hearing or why the paperwork error was unaddressed for two years.
“Every health care licensee is afforded due process rights under the law,” he said.
Liebowitz, 57, did not respond to requests seeking comment.
Tougher penalties, but are they used?
The health department doesn’t know how many doctors accused of inappropriately prescribing pain medication can still give out pain pills. The Sun Sentinel found out by reviewing hundreds of unresolved cases.
The pending cases include a Fort Lauderdale doctor who was charged by the health department six years after he was first investigated; a Naples-area doctor accused of writing painkiller prescriptions while his license was suspended; and a Clearwater doctor with three open cases, each more than five years old.
Dalton said health department prosecutors prioritize cases based on the severity of the allegations, whether there are multiple accusations against a doctor or if a doctor has been disciplined before.
“We take very seriously our role in the protection of Florida’s patients and our duty to follow the law in the fair investigation and prosecution of any health care provider we license,” he said.
One of the ways state lawmakers have tried to address Florida’s painkiller problem over the past decade is by stepping up enforcement penalties.
A 2011 state law added a special punishment for doctors found to have inappropriately doled out pain medication, requiring state boards to issue a minimum six-month suspension and $10,000 fine. Repeat offenders are supposed to get extra penalties.
But the health department cannot say how often the new punishment has been used — or if it has been used at all.
State tries to discipline, but doctor rejects it
State investigators as long ago as 2009 were concerned about Dr. Willem Ouw, saying in reports that the Broward County doctor had a pattern of giving out painkillers in large amounts.
In 2013, the Department of Health charged him in two cases. But they didn’t stop him from writing prescriptions.
The cases involving Ouw, 84, show how much power doctors have to avoid punishment and how state health regulators fail to follow through on discipline cases. State health officials prefer to resolve most doctor discipline cases through settlement agreements, which require approval from state medical boards — and the doctors themselves.
The state Board of Medicine, which regulates doctors, tried in June of 2014 to restrict Ouw from prescribing controlled substances, put him under supervision for a year and fine him $60,000.
But Ouw rejected the board’s punishment and health department officials made no further efforts to try and discipline him.
Nor did the state suspend Ouw’s license while the prosecution continued. Though the state has such power, it rarely uses it, the Sun Sentinel found.
With his license intact, federal officials said Ouw ran a pill mill, illegally giving out prescriptions for more than 480,000 oxycodone, amphetamine and morphine pills.
In June, federal authorities arrested Ouw and barred him from prescribing pills, doing what Florida health regulators tried to do three years earlier.
Ouw, who declined to comment through his federal defense attorney, is scheduled to go on trial in January.
The health department’s cases against him remain unresolved.
State Rep. Katie Edwards-Walpole, D-Plantation, said doctors accused of overprescribing should be prosecuted like drug dealers instead of waiting on state health regulators to act.
“I’m exasperated,” she said. “Why should they be provided with added layers of protections?”