A Medford doctor is accused of gross negligence, dishonorable conduct and violation of the federal Controlled Substances Act after he repeatedly overprescribed painkillers to high-risk patients, one of whom died from an overdose, according to the Oregon Medical Board.
The board recommends that Dr. Thomas Purtzer, a neurosurgeon and pain management physician who previously operated a clinic in Medford, lose his license and pay a $10,000 civil penalty.
The board's review of patient records found Purtzer failed to obtain or review medical histories of several high-risk patients and ignored signs of drug abuse, which included requests for early refills — which he filled — and inconsistent drug screens.
OMB says Purtzer initiated high-dose opioid "bridging therapy" to transition methadone patients to a different drug without medical evidence to support his treatment plans.
"(Purtzer's) practice failed to conform to the standard of care and subjected his patients to the risk of harm," the documents state.
Under Oregon law, Purtzer is entitled to a hearing to contest the findings. OMB officials said it is not known when the case will be resolved.
Multiple attempts to reach Purtzer Monday were unsuccessful. Phone numbers listed either indicated voicemail inboxes were full or had been disconnected. His clinic, listed on his website as the Intractable Pain Center off McAndrews Road, has been vacated.
The OMB reported Purtzer voluntarily withdrew from practice and placed his license on inactive status in November 2013. The board issued its complaint and notice of proposed disciplinary action in February.
The complaint details several cases in which Purtzer overprescribed narcotics. One patient, identified as "Patient D," allegedly first came to Purtzer in January 2012 for treatment of opiate addiction, which included a history of overdosing on prescription drugs and heroin.
Purtzer started Patient D on morphine sulfate, a pain reliever, and told him to determine his own appropriate dose, OMB's complaint states. Purtzer received a phone report that Patient D was selling his medications on the street and learned that the patient's urinalysis results showed he'd been using heroin but not the Klonopin he'd been prescribed.
"Nevertheless, (Purtzer) continued prescribing Suboxone and Klonopin to Patient D at his last office visit on Nov. 8, 2012," documents read.
Patient D died from an apparent intravenous heroin overdose on Nov. 11, 2012. A police investigation showed Patient D had been selling or trading his prescriptions for heroin.
Another high-risk patient, "Patient E," had come for treatment of chronic pain that Purtzer attributed to fibromyalgia syndrome, and for low back and leg pain. Patient E also had a prior diagnosis of bipolar disorder. The report states Purtzer put Patient E on a regimen of oxycodone, clonazepam and carisprodol without maintaining effective surveillance measures and while continuing her on regular daily doses of lithium "without obtaining periodic labs for lithium levels or monitoring thyroid and kidney functions."
The OMB has investigated Purtzer before for his treatment of chronic pain patients and the manner in which he prescribed narcotics. Purtzer entered into a corrective action agreement with the OMB in 2009 and successfully completed a Physicians Education Evaluation and Renewal Program, the OMB's complaint states.
In September 2012, the OMB opened another investigation after a patient who'd been receiving "significant narcotics" from Purtzer died of an overdose. The investigation closed in December 2012 with OMB notifying Purtzer of its concern that "he should obtain prior medical records before treating a chronic pain patient with opioids."
The current investigation stems from a complaint the OMB received over Purtzer's prescribing of Suboxone to treat opioid addiction.
Reach Mail Tribune reporter Ryan Pfeil at 541-776-4468 or by email at firstname.lastname@example.org.