Saying they were frustrated by how long their investigation took, medical board officials on Thursday stripped Dr. Kevin Buckwalter of his license to prescribe controlled substances after a review of his records found four cases of malpractice, including one where “excessive” doses of narcotics contributed to a patient’s death.
Family members of patients who died while under Buckwalter’s care say they are relieved by the action, but that it’s too little, too late.
“I think he’s a menace to society in general and should never be able to practice medicine again,” said Don Baile, whose wife, Barbara, died from side effects of narcotic medicines prescribed by Buckwalter, according to experts who reviewed her records.
The Sun reported in September and October the stories of four patients who died or overdosed on narcotics while under Buckwalter’s care. Experts who reviewed the records in each case called Buckwalter reckless and negligent and said he should not be practicing medicine.
Louis Ling, executive director of the Nevada State Medical Examiners Board, said the probe into the Henderson physician’s prescribing habits highlights the need to change the investigation process so it’s “more responsive and more timely.” The board will discuss possible legislative changes at its December meetings, he said.
“We’d like to find a way to make this faster,” Ling said.
Ling would not say how long the Buckwalter investigation has taken, but said it went as fast as it could have given current state laws and the fact that multiple agencies were involved. Sources have told the Sun the Drug Enforcement Administration is also investigating Buckwalter, but the agency will not comment.
Dr. Jerry Calvanese, an emergency medicine physician in Reno, reviewed on behalf of the medical board the four patient files. They were not the same cases reported by Sun. He wrote in an affidavit that the “vast majority of records include essentially no physical exam” and that there are concerns Buckwalter has administered inappropriate narcotic shots in his office without taking proper precautions to protect patients. He called Buckwalter’s records “vague, haphazard and illegible,” and not up to expected standards.
In the case of the patient who died, Buckwalter prescribed “excessive” doses of the narcotic painkillers OxyContin and Kadian in 2004 and 2005, documents show.
In the three other cases, Buckwalter’s records show no evaluation
of the patients’ response to medications, no explanation for why patients were given maximum allowable doses and few records related to treatment outcomes or justification of increased controlled substance prescriptions, the medical board complaint said.
During an emergency meeting Thursday the medical board summarily suspended Buckwalter’s license to prescribe drugs such as Xanax, an anti-anxiety medication; hydrocodone, the narcotic in the brand name drugs Vicodin and Lortab; and oxycodone, the primary ingredient in OxyContin.
Buckwalter is charged with one count each of malpractice, failure to maintain adequate and complete medical records and writing prescriptions for controlled substances in an illegal manner. Ling said the investigation is ongoing and that a hearing will be scheduled in the future.
If Buckwalter is found guilty, discipline could include probation, a public reprimand, fines or the suspension or revocation of his license to practice medicine, according to state law.
“At least the effect of this order is that he cannot cause any more potential harm with his controlled substance prescribing,” Ling said.
Buckwalter was served with the decision Thursday morning. Bryce Buckwalter, the doctor’s brother who also serves as his attorney, told the Sun late Thursday in an e-mail: “I must demand that you not print any further articles, including the one set to run (today). If you decide to go ahead and print the article, our response is that we still believe that his treatment and care of all his patients was reasonable and appropriate given the symptoms that were presented. We believe that the suspension was improper and we will be seeking the assistance of the court in trying to have the suspension lifted.”
The Nevada State Pharmacy Board also suspended Buckwalter’s license to prescribe controlled substances as a result of the medical board’s action. A fax was sent Thursday to all pharmacies in Nevada notifying them not to fill any prescriptions by Buckwalter for controlled substances.
Buckwalter attended medical school at Ross University in the West Indies and in 1997 was licensed to practice pediatrics and family medicine in Nevada. Three former employees described him to the Sun as a kindhearted but incompetent doctor who continued prescribing drugs to patients even when he was informed they were drug addicts or drug dealers, or had overdosed from the medications. He thought he was helping people, they said, but he also must have been making money because, they said, he saw as many as 80 patients a day.
Family members of patients who died while under Buckwalter’s care said the medical board should have summarily suspended his license to practice — and that the medical board could have saved lives by taking action after a 2005 complaint.
In 2005, newlyweds Clint and Andrea Duncan died within days of their first anniversary after overdoses on narcotics and Xanax prescribed by Buckwalter. Andrea Duncan’s father, John DeBaun, filed a complaint with the medical board. The board said it found no evidence of wrongdoing by the doctor. Buckwalter has no record of being disciplined.
In 2007 Buckwalter said in a sworn deposition — given on behalf of Andrea Duncan in an unrelated lawsuit — that he did not examine her, did not order her records from other doctors and gave her large quantities of controlled substances because she asked for them. Experts say the deposition showed a stunning disregard for quality patient care.
DeBaun sent a letter to the medical board in May, urging investigators to reopen the case against Buckwalter based on his sworn deposition. Medical board officials declined, saying they had an open investigation.
Since the 2005 complaint, two cases have been reviewed by experts on behalf of the Sun. They said Buckwalter’s actions contributed to patient deaths.
Barbara Baile, 69, was prescribed heavy doses of narcotics by Buckwalter to treat her hip and back pain. Records show that a side effect of the drug, constipation, caused her bowels to rupture, poisoning her body. She died in April from sepsis. Her husband, Don Baile, told the Sun he sat in on every appointment with Buckwalter and though his wife complained of constipation the doctor offered no remedy other than over-the-counter options. Experts who reviewed the case said Buckwalter should have removed the blockage manually or prescribed a drug to treat the constipation.
The medical board has not even scratched the surface with its actions against Buckwalter, Don Baile said. Buckwalter seems friendly, Baile said, “but when it comes down to it, what really lurks beneath is a dangerous person.”
Staci Voyda’s mother thinks her daughter would still be alive if the medical board had taken action sooner. In an 11-day period in August, Buckwalter prescribed 310 oxycodone pills to Voyda, a drug addict whose drug of choice was OxyContin. Two weeks later, Voyda put a gun to her head and killed herself. Her family says Buckwalter fueled Voyda’s addiction, contributing to her death.
Rene Kulon, Voyda’s mother, said she was relieved Buckwalter can no longer prescribe the narcotic medicines, but hurt that her daughter was his “last victim.”
The suspension of Buckwalter’s license “could have happened before Staci even got a chance to walk into his office,” Kulon said. “It makes me angry they didn’t pursue this and get this doctor off the streets long ago.”
Dr. David Kloth, a Connecticut specialist and a past president of the American Society of Interventional Pain Physicians, is one of four doctors who reviewed Buckwalter’s patient records with the families’ permission on behalf of the Sun. He said there is “no question” the Andrea Duncan file showed that Buckwalter’s prescribing habits were “atypical and dangerous.”
“I don’t know why the medical board did not pursue it more rigorously at that juncture,” Kloth said.
Kloth said Thursday’s action by the medical board seems appropriate because all the cases he’s seen show an inability to prescribe controlled substances. Plus, he said, medical boards need to exercise caution to ensure they don’t act prematurely or without sufficient evidence.
Kloth predicted there will be more action by authorities soon.
“You have not heard the last of this from the state or the DEA,” Kloth said. “It would not be surprising if criminal charges are brought at some point.”
Marshall Allen can be reached at 259-2330 or at marshall.allen@lasvegassun.com.
In its investigation of Dr. Kevin Buckwalter, the Sun asked experts to review the medical records of four of his patients, with the patient’s or his family’s permission. In each case they concluded Buckwalter’s negligence had contributed to the patient’s death or overdose.
• Andrea Duncan was being prescribed more than 150 narcotic painkillers a month and as many as 300 Xanax pills at a time. At 2 mg each, the Xanax tablets were four to eight times a typical dose, experts said. She overdosed in August 2005 and died.
• Barbara Baile, 69, began seeing Buckwalter in April 2004 complaining of pain in her hips and back. Baile died in April, a victim of one of the side effects of narcotics — severe constipation, which ruptured her bowels and caused her death by sepsis. Her death should have been prevented, experts said.
• Buckwalter prescribed Michael Hammond, a Las Vegas business executive, more than 17,000 narcotic painkillers in
3 years, until June 2008 — even after Hammond had overdosed on the pills.
• Staci Voyda was an OxyContin addict who was 19 when she went to Buckwalter in February 2007 to get off drugs. Over an 11-day period this summer, Buckwalter prescribed her 310 pills of oxycodone, the primary ingredient in her drug of choice, OxyContin. Two weeks later, on Aug. 26, Voyda put a gun to her head and killed herself.
Source: Las Vegas Sun
