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Medical Board Rejects Deal for Doctor Accused of Malpractice

Posted on Nov 07, 2009

By Cy Ryan
Las Vegas Sun
Saturday, Nov. 7, 2009, 2 a.m.

The Nevada Board of Medical Examiners rejected Friday a proposed settlement with a Henderson physician linked by authorities to the deaths of eight patients after prescribing them narcotic painkillers.

The proposed agreement with Dr. Kevin Buckwalter called for him to plead guilty to three counts of malpractice, pay a $4,000 fine and allow the board to revoke his license to practice. The revocation would have been stayed if Buckwalter granted the board "unfettered access" to his medical records.

After 18 months Buckwalter could have applied to end the revocation of his license.

It was unclear why the medical board rejected the settlement, which was negotiated by the medical board's counsel, Edward Cousineau, and Buckwalter's brother, attorney Bryce Buckwalter.

Board member Dr. Michael Fischer, who made the motion to reject the settlement, refused to say whether the panel viewed it as too lenient or too strict. Board officials said members could not comment on the case because it hasn't been resolved.

But one medical official familiar with the workings of the board said the panel was acting cautiously because of recent media scrutiny of its actions and motives. The board doesn't want to "be perceived as letting him off too easy," said the official who asked not to be identified.

The official said board members want the matter resolved during a full hearing, where evidence is presented publicly, instead of signing off on a settlement negotiated behind closed doors.

Douglas Cooper, interim executive director of the medical board, confirmed the Buckwalter case will be resolved in a disciplinary trial before the board.

In November 2008, Buckwalter was stripped by the medical board and the Drug Enforcement Administration of his license to prescribe controlled substances after a Sun investigation linked his practice to multiple patient deaths. The oversight agencies linked Buckwalter to eight deaths.

Buckwalter, who has stopped practicing medicine, faces a number of lawsuits accusing him of violating medical standards when he prescribed large doses of narcotic painkillers that contributed to patients' deaths.

The state's allegations against Buckwalter focus on four cases in which he is accused of writing excessive prescriptions without keeping adequate records.

During Friday's medical board meeting, Fischer asked about the other Buckwalter cases reported by the Sun. But Cousineau, the board's counsel, said the panel could discuss only the four cases in the state's complaint.

In one, the complaint accuses Buckwalter of prescribing excessive amounts of the pain medicines OxyContin and Kadian, which contributed to the death of the patient.

In another, the complaint says Buckwalter wrote 49 prescriptions for the anti-anxiety drug Alprazolam but provided no record or justification why. Buckwalter started the patient at the maximum dosage, the complaint noted.

Buckwalter also wrote 61 prescriptions of Alprazolam for a patient between June 2006 and April 2008 without documenting the patient's response to the medication and the reason for increasing doses, according to the complaint.

The fourth case found that Buckwalter wrote 71 prescriptions for a controlled substance without documenting "the reasons for medication changes relating to narcotics, benzodiazepines and muscle relaxer."

The state investigation also found inadequate record keeping.

Dr. Jerry Calvanese, a medical reviewer for the board, examined the records of numerous Buckwalter patients. In an affidavit, he said: "A vast majority of the records include essentially no physical exam. Even when there is documentation in the records of a physical exam, the documentation is mostly illegible ... In addition, my review has created concerns in my mind that Dr. Buckwalter has administered inappropriate narcotics shots in the office setting and not taken proper steps to ensure patient safety thereto."

Bryce Buckwalter told the board that his brother is a "good doctor who loves helping people" and is eager to return to practicing medicine. Since his suspension, Kevin Buckwalter has received 174 hours of medical education, 40 percent of it in pain management, he said.

Kevin Buckwalter recognizes the issues with his medical practice, his brother said.

"It is something we have dealt with," he said. "It comes down to a chart problem."

The original article can be read in its entirety at http://www.lasvegassun.com/news/2009/nov/07/medical-board-rejects-deal-doctor-accused-malpract/.

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