Serious medical inquiry

Wednesday, Oct. 22, 2008 | 2:07 a.m.

A family doctor who wrote prescriptions that could be linked to three deaths is still seeing patients in his Henderson office, despite being under investigation by state authorities.

His medical license has not been suspended, nor has his practice been restricted, even though several complaints against him have led to an investigation by the Nevada State Medical Examiners Board.

We are not alone in questioning why the board is delaying action against Dr. Kevin Buckwalter, whose prescribing methods have been documented by Las Vegas Sun reporter Marshall Allen.

As part of his reporting, Allen consulted experts in treating pain. They all reviewed medical records made available either by Buckwalter’s former patients or by the families of his former patients.

One of the experts, Dr. Andrea Trescot, a nationally known pain management specialist in Florida, told Allen for a story printed Tuesday, “He (Buckwalter) needs to have an emergency revocation of his license.”

Also interviewed for Tuesday’s story was Nevada Assemblywoman Sheila Leslie, D-Reno, chairwoman of the Legislative Health Care Committee. She said the situation with Buckwalter reveals major flaws in Nevada’s system of overseeing doctors.

The Sun’s reporting on Buckwalter began last month when Allen disclosed that the doctor had prescribed more than 20,000 pills to a man who had sought treatment for pain stemming from a neck injury. The pills, prescribed from January 2005 to June 2008, led the man to enter an addiction recovery program, which was successful.

Allen’s story on this incident followed a series of stories he had written this summer documenting Nevada’s population as “among the most narcotic-addled in the United States.”

Last week Allen followed up with a story based largely on the medical records of three former Buckwalter patients, including Andrea Duncan. The 26-year-old died in 2005 after overdosing on drugs prescribed by Buckwalter. Records showed she had been prescribed more than 150 painkillers a month and up to 300 extra-strength Xanax pills at a time.

The woman’s parents had filed a complaint with the medical board against Buckwalter, but the board ruled there was no evidence of wrongdoing.

But the four pain experts consulting for the Sun, including Dr. David Kloth, a Connecticut specialist, agreed it was stunning that the board did not discipline Buckwalter.

Allen also wrote about 69-year-old Barbara Baile and 20-year-old Staci Voyda.

Baile began seeing Buckwalter in 2004. She died in April of this year from complications of a side effect of a drug she had been prescribed.

Voyda went to see Buckwalter last year in an effort to kick an addiction to OxyContin, a powerful painkiller. Over 11 days this summer, he increased her medications, prescribing 310 pills of oxycodone, the active ingredient in OxyContin. On Aug. 26, Voyda killed herself.

The medical experts working with the Sun said the care provided by Buckwalter to these three people, as shown by their medical records, was so poor it may have constituted medical malpractice.

Former Buckwalter employees have been interviewed by Allen. One said that about half of Buckwalter’s 80 patients a day — more than two times the daily patient load carried by most family doctors — were coming in only for prescription refills. Others said that Buckwalter did not ask for X-rays or body scans to document the pain of new patients, and that many patients complained he never examined them.

A Las Vegas pain specialist consulting with the Sun said it seems clear that Buckwalter — who has failed to acknowledge the Sun’s requests for comment — was prescribing whatever pain medicines his patients wanted. “The lack of diagnoses, lack of records ... and lack of counseling are all problems,” the doctor said.

The medical board has received complaints about Buckwalter — many of them filed after the Sun’s first story last month — and is investigating the doctor. Louis Ling, the board’s attorney, said the board must proceed cautiously in such cases.

“The medical board can take away their (medical) licenses, ruin their ability to make a living,” Ling told Allen. “If that is appropriate, we want to make sure it is done in a legally supportive way.”

Our view is that in cases such as Buckwalter’s, it would be better if the board erred on the side of the public. Given the complaints against the doctor, and the documentation disclosed in Allen’s stories, it is hard to imagine anyone questioning a suspension of his license or at least an order restricting his privilege to write prescriptions.