DOCTOR'S LICENSE SUSPENDED

Board Details Cases Of Those At S. Dallas Clinic Who Died Of Overdoses

The Texas State Board of Medical Examiners took emergency action Friday to
temporarily suspend the medical license of Dr. Daniel Maynard, whose South
Dallas clinic has been linked by investigators to 11 deaths.

"The [doctor's] continuation in the practice of medicine would constitute a
continuing threat to the public welfare," the board wrote in a temporary
suspension order.

The doctor's attorney, Jim Rolfe, could not be reached for comment despite
repeated tries Friday. He insisted in a previous interview that Dr. Maynard
had done nothing wrong and had caused no patients' deaths.

The suspension order details the cases of a handful of Dr. Maynard's
patients who died of drug overdoses. It does not identify the patients, and
a board official declined to provide details, citing confidentiality laws.

But two of the deaths cited in the order do not appear to be among the 11
previously disclosed by law officers. The circumstances and dates of death
of the two patients do not match those described by law officers who raided
Dr. Maynard's office, home and banks last week.

That would bring to 13 the number of deaths that authorities are
attributing in court documents to the doctor's prescription practices.

In one instance cited in the order, a patient who was prescribed various
painkillers and sedatives also started receiving 30 methadone tablets ­
despite the fact that no medical tests supported the addition of the drug.

The patient "was first prescribed 30 methadone tablets monthly; however, by
December of 2002, ... [Dr. Maynard] was providing 200 tablets of methadone
monthly" to the patient, who died in April of an apparent drug overdose,
the document said.

Maynard not invited

The suspension went into effect shortly before noon Friday. The board faxed
its decision to Dr. Maynard, who was not invited to the disciplinary
panel's emergency meeting in Austin. The suspension is in effect at least
until the board conducts a July 7 hearing on the matter, during which Dr.
Maynard may present evidence.

The suspension came 10 days after the raid on properties of Dr. Maynard,
57, a doctor of osteopathy who has been a general practitioner in Texas for
three decades. The doctor's clinic had remained open until Friday, although
authorities had frozen his Medicaid and Medicare reimbursements.

In the search warrant affidavit, a Dallas police investigator accused Dr.
Maynard of prescribing narcotics without a valid medical purpose and
defrauding the Medicare and Medicaid systems by charging for medical
services that were never performed.

Dallas County District Attorney Bill Hill praised the board's action
Friday, saying his office had been asked to provide the search warrant
affidavit for the panel's review. He said the board's findings would
bolster the ongoing criminal investigation.

"It will help us in the sense that we have reliable medical authority to
corroborate our claims that Dr. Maynard was doing what we alleged in the
affidavit," he said.

He said investigators had been busy combing through records seized during
last week's raid.

"At some point in time, a grand jury will be convened to review these
matters," Mr. Hill said.

New bill allowed action

In a coincidental twist, on the same day that investigators raided Dr.
Maynard's clinic on Martin Luther King Jr. Boulevard, Texas Gov. Rick Perry
signed the bill that gave the medical board the authority to take emergency
action against him. The procedure was used for the first time against Dr.
Maynard.

The suspension order alleged that Dr. Maynard has "exhibited a pattern of
conduct involving improper nontherapeutic and medically unnecessary
prescribing of narcotics, controlled substances and dangerous drugs to
patients."

"This conduct appears to have resulted in patient harm and is related to
their deaths from apparent overdoses," the order said.

The board also wrote that Dr. Maynard kept inadequate records as required
to support the long-term prescribing of controlled substances and dangerous
drugs.

"There is a complete lack of objective medical evidence to support the
prescribing activities" of Dr. Maynard, the order said.

Dr. Maynard's clinic was locked and dark Friday afternoon, a vast
difference from the days when patients crowded into his office.

Some patients continued to staunchly defend the doctor, saying they
believed he would be vindicated.

"He takes the time with his patients,' " said Eddie Harrell. "He is a
wonderful man."

Mr. Harrell said he visited Dr. Maynard once a month for treatment of
chronic back pain, asthma, an ulcer and bad nerves.

"He gave me what my body needed," said Mr. Harrell, adding that he did not
believe that the doctor ever prescribed him too much medicine.

Mr. Harrell said the closing of Dr. Maynard's clinic would create a
hardship for those in the neighborhood who lack the transportation to
easily see another doctor.

Officials with the State Board of Medical Examiners and the Texas State
Board of Pharmacy disagreed Friday about how patients with existing
prescriptions from Dr. Maynard should proceed.

"Any prescriptions written while he still had a license are still valid,"
said Jane McFarland, special projects manager for the medical board. "Any
dated tomorrow wouldn't be valid."

Can't prescribe drugs

She said that if the doctor wrote new prescriptions during his suspension,
he could face criminal charges of practicing without a medical license. The
pharmacy board, however, said pharmacists should not fill prescriptions by
a doctor whose license has been suspended.

"If a doctor's license is invalid, the prescriptions are invalid while the
license is suspended," said Carol Fisher, director of enforcement.

However, she said the board recognizes emergency situations.

"We are concerned if it's a maintenance kind of medication, like heart
medication or something like that," she said. "We don't want to leave the
patient in the lurch, so the law does allow an emergency kind of dispensing."

She said the pharmacy board does not notify pharmacists when a doctor's
license has been suspended or revoked.

Professionals in the medical community said the allegations against Dr.
Maynard should not be used to mar the reputations of other practitioners.

"There's probably millions of people for whom chronic pain is destroying
their lives and limiting their functionality. And on the opposite side of
the scale, there's precious little inappropriate prescribing," said Dr.
Barry Cole, director of education at the American Academy of Pain
Management in Sonora, Calif.

He said that if Dr. Maynard saw as many as 150 to 200 patients a day as
authorities allege ­ he acted unethically.

"Unless this guy is hyped up on more pots of coffee than anybody I've ever
met, then how do you treat that many people that fast?" Dr. Cole said.