Monday, December 01, 2008

Board said Kerwin furnished excess pain pills; two patients OD'd

By KEN CARLSON
kcarlson@modbee.com

last updated: May 31, 2008 09:51:12 AM

Dr. David Kerwin of Modesto surrendered his medical license, effective Friday, to settle state Medical Board charges of unnecessary and excessive prescribing of narcotic pain medications to patients, including two who died from drug overdoses.

The longtime Modesto physician was facing Medical Board disciplinary action on charges of unprofessional conduct, gross negligence and repeated violation of laws for prescribing controlled substances for patients.

Kerwin had a right to contest the administrative action in a hearing, but elected to surrender his license, the Medical Board said in a news release Friday. He was disciplined for overprescribing drugs in 1982 and for a five-year probationary period was barred from prescribing strong pain medications for patients.

The Medical Board filed the recent administrative action in July on charges of prescribing excessive medications to seven patients from 2000 to 2006. Two of the patients died from overdoses of hydrocodone, including a 47-year-old man given more than three times the normal dose of the pain medication for his condition, the board accusation said.

Kerwin's attorney, Robert Zaro of Sacramento, said the physician decided to retire instead of contesting the administrative action. Kerwin is in his 70s and has held a California medical license since 1962.

"You have to keep in mind those are allegations only," Zaro said Friday. "And at his age, it is important to realize that going into litigation for years is not the best thing for him, his family or his health."

Kerwin announced to patients this month that he was closing his 110 Santa Barbara Ave. practice and suggested that patients make arrangements with other physicians or public health clinics. His office referred media inquiries to his attorney, who declined to discuss specific allegations against Kerwin.

The family members of some patients said Kerwin was known as "Dr. Feelgood" for his policies of prescribing pain pills to patients who asked for them.

"It's amazing that nothing was done all these years," said Susan Houston, sister of a patient who suffered a fatal overdose. She said her family named Kerwin in a Medical Board complaint after obtaining a list of her brother's pharmacy purchases.

She said her brother had problems with addiction and the doctor should have considered his prior struggles with alcohol.

"My brother started with 30 pills (of hydrocodone) and, in six months, he was getting close to 1,000 pills a month," she said.

900 pain pills in five weeks

According to the board accusation, Houston's brother went to Kerwin in July 2005 complaining of knee and hip pain. Kerwin increased his hydrocodone prescription and upped it again Dec. 5, 2005, when the patient complained of panic attacks.

Seven days later, her brother collapsed at home, his lungs filled with fluid. The father of two died Jan. 17, 2006, of acute hydrocodone toxicity. Over the five weeks before his death, Kerwin prescribed 900 hydrocodone tablets to the patient, the accusation said.

Sabrina Rice of Hughson said her husband started taking pain pills to deal with a grandparent's death and it turned into an addiction that almost destroyed their marriage. Kerwin routinely refilled the prescriptions even after she told the office he was hooked, she said.

"Everyone has to take responsibility for their actions, but when you are handing them out readily, you are pretty much a drug dealer," Rice said. "I don't think he even realized the magnitude of what all of us had to face because of his actions."

Doctor saw uninsured patients

Other people defended Kerwin, saying he accepted the uninsured and chronically ill patients whom other physicians rejected.

Ralph McKinnis, an accountant and former Modesto resident living in Madera, said Kerwin treated his wife for severe psoriasis and attention deficit disorder, closely monitoring her medications to prevent drug interactions.

"A lot of doctors in Modesto don't believe ADD continues into adulthood, but she is living proof," he said. "The government has been so restrictive of the medication it hurts people who need it. A lot of this medication is stuff you can't just quit."

Since news of Kerwin's legal problems broke last year, others have expressed concern that patients won't receive assistance in withdrawing from narcotic medications.

The Medical Board faulted the doctor for failing to inquire about patients' substance abuse histories, not maintaining treatment plans or objectives, having incomplete medication records, and failing to evaluate patients for medical problems.

Under the Health and Safety Code, doctors may prescribe narcotic pain relievers or sedatives when required to treat disease, injury or illness. Physicians are supposed to screen for patients who are looking for drugs to feel good.

Bee staff writer Ken Carlson can be reached at kcarlson@modbee.com or 578-2321.

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