Pubdate: Wed, 05 Feb 2003 Source: Sun News (Myrtle Beach, SC) Copyright: 2003 Sun Publishing Co. Contact: http://www.myrtlebeachonline.com/mld/sunnews/ Details: http://www.mapinc.org/media/987 Note: apparent 150 word limit on LTEs Author: Kenneth A. Gailliard EXPERT: CLINIC DIDN'T FOLLOW RULES FLORENCE - Medical records from a defunct Myrtle Beach pain management clinic show its doctors, including three on trial for illegally distributing narcotics, failed to comply with state guidelines, said Art Jordan, an expert in the field. A pain management specialist and neurologist from Myrtle Beach, Jordan said patient examinations at Comprehensive Care and Pain Management Center were too brief, and some doctors signed blank prescriptions and met with groups of patients before issuing prescriptions, based on client files he reviewed. "It's illegal to sign blank prescriptions," Jordan said. Those actions were outside the normal course of legitimate medical practice, said Jordan, who reviews physician files for the S.C. Board of Medical Examiners disciplinary commission. According to the board's adopted pain management guidelines, doctors should: Document a patient's medical history, including examinations. Have written treatment plans and objectives to help determine treatment success. Discuss risks and benefits of controlled substances with patients. Periodically review the treatment courses. Keep adequate records. Former Myrtle Beach pain center doctors Michael Jackson, Ricardo Alerre and Deborah Bordeaux face charges listed in a 93-count federal indictment, including conspiracy to distribute controlled substances, including OxyContin, and conspiracy to launder money. During testimony Tuesday, Jordan said medical records for a patient Jackson saw in June 1998 indicated the patient received a prescription for Lorcet with no explanation for why the drug was prescribed. The record also showed the patient's medication was switched to OxyContin at the patient's request without documentation to explain the change. Court ended Tuesday before Jackson's lawyer could cross-examine Jordan on his testimony. Jordan said records for another patient, who had been seen by Jackson and Bordeaux at different times, didn't include follow-up information on how much narcotics the Lancaster man had taken. "The overall amount of history was deficient," Jordan said when questioned by Mary Bayluss, a lawyer for Bordeaux. "It's important to have as much history as you can." He also said records indicated Alerre once prescribed narcotics to a patient after the center received information the man was selling the drugs he received. Alerre's lawyer, William Nettles, said Alerre wrote a prescription because the man complained of pain. Also Tuesday, Drug Enforcement Administration investigator Adam Robeson testified that Jackson and Bordeaux, during an interview in 2000, described their concerns about the practices at Comprehensive Care and Pain Management Center. The two doctors, and others by then, had left to join another pain center in Myrtle Beach. David Vandergriff, who started the new clinic, "called us because they wanted to tell us what they did wrong at the clinic," Robeson said. Vandergriff was among three employees and five doctors at Comprehensive Care who pleaded guilty to various charges including illegally writing prescriptions for narcotics outside the normal course of medical practice between 1997 and 2001. Testimony so far in the trial has revealed that doctors at the clinic spent nearly five years writing narcotic prescriptions and ordering a variety of medical tests under the guise of a legitimate medical practice. DEA agents said they seized the records or more than 3,000 of the clinic's patients. Witnesses have testified that about half the patients were in legitimate pain, but the remainder were about 25 percent drug abusers and 25 percent drug dealers. Defense witnesses are expected to begin testimony when the trial resumes at 10 a.m. today.