Pubdate: Wed, 18 Jun 2003
Source: State, The (SC)
Copyright: 2003 The State
Contact:  http://www.thestate.com/
Details: http://www.mapinc.org/media/426
Author: Lisa Falkenberg

TEXAS DOCTOR UNDER INVESTIGATION IN 11 PATIENT DEATHS

The Associated Press

Dallas Dr. Daniel Maynard took no appointments. Instead, hundreds of 
patients would wait for hours in the parking lot in a line that began 
forming the night before.

"When you've got 300 people ahead of you, you know a production line is 
what he's doing," said former patient Walter Shearin, 53, who would wait 
eight to 10 hours to see Maynard and get his prescription for narcotics 
renewed. "It's a red flag."

Maynard's practice was a red flag to state and federal authorities, too. 
They raided his clinic, home and bank last week and seized thousands of 
documents and computer equipment in an investigation into the deaths of 11 
patients, several of whom died of drug overdoses or toxic combinations of 
drugs.

Investigators alleged in court papers that Maynard prescribed narcotics 
without a valid medical purpose.

No charges have been filed. But the 57-year-old doctor could face 
manslaughter or criminal negligent homicide charges, investigators said.

The investigation involves far more deaths than similar cases brought 
recently against doctors in Florida, Georgia and New Mexico, officials said.

The doctor still holds his medical license. But the district attorney's 
office has asked the federal Drug Enforcement Agency to revoke his license 
to prescribe narcotics. And the state canceled Medicaid reimbursement 
payments to the clinic.

The investigation has come as a relief to relatives of patients who died 
under Maynard's care. But the news was met with shock and frustration by 
lines of patients who took turns knocking on the locked door of the South 
Dallas clinic last week, waiting to be escorted in.

The doctor has not spoken publicly about the investigation. But his 
attorney, Jim Rolfe, said Maynard is "completely innocent."

"He did not prescribe anything to anyone that was not medically necessary, 
medically sound or medically OK to do so," Rolfe said, adding that the 
number of deaths -- 11 people, ages 29 to 62, over the past three years -- 
is "really not abnormal" considering the number of patients Maynard has.

Records show that in 2002, Maynard wrote more prescriptions for the 
sedative diazepam (also known by the brand name Valium) than any other 
doctor in Texas. And he wrote the second-most prescriptions for Tylenol 
with codeine. In all, he wrote 54,748 prescriptions last year, according to 
the records.

If Maynard worked an average 270 days a year, eight hours a day, that would 
work out to about 200 prescriptions per day.

"When we say 25 per hour, there's no way you could see the patient and 
write the prescriptions, much less document the whole situation," said Dale 
Austin, chief operating officer for the Federation of State Medical Boards.

Sandra Blackburn, a 47-year-old teacher, lost her two older brothers after 
years of pleading with them to stop seeing Maynard.

"I personally believe he's a drug dealer," she said. "He's a legal drug 
dealer. That's the sad thing."

Her brother Cecil Armitage, 62, died in March, surrounded by dozens of 
prescription bottles. Court records show Maynard had written him 23 
prescriptions for such drugs as the pain reliever and cough suppressant 
hydrocodone, Viagra, diazepam and cough syrup with codeine.

Blackburn's other brother, 52-year-old Harold Armitage, who suffered from 
high blood pressure, hepatitis C and kidney failure, was killed in a 
traffic accident after going to Maynard for pain medication. He had been 
prescribed such drugs as diazepam, hydrocodone, the muscle relaxant 
carisoprodol and Viagra, according to court records.

Patients waiting outside Maynard's clinic defended him as a kindhearted 
doctor who hands out cash to hungry people so they can buy fried chicken 
down the street and has become an institution in a part of town where 
haggard men ask strangers for bus fare and sirens wail incessantly.

"There's a lot of pain in this neighborhood and this is his specialty, 
treating pain," said patient Lawrence Stephenson, 58. He said he takes a 
narcotic for back pain.

Rebecca Martinez said Maynard is "the one who keeps my mom and dad alive."

District Attorney Bill Hill said support from patients is to be expected: 
"That's where they're getting their dope."

The district attorney and five other agencies, including the FBI and the 
DEA, began investigating Maynard after complaints by family members of 
patients who died from drug overdoses. Hill said it could take months to go 
through the seized evidence to determine whether Maynard, a doctor of 
osteopathy and a Texas general practitioner since 1973, will face charges.

Meanwhile, Rolfe said the doctor is still seeing patients -- 64 last 
Thursday alone.

"He's been in the community of South Dallas for 24 years," Rolfe said. 
"He's going to continue to practice as long as he possibly can."
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MAP posted-by: Larry Stevens